Gay Community Periodic Survey SYDNEY, February 2011

Transcription

1 Gay Community Periodic Survey SYDNEY, February 0 Peter Hull Martin Holt Limin Mao Shih-Chi Kao Garrett Prestage Iryna Zablotska Kathy Triffitt Barry Edwards John de Wit National Centre in HIV Social Research ACON The Kirby Institute Positive Life NSW New South Wales Department of Health

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3 Gay Community Periodic Survey SYDNEY, February 0 Peter Hull Martin Holt Limin Mao Shih-Chi Kao Garrett Prestage Iryna Zablotska Kathy Triffitt Barry Edwards 5 John de Wit National Centre in HIV Social Research ACON The Kirby Institute Positive Life NSW 5 New South Wales Department of Health National Centre in HIV Social Research Faculty of Arts and Social Sciences The University of New South Wales

4 National Centre in HIV Social Research Level, Robert Webster Building University of New South Wales Sydney NSW 05 Australia Telephone: Fax: Website: National Centre in HIV Social Research 0 ISBN Cover photograph Stockbyte, reproduced under licence Design and layout by Judi Rainbow The National Centre in HIV Social Research is partially funded by the Australian Department of Health and Ageing and is affiliated with the Faculty of Arts and Social Sciences at the University of New South Wales. Suggested citation: Hull, P., Holt., M., Mao, L., Kao, S., Prestage, G., Zablotska, I., Triffitt, K., Edwards, B., & de Wit, J. (0). Gay Community Periodic Survey: Sydney February 0. Sydney: National Centre in HIV Social Research, The University of New South Wales. Available at

5 Contents Acknowledgments List of tables Glossary ii iii v Executive summary Demographic profile HIV status and testing Sexual partnerships and practices Sexual health Drug use Knowledge and use of PEP and PrEP Findings Reporting Tables Appendix A Gay Community Periodic Survey: Sydney, February 0 i

6 Acknowledgments We acknowledge the following individuals and organisations for contributing to the success of this project: NSW Health who funded the project ACON for ongoing support of the study and assistance in data collection Survey coordinator Chi Kao Recruiters who successfully recruited participants at venues and events Survey participants The,9 men who contributed their time to ensure that the study was fully inclusive of their particular circumstances Venues The management and staff of the various gay community venues, gyms and clinics who gave permission for the survey to be administered on their premises National Centre in HIV Social Research Judi Rainbow ii Gay Community Periodic Survey: Sydney, February 0

7 List of tables Table : Recruitment venue 5 Table : Age 5 Table : HIV testing 5 Table : HIV test results 6 Table 5: Likelihood of testing for HIV among non-hiv-positive men if rapid HIV testing were available, by location 6 Table 6: Use of combination antiretroviral treatment among HIV-positive men 6 Table 7: HIV viral load and combination antiretroviral treatment (ART) use among HIV-positive men 6 Table 8: Sexual relationships with men in the six months prior to the survey 7 Table 9: Agreements with regular male partners about sex within the relationship 7 Table 0: Agreements with regular male partners about sex outside the relationship 8 Table : Match of HIV status between regular partners 8 Table : Anal intercourse and condom use with regular partners 9 Table : Unprotected anal intercourse with regular partners, by match of HIV status 9 Table : HIV-negative men who engaged in UAIR and always used riskreduction strategies with partners who were not concordant 9 Table 5: Anal intercourse and condom use with casual partners 0 Table 6: Any unprotected anal intercourse with casual partners, by HIV status of participants 0 Table 7: Disclosure of HIV status to or from casual partners, by HIV status of participants 0 Table 8: Consistent disclosure of HIV status to casual partners with whom men engaged in unprotected anal intercourse, by HIV status of participants Table 9: Positioning in unprotected anal intercourse with casual male partners,by HIV status of participants Table 0: Men who engaged in UAIC in the last six months who always used risk-reduction strategies, by HIV status of participants Table : Where men met their male sex partners in the six months prior to the survey Table : Place attended for last syphilis test Table : Knowledge about syphilis Table : STI testing among HIV-positive men Gay Community Periodic Survey: Sydney, February 0 iii

8 Table 5: STI testing among HIV-negative men Table 6: If participants were diagnosed with an STI, how many of their sex partners did they inform? Table 7: Recreational drug use among all men in the six months prior to the survey 5 Table 8: Recreational drug use among HIV-positive men in the six months prior to the survey 6 Table 9: Recreational drug use among HIV-negative men in the six months prior to the survey 6 Table 0: Injecting drug use in the six months prior to the survey, by HIV status of participants 7 Table : Party drug use and group sex in the six months prior to the survey 7 Table : Knowledge that post-exposure prophylaxis is available 7 iv Gay Community Periodic Survey: Sydney, February 0

9 Glossary ART antiretroviral treatment HIV human immunodeficiency virus HIV-seroconcordant relationship a relationship in which both partners are of the same HIV status, either HIV-positive or HIV-negative HIV-serodiscordant relationship a relationship in which both partners are known (as a result of testing) to be of different HIV status, e.g. HIV-positive and HIVnegative HIV-serononconcordant relationship a relationship in which the HIV status of at least one partner in the relationship is not known, e.g. HIV-positive and untested, HIV-negative and untested, or both untested HIV status a person s antibody status established by HIV testing, e.g. HIV-negative, HIV-positive, or unknown (untested) PEP post-exposure prophylaxis PrEP pre-exposure prophylaxis STI sexually transmissible infection UAIC unprotected anal intercourse with casual partners UAIR unprotected anal intercourse with regular partners Gay Community Periodic Survey: Sydney, February 0 v

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11 Executive summary The Sydney Gay Community Periodic Survey is a cross-sectional survey of gay and homosexually active men recruited at a range of gay community sites in Sydney. From its start in 996, the project has been funded by NSW Health and supported by ACON and Positive Life NSW. The major aim of the survey has been to provide data on sexual, drug use and testing practices related to the transmission of HIV and other sexually transmissible infections (STIs) among men involved in the local gay community. The data presented in this report are from the period 007 to 0. In February 0, 9 men were recruited at 0 data collection sites which included gay social venues (bars and gyms), sex-on-premises venues, sexual health clinics and Fair Day (part of the Sydney Gay and Lesbian Mardi Gras). The response rate was 7.%. In the February 0 round there was a significant increase in men recruited from social venues and sexual health clinics, and a corresponding decrease in men recruited from Fair Day. These changes should be borne in mind when interpreting the results. Demographic profile As in previous surveys, the men in the sample were primarily of Anglo-Australian background, lived in the metropolitan Sydney area, were well educated and in fulltime employment. Since 007, there have been slight though significant increases in the proportions of men aged 5 9 years or over 50 years and a corresponding decrease in the proportion of men in their thirties. Over time, there has been a steady increase in the ethnic diversity of the sample. Since 007, the proportions of men of European and non-european backgrounds have increased significantly while the proportion of Anglo-Australian men has declined significantly. HIV status and testing The overwhelming majority of men in the sample reported having ever been tested for HIV (9.0%). Of the whole sample, most men reported that they were HIVnegative (79.7%) with smaller proportions reporting that they were HIV-positive (.5%) or did not know their HIV status (8.9%). In 0, a question was added asking men whether they would be more or less likely to get tested for HIV if rapid HIV testing were available in different locations. Just under half indicated they would be more likely to get tested for HIV if it was available at a clinic/gp (7.%) or at home (5.9%), and over a third said they would be more likely to get tested if rapid testing was available at a community organisation (6.8%). Between 007 and 0, there has been a significant upward trend in the proportion of HIV-positive men who reported being on treatment. In 0, 80.6% of HIVpositive men said they were receiving combination treatment for HIV. In 0, nearly all the HIV-positive men on treatment (96.%) reported an undetectable viral load, compared with 6.6% of HIV-positive men not on treatment. Sexual partnerships and practices In 0, almost a third of men reported being in a monogamous relationship with a regular male partner (0.8%), a similar proportion reported having both regular and casual partners (9.8%), and a quarter had casual partners only (.6%). Fifteen Gay Community Periodic Survey: Sydney, February 0

12 Executive summary percent of men surveyed reported no sexual relationships with men in the six months prior to the survey. These proportions have been relatively stable since 007. Among men with regular partners in 0, 6.% reported an agreement with their regular partner about sex within the relationship and a smaller proportion (57.9%) reported an agreement about sex outside the relationship. In 0, the most commonly held agreements about sex within a relationship specified that anal intercourse could occur without a condom (.%) or that condoms must always be used for anal intercourse (6.0%). The most commonly held agreements about sex outside a relationship specified that no sex with casual partners was allowed (6.%) or that condoms must always be used for anal intercourse with casual partners (6.%). Over the reporting period the proportions of men who have relationship agreements about sex within or outside the relationship have increased. In 0, among HIV-positive men with regular partners, 7.8% reported that they were in a seroconcordant relationship, 5.0% said they were in a serodiscordant relationship, and 7.% said they were in a serononconcordant relationship. Over the reporting period there have been no significant changes in this relationship profile. In 0, three-quarters of HIV-negative men with regular partners reported being in a seroconcordant relationship (7.%), with smaller proportions in serononconcordant (9.9%) and serodiscordant relationships (5.7%). Since 007, the proportion of HIVnegative men in seroconcordant relationships has significantly increased, while the proportion of men in serononconcordant relationships has declined. Half of the men with regular partners (9.%) reported some unprotected anal intercourse with their regular partner (UAIR), while over a quarter reported always using condoms for anal intercourse (7.9%). In 0, over one in five men with regular partners (.9%) reported having no anal intercourse with their regular partner. Between 00 and 0 there was a significant decline in the proportion of men reporting UAIR. Rates of UAIR typically vary according to the HIV status of regular partners. In 0, among HIV-positive men with regular partners, the rate of UAIR was similar for men with seroconcordant regular partners (.%) and men with partners who were not seroconcordant (6.%). Half of HIV-positive men in relationships (50.%) avoided UAIR. Among HIV-negative men with regular partners,.% reported seroconcordant UAIR, almost one in ten (9.%) reported UAIR that was not seroconcordant and nearly half (8.6%) avoided UAIR. Since 007, there has been a significant increase in the proportion of HIV-negative men who engage in seroconcordant UAIR, and a significant decrease in the proportion of HIV-negative men who report UAIR with partners who are not seroconcordant. Use of condoms for anal intercourse remains more common with casual partners than with regular partners. In 0, almost half of the men reported always using condoms for anal intercourse (6.9%), while a third (.%) reported any unprotected anal intercourse with casual partners (UAIC). Although the rate of UAIC was stable between 00 and 0, the trend over time shows a gradual increase. In 0, HIV-positive men with casual partners remained more likely to report any UAIC (56.%) than HIV-negative men with casual partners (9.8%). Since 007, the proportion of HIV-positive men who report UAIC has remained stable, while the proportion of HIV-negative men reporting UAIC has increased significantly (although it did not change significantly between 00 and 0). In 0, disclosure of HIV status before sex to any casual partners was more commonly reported by HIV-positive men (76.%) than by HIV-negative men (5.9%). Disclosure of HIV status to casual partners has increased significantly among HIVnegative men since 007. Among men who reported any UAIC, similar proportions of HIV-positive (6.9%) and HIV-negative (7.%) men reported having consistently disclosed their HIV status to all partners with whom they had UAIC. Over time, HIVnegative men who engage in UAIC have become significantly more likely to disclose their HIV status to partners with whom they have UAIC. Gay Community Periodic Survey: Sydney, February 0

13 Executive summary In 0, new questions were introduced to assess the use of non-condom-based risk reduction strategies among men who engage in UAIC. Over a third of HIV-positive men who reported engaging in UAIC (6.9%) said they only had UAIC when they knew their partners were seroconcordant (serosorting). The proportions of HIVpositive men who reported always using strategic positioning or withdrawal during UAIC were relatively small ( 5%). Among HIV-negative men who engaged in UAIC, a third (.5%) said they only had UAIC with casual partners who they knew were seroconcordant (serosorting), with smaller proportions (around one in ten) reporting consistent strategic positioning or withdrawal before ejaculation. In 0, almost four in every ten men (8.6%) said they had sex with men they met through the internet. Other commonly reported locations used to meet male sex partners were gay bars (0.%), gay saunas (.%) and overseas (.0%). In 0, almost a third of men (9.%) said they had used a mobile application like Grindr to meet sex partners. Sexual health As in previous surveys, in 0 a higher proportion of HIV-positive men (90.9%) reported having any sexual health test (including a blood test for syphilis) compared with HIV-negative men (7.%). Since 007, there have been significant increases in the proportions of HIV-positive and HIV-negative men reporting any STI test (not including blood tests). The proportion of HIV-positive men reporting any STI test (including blood tests) has increased significantly since 007. In 0, 79.5% of HIV-positive men and 60.% of HIV-negative men reported a blood test for syphilis. The majority of these men reported testing for syphilis at their regular GP or a sexual health centre. Almost three-quarters of all men were aware that syphilis can be symptomless (7.%) and that it is transmissible through oral sex (70.%). There was a small but significant decline in knowledge about syphilis between 00 and 0. Drug use Recreational drug use was common within the sample, with the most frequently used drugs in the six months prior to the survey being amyl/poppers (0.%), ecstasy (9.8%), marijuana (7.9%), Viagra (.%), cocaine (0.6%) and GHB (.%). Since 007, there have been significant decreases in the use of ecstasy, marijuana, crystal methamphetamine, amphetamine/speed and ketamine. Over time the proportion of men who say they haven t used any drugs has increased significantly (9.0% of all men in 0). Similarly, the proportion of men who say they have used drugs for sex has decreased significantly since 007. In general, HIV-positive men remain more likely to report drug use compared with HIV-negative men. HIV-positive men have a disproportionately high rate of drug injection (.% in 0) compared with HIV-negative men (.7%), and this rate has been consistently higher over time. Rates of injecting drug use have declined among HIV-negative men during the reporting period. Knowledge and use of PEP and PrEP In 0, over half the participants reported that they knew post-exposure prophylaxis (PEP) was available, a significant decline from 00. In 0, questions were added to assess the use of anti-hiv (antiretroviral) drugs for prevention of HIV before and after unprotected sex pre-exposure prophylaxis (PrEP) and PEP. Unlike PEP, PrEP is not currently available in Australia through the health system. Thirty-seven men (.%) said they had used anti-hiv drugs before unprotected sex as PrEP and 80 men (.8%) said they had used anti-hiv drugs as PEP. Gay Community Periodic Survey: Sydney, February 0

14 Findings Reporting Data are shown for the period Each table includes the statistical significance (p-value), if any, of the change between 00 and 0 and the trend over time (007 0). An alpha level of.05 was used for all statistical tests. In tables where there are mutually exclusive categories (shown on separate rows), the p-value of the chi-square test (if shown) indicates a statistically significant change within one or more of the categories between 00 and 0. A short commentary is given under some tables indicating in which category or categories a significant change has occurred. For statistically significant trends over time, the direction of the change (an increase or decrease) is indicated. Where there is no significant change, ns (non-significant) is shown. Please exercise caution in interpreting data where there are few reported cases (low numbers). Where there are low frequencies or data over time are not comparable, reporting of proportions may be misleading. In such cases, we have omitted percentages and did not perform statistical tests for changes over time; these cases are marked NA (not applicable). When data are missing or were not collected in a given year, this is indicated in the table by a dash ( ). Tables The findings of the survey are presented in tables to below. Gay Community Periodic Survey: Sydney, February 0

15 Findings Table : Recruitment venue Change from 00 test (p-value) test for trend (p-value) Fair Day, (60.),0 (58.6),88 (5.9),69 (60.),6 (5.8) p <.00 p <.00 Sexual health clinics 66 (.) 99 (9.0) 6 (.) 5 (5.6) 7 (0.) p <.00 p <.0 Sex-on-premises venues 5 (6.5) 0 (0.8) 09 (8.9) 99 (.0) (0.5) ns p <.00 Social venues 5 (.8) 8 (.7) 588 (5.) 69 (.) 069 (.5) p <.00 p <.00 Total, (00), (00),6 (00),79 (00),9 (00) Considerably more men were recruited in 0 than in previous years. Compared to 00, significantly greater proportions of men were recruited from sexual health clinics and social venues. Conversely, significantly fewer men were recruited at Fair Day. Over the period 007 0, there were significant upward trends in the proportions of men recruited from social venues and sex-on-premises venues. Conversely, there were downward trends in the proportions of men recruited at the Fair Day and sexual health clinics. Table : Age Change from 00 test (p-value) test for trend (p-value) Under 5 5 (0.7) 68 (.) 08 (.8) 8 (0.) 56 (.) ns ns (.) 0 (.8) (.0) 96 (.6) 5 (7.) p <.0 p < (5.) 705 (.) 75 (.6) 880 (.5) 97 (0.6) ns p < (7.8) 60 (8.8) 560 (5.0) 758 (8.0) 8 (6.5) ns ns 50 and over 80 (.) 8 (.9) 06 (.7) 9 (.5) 60 (.5) ns p <.0 Total,96 (00),86 (00),0 (00),707 (00),76 (00) There were few changes in the age profile of the sample between 00 and 0. However, since 007 there have been significant upward trends in the proportions of men in the 5 9 and over 50 age groups. Conversely, there has been a significant downward trend in the proportion of men in the 0 9 age group. Table : HIV testing Change from 00 test (p-value) test for trend (p-value) All men Ever tested for HIV,65 (9.),075 (9.), (9.0),50 (9.),860 (9.0) ns ns Total, (00), (00),6 (00),79 (00),075 (00) Non-HIV-positive men Tested for HIV in previous months,75 (7.6),7 (7.),9 (7.8),6 (66.7),790 (7.9) p <.00 p <.05 Total,868 (00),76 (00),86 (00),9 (00),90 (00) In 00 there was a significant increase in proportion of non-hiv-positive men who reported HIV testing in the months prior to being surveyed. However, this increase follows a significant decrease recorded in 00. Since 007 there has been a slight downward trend in the proportion of non-hiv-positive men reporting recent HIV testing. Gay Community Periodic Survey: Sydney, February 0 5

16 Findings Table : HIV test results Change from 00 test (p-value) test for trend (p-value) HIV-positive 90 (.) 0 (.5) 80 (.) 87 (0.6) 5 (.) p <.05 HIV-negative,778 (8.),75 (8.) 68 (79.),5 (85.9),8 (85.) ns p <.0 No results 9 (.) 8 (.) 6 (7.7) 6 (.6) 6 (.) p <.0 Total,60 (00),07 (00),5 (00),96 (00),85 (00) Since 007 there has been a slight, though significant, decline in the proportion of HIV-positive men in the sample and a significant increase in the proportion of HIV-negative men. Table 5: Likelihood of testing for HIV among non-hiv-positive men if rapid HIV testing were available, by location Home Clinic/GP Gay community organisation Less likely 95 (.9) 7 (5.) 5 (.) About the same 65 (.0) 995 (5.0) 9 (. More likely,05 (5.9),8 (7.),07 (6.8) Table 6: Use of combination antiretroviral treatment among HIV-positive men Change from 00 test (p-value) test for trend (p-value) On treatment 9 (66.8) 6 (7.5) (77.) 5 (77.6) 70 (80.6) ns p <.00 Total 86 (00) 9 (00) 75 (00) 77 (00) 5 (00) Since 007 there has been a significant increase in the proportion of HIV-positive men using combination antiretroviral treatment. Table 7: HIV viral load and combination antiretroviral treatment (ART) use among HIV-positive men Detectable viral load Change from 00 test (p-value) test for trend (p-value Using ART (.) (0.5) (0.5) 5 (7.0) 0 (.7) ns p <.00 Total 87 (00) 0 (00) 0 (00) (00) 70 (00) Not using ART 6 (69.7) 6 (80.) 6 (7.0) 5 (58.) 7 (7.) ns ns Total 89 (00) 76 (00) 6 (00) 60 (00) 6 (00) Of the HIV-positive men using ART, about % had a detectable viral load in 0. Since 007, there has been a significant decline in the proportion of HIV-positive men on treatment reporting a detectable viral load. Among HIV-positive men not on treatment, almost three-quarters reported a detectable viral load in 0. 6 Gay Community Periodic Survey: Sydney, February 0

17 Findings Table 8: Sexual relationships r with men in the six months prior to the survey Change from 00 test (p-value) test for trend (p-value) None 9 (5.) 09 (5.) 70 (6.8) 6 (.8) ns Casual only 50 (.5) 66 (.0) 5 (.) 70 (.6) ns Regular plus casual 65 (0.) 6 (.8) 659 (9.9) 897 (9.8) ns Regular only (monogamous) 675 (.) 608 (0.0) 6 (9.) 96 (0.8) ns Total,67 (00),07 (00),0 (00),009 (00) Reliable data not available for 00. Table 9: Agreements with regular male partners about sex within the relationship Change from 00 test (p-value) test for trend (p-value) No spoken agreement about anal intercourse/no sex 906 (5.9) 68 (.) 695 (0.9) 8 (7.7) p <.00 No anal intercourse permitted 69 (.) 7 (.7) 88 (5.) 69 (.) ns Anal intercourse permitted only with a condom 0 (8.0) 55 (.8) 99 (.5) 56 (6.0) p <.00 Anal intercourse permitted without a condom 0 (.0) 88 (.) 57 (0.) 76 (.) p <.00 Total,68 (00),55(00),699 (00) 6 (00) Reliable data not available for 00. Since 007, there has been a significant decline in the proportion of men without an agreement with their regular partner about sex within their relationship. During the same period, there has been a significant increase in the proportions of men whose agreements permit anal intercourse with and without condoms. Gay Community Periodic Survey: Sydney, February 0 7

18 Findings Table 0: Agreements with regular male partners about sex outside the relationship Change from 00 test (p-value) test for trend (p-value) No spoken agreement about casual sex 99 (59.0) 7 (6.5) 80 (7.) 90 (.) p <.00 No sexual contact with casual partners permitted 5 (8.7) 7 (.0) 9 (.) 56 (6.) p <.00 No anal intercourse with casual partners permitted 6 (.7) (.8) 6 (.8) 6 (.8) ns Anal intercourse with casual partners permitted only with a condom 9 (7.) 79 (.) 9 (.) 57 (6.) p <.00 Anal intercourse with casual partners permitted without a condom 7 (.) 6 (.) 7 (.8) 55 (.5) ns Total,68 (00),55 (00),699 (00),6 (00) Reliable data not available for 00. Since 007 there has been a significant downward trend in the proportion of men with regular partners who did not have a spoken agreement about sex outside their relationship. Conversely, there have been significant upward trends in the proportions of men with agreements that prohibit sexual contact with casual partners or that allow anal intercourse with condoms. Table : Match of HIV status between regular partners Change from 00 test (p-value) test for trend (p-value) HIV-positive participants Seroconcordant 77 (9.7) 68 (5.8) 67 (.) 69 (9.7) 79 (7.8) ns ns Serodiscordant 7 (8.) 79 (.6) 76 (9.0) 65 (7.) 9 (5.0) ns ns Serononconcordant (.) (.6) 5 (6.7) 0 (.0) 6 (7.) ns ns Total 9 (00) 90 (00) 95 (00) 7 (00) 09 (00) HIV-negative participants Seroconcordant 59 (7.) 75 (6.8) 79 (6.) 76 (5.5),0 (7.) p <.00 p <.00 Serodiscordant 6 (.9) 6 (5.) 6 (5.) (.9) 00 (5.7) p <.00 Serononconcordant 600 (7.8) 0 (.0) 78 (0.6) 676 (5.6) 8 (9.9) p <.00 p <.00 Total,55 (00),7 (00),5 (00),8 (00),75 (00) The proportions of HIV-positive men in seroconcordant, serodiscordant and serononconcordant relationships have been steady over the reporting period. Compared to HIV-positive men in relationships, HIV-negative men with regular partners are more likely to be in a seroconcordant relationship. The proportion of HIV-negative men in seroconcordant relationships increased significantly in 0, continuing an upward trend over time. The proportion of HIV-negative participants in serodiscordant relationships was significantly higher in 0 than in 00. However, this increase follows a significant decrease in 00. The proportion of HIV-negative participants in serononconcordant relationships declined significantly in 0, continuing a significant downward trend since Gay Community Periodic Survey: Sydney, February 0

19 Findings Table : Anal intercourse and condom use with regular partners Change from 00 test (p-value) test for trend (p-value) No anal intercourse 08 (8.) 98 (9.) 75 (6.) 8 (9.9) 9 (.9) p <.00 Always uses a condom 96 (9.5) 6 (8.) 50 (0.0) 56 (9.6) 60 (7.9) ns ns Sometimes does not use a condom 877 (5.) 80 (5.8) 9 (5.8), (60.),065 (9.) p <.00 Total,68 (00),55 (00),699 (00),8 (00),6 (00) The proportion of participants with regular partners who reported no anal intercourse increased significantly in 0. However this increase follows a significant decrease in 00. Conversely, there was a significant decrease in the proportion of men who did not always use condoms with their regular partner, this followed a significant increase in 00. Table : Unprotected anal intercourse with regular partners, by match of HIV status Change from 00 test (p-value) test for trend (p-value) HIV-positive men Seroconcordant-positive UAIR 58 (8.) 9 (5.) 50 (5.) 6 (5.) 9 (.) ns ns Not concordant UAIR 56 (7.5) 50 (5.8) 60 (0.) 7 (7.0) 55 (6.) ns ns No UAIR 90 (.) 95 (9.0) 88 (.) 66 (7.9) 05 (50.) ns ns Total 0 (00) 9 (00) 98 (00) 7 (00) 09 (00) HIV-negative men Seroconcordant-negative UAIR 76 (8.8) 56 (6.6) 97 (9.8) 5 (5.0) 70 (.) p <.00 p <.00 Not concordant UAIR 09 (.7) 07 (6.6) 87 (5.0) 9 (6.) 60 (9.) p <.00 p <.00 No UAIR 60 (7.5) 58 (6.8) 56 (5.) 577 (8.7) 85 (8.6) p <.00 Total,05 (00),7 (00),8 (00),90 (00),75 (00) Half of HIV-positive participants with regular partners reported no unprotected anal intercourse with their regular partners (UAIR) in 0. Among HIV-positive men reporting UAIR, similar proportions reported UAIR with either seroconcordant or serononconcordant regular partners. In 0, almost half of HIV-negative participants with regular partners reported no UAIR, a significant increase from 00. Of the HIV-negative men reporting UAIR, the majority were in seroconcordant relationships. From 00 to 0 there was a significant increase in the proportion of participants reporting seroconcordant UAIR, continuing a significant upward trend since 007. Since 007 there has been a corresponding decrease in serononconcordant UAIR reported by HIV-negative men. Table : HIV-negative men who engaged in UAIR and always used risk-reduction reduction strategies with partners who were not concordant Change from 00 test (p-value) test for trend (p-value) Took insertive position during UAIR 79 (5.6) 5 (6.) 65 (.8) (8.6) 5 (.5) ns ns Partner withdrew before ejaculation when participant was receptive 6 (0.7) 5 (5.) (8.) 8 (.) 6 (8.8) ns ns Total (not mutually exclusive) Gay Community Periodic Survey: Sydney, February 0 9

20 Findings Table 5: Anal intercourse and condom use with casual partners Change from 00 test (p-value) test for trend (p-value) No anal intercourse 85 (.) 88 (9.) 5 (6.0) 6 (5.5) 99 (0.0) p <.0 p <.0 Always uses a condom 76 (6.8) 765 (5.) 7 (7.) 850 (50.) 97 (6.9) ns Sometimes does not use a condom 6 (9.0) 6 (9.) 58 (6.9) 585 (.5) 660 (.) ns Total,59 (00),89 (00),578 (00),698 (00),996 (00) In 0, a third of men with casual partners reported any unprotected anal intercourse with those partners (UAIC). There was no significant change in this indicator between 00 and 0, but the trend over time appears to remain upwards. Since 007 there has been a downward trend in the proportion of men reporting no anal intercourse with casual partners. Table 6: Any unprotected u anal intercourse with casual partners, by HIV status of participants Change from 00 test (p-value) test for trend (p-value) HIV-positive men (56.5) 0 (5.8) 7 (6.) 7 (59.6) (56.) ns ns Total (00) (00) 08 (00) (00) 5 (00) HIV-negative men 88 (.5) 9 (.9) 6 (.) 9 (.) 6 (9.8) ns Total, (00),67 (00),9 (00),9 (00),55 (00) The rate of UAIC reported by HIV-positive men has been stable during the reporting period. In 009 there was a significant increase in the proportion of HIV-negative men who reported any UAIC which has been sustained over the last three years. Table 7: Disclosure of HIV status to or from casual partners, p by HIV status of participants Change from 00 test (p-value) test for trend (p-value) HIV-positive men Told casual partners 9 (69.6) 68 (75.) 60 (76.9) 6 (77.0) 9 (76.) ns ns Told by casual partners 5 (58.) 5 (65.0) 7 (6.) (67.) 65 (65.7) ns ns Total (not mutually exclusive) 08 5 HIV-negative men Told casual partners 5 (.) 557 (7.7) 555 (9.) 70 (5.) 80 (5.9) ns p <.00 Told by casual partners 555 (5.) 58 (7.0) 556 (9.) 70 (5.9) 87 (5.0) ns p <.00 Total (not mutually exclusive),,67,9,9,55 Rates of HIV disclosure to and from casual partners have remained stable among HIV-positive men during the reporting period. During the same period, there have been significant upward trends in the proportions of HIVnegative men reporting HIV disclosure to or from their casual partners. 0 Gay Community Periodic Survey: Sydney, February 0

21 Findings Table 8: Consistent disclosure d of HIV status to casual partners with whom men engaged in unprotected anal intercourse,, by HIV status of participants Change from 00 test (p-value) test for trend (p-value) HIV-positive men 7 (8.8) 9 (.5) 9 (8.6) 5 (5.) 5 (6.9) ns ns Total (00) 0 (00) 7 (00) 7 (00) (00) HIV-negative men 6 (.9) 67 (.0) 99 (7.) 0 (.8) 68 (6.) p <.00 p <.00 Total 88 (00) 9 (00) 6 (00) 9 (00) 6 (00) Among HIV-negative participants who reported UAIC, there was a significant increase in the proportion who reported disclosing their HIV status to all casual partners in 0. Table 9: Positioning in unprotected anal intercourse with casual male partners, by HIV status of participants Change from 00 test (p-value) test for trend (p-value) HIV-positive men Receptive-only UAIC 9 (5.7) 0 (6.7) (8.7) (.) (5.6) ns ns Total (00) 0 (00) 7 (00) 7 (00) (00) HIV-negative men Insertive-only UAIC 97 (.7) 99 (.0) 0 (.) 8 (5.) 6 (5.) ns ns Total 88 (00) 9 (00) 6 (00) 9 (00) 6 (00) Table 0: : Men who engaged in UAIC in the last six months who always used risk-reduction reduction strategies,, by HIV status of participants HIV-positive men 0 Ensured partners were seroconcordant before UAIC (serosorting) 5 (6.9) Took receptive position during UAIC when partners were not concordant 7 (5.0) Participant withdrew before ejaculation when he was insertive 6 (.) Partner withdrew before ejaculation when participant was receptive 6 (.) Total (not mutually exclusive) HIV-negative men Ensured partners were seroconcordant before UAIC (serosorting) 50 (.5) Took insertive position during UAIC when partners were not concordant 9 (0.6) Participant withdrew before ejaculation when he was insertive 8 (8.) Partner withdrew before ejaculation when participant was receptive 50 (0.8) Total (not mutually exclusive) 6 Gay Community Periodic Survey: Sydney, February 0

22 Findings Table : Where men met their male sex partners in the six months prior to the survey Change from 00 test (p-value) test for trend (p-value) Internet 87 (7.),08 (8.5) (8.6) ns ns Mobile app e.g. Grindr 70 (.9) Gay bar 857 (6.5) 97 (5.7) 968 (0.) p <.00 Gay sauna 85 (5.6) 98 (6.) 995 (.) p <.00 Dance party 58 (.9) 577 (.) 50 (5.8) p <.00 Other sex venues 80 (0.5) 70 (7.) 7 (.8) p <.05 p <.0 Beat 0 (7.) 5 (5.6) (.9) p <.00 Private sex parties 58 (.0) 5 (9.0) 0 (6.6) p <.00 p <.05 Gym 5 (0.) 65 (9.8) 97 (9.) ns ns Sex workers 77 (.8) 95 (.0) ns In other Australian cities 6 (.5) 587 (8.) p <.00 Elsewhere in Australia 7 (5.) 90 (.) p <.00 Overseas 5 (.9) 690 (5.) 67 (.0) p <.00 Total (not mutually exclusive),6,79,9 Table : Place attended for last syphilis test 00 0 Change from 00 test (p-value) HIV-positive men Regular GP 7 (6.0) 0 (65.7) Another GP 5 (.8) 5 (.5) Sexual health clinic (6.) 57 (7.0) HIV clinic 5 (8.7) 5 (5.) Never tested/don t know (0.) (0.6) Total 7 (00) 5 (00) HIV-negative men Regular GP 99 (5.9),5 (5.) Another GP 8 (.7) (5.5) Sexual health clinic 660 (6.5) 75 (6.6) HIV clinic 5 (.0) 56 (.7) Never tested/don t know 7 (0.9) (.0) Total,808 (00),055 (00) ns p <.00 Gay Community Periodic Survey: Sydney, February 0

23 Findings Table : Knowledge about syphilis 00 0 Change from 00 test (p-value) Aware that syphilis can have no physical symptoms,5 (79.),06 (7.) p <.00 Aware that syphilis can be transmitted through oral sex,0 (7.0),0 (70.) p <.00 Total (not mutually exclusive),79,9 In 0, the proportions of participants who were aware that syphilis can have no physical symptoms or can be transmitted through oral sex were significantly lower than in 00. Table : STI testing among HIV-positive men Change from 00 test (p-value) test for trend (p-value) Anal swab 5 (5.) 9 (9.) 5 (5.9) 75 (6.0) 0 (6.5) ns p <.05 Throat swab 60 (5.6) 65 (5.6) 58 (56.) 76 (6.) 0 (6.5) ns p <.05 Penile swab 0 (.0) (.0) 5 (.) (6.7) 55 (.0) ns ns Urine sample 77 (60.) 8 (60.6) 75 (6.5) 9 (66.9) 5 (7.6) ns p <.0 Blood test for syphilis (80.0) 0 (76.7) 80 (79.6) ns Blood test other than for HIV 6 (7.7) 7 (78.5) 0 (78.6) 96 (68.) 75 (78.) p <.0 ns Any STI test (not including blood tests) 95 (66.6) 05 (67.9) 97 (70.) 06 (7.8) 69 (76.) ns p <.0 Any STI test (including blood tests) 50 (85.) 60 (86.) 5 (90.0) 9 (86.8) 0 (90.9) ns p <.05 Total (not mutually exclusive) From 009, the item Blood test for syphilis was added to the question about sexual health testing in the last six months, and was subsequently included in the calculation for any STI test (including blood tests). The majority of HIV-positive participants reported having at least one STI test in 0. Since 007 there have been significant upward trends in the proportions of HIV-positive men reporting any STI test (including and not including blood tests). Gay Community Periodic Survey: Sydney, February 0

24 Findings Table 5: STI testing among HIV-negative men Change from 00 test (p-value) test for trend (p-value) Anal swab 78 (.6) 796 (5.9) 778 (6.) 95 (.),8 (8.) p <.0 p <.0 Throat swab 8 (6.9) 85 (9.) 80 (9.),0 (7.6),5 (50.9) p <.05 p <.05 Penile swab 65 (6.0) 669 (8.5) 66 (7.7) 789 (6.7) 9 (8.5) ns ns Urine sample 97 (5.),000 (57.6) 957 (56.7),0 (56.), (58.9) ns p <.05 Blood test for syphilis,00 (6.0),7 (59.),8 (60.7) ns Blood test other than for HIV,00 (55.9),0 (59.6) 96 (57.0),89 (55.),8 (5.9) ns p <.05 Any STI test (not including blood tests),07 (57.9),05 (60.),0 (60.5),78 (59.),57 (6.0) ns p <.0 Any STI test (including blood tests),5 (68.),0 (70.8),99 (7.0),5 (7.),7 (7.) ns ns Total (not mutually exclusive),79,76,689,5,5 From 009, the item Blood test for syphilis was added to the question about sexual health testing in the last six months, and was subsequently included in the calculation for any STI test (including blood tests). Between 00 and 0 there were significant increases in the proportions of HIV-negative participants reporting anal and throat swabs for STIs. Since 007 there has been a significant upward trend in the proportion of HIV-negative participants reporting any STI test (not including blood tests). Table 6: If participants were diagnosed with an STI, how many of their sex partners did they inform? 00 0 Change from 00 test (p-value) None 0 (.8) 67 (.5) A few 88 (.) 5 (.9) Some 9 (.) 9 (.9) All 86 (6.7) 6 (7.) Not been diagnosed/don t know,95 (7.8),75 (7.) Total,79 (00),9 (00) ns Gay Community Periodic Survey: Sydney, February 0

25 Findings Table 7: Recreational drug use among all men in the six months prior to the survey Change from 00 test (p-value) test for trend (p-value) Marijuana 808 (.5) 79 (.7) 767 (.7) 90 (.) 89 (7.9) p <.00 p <.00 Amyl,00 (.8) 97 (.7),08 (.8),0 (.),9 (0.) p <.0 ns Ecstasy 98 (.9) 857 (8.6) 9 (9.8) 975 (5.9) 95 (9.8) p <.00 p <.00 Amphetamine (speed) (9.0) 5 (5.8) 7 (5.9) 86 (.) 6 (.) p <.00 p <.0 Crystal methamphetamine 9 (6.8) (5.5) 9 (.5) 7 (.7) 55 (.) ns p <.00 Viagra 77 (0.) 65 (0.9) 50 (.) 59 (.8) 68 (.) ns ns Cocaine 78 (0.) 9 (7.6) 9 (.0) 598 (.0) 659 (0.6) ns p <.05 Ketamine (special K) 6 (5.5) 8 (.7) 0 (.8) 8 (0.) 06 (9.6) ns p <.00 GHB 97 (.7) 09 (.9) 6 (.9) 56 (.) (.) ns ns LSD 97 (.) 0 (.6) 7 (5.) 50 (5.5) Heroin 9 (0.8) 5 (0.7) (.) 5 (0.6) 7 (0.8) ns ns Steroids 6 (.6) 5 (.) 6 (.0) 60 (.) Mephedrone (meow meow) 69 (.) Other drugs 0 (.) 88 (.0) 9 (5.5) 8 (5.) 08 (6.5) ns p <.00 Total (not mutually exclusive),,6,79,9 Number of drugs used None 756 (.) 75 (.9) 777 (.) 97 (.),6 (9.0) p <.00 p <.00 One or two drugs 678 (8.9) 66 (9.7) 75 (0.5) 88 (0.8) 98 (9.7) ns ns More than two drugs 908 (8.8) 807 (6.) 85 (6.) 95 (5.),000 (.) p <.0 p <.0 Total, (00), (00),6 (00),79 (00),9 (00) Steroids and LSD were omitted in 0 while Meow Meow was added to the list. Since 007 there has been a significant increase in the proportion of men who report no drug use in the previous six months. Gay Community Periodic Survey: Sydney, February 0 5

26 Findings Table 8: Recreational drug use among HIV-positive men in the six months prior to the survey Change from 00 test (p-value) test for trend (p-value) Marijuana 0 (7.8) 57 (5.0) 5 (5.9) (9.) 5 (.) p <.05 ns Amyl 67 (57.0) 65 (5.6) 5 (5.6) 69 (58.9) 8 (5.) ns ns Ecstasy 9 (7.) (.) 0 (9.) (.) (.) p <.0 p <.00 Amphetamine (speed) 65 (.) 6 (.) 5 (9.) 5 (8.5) 5 (.8) p <.05 p <.0 Crystal methamphetamine 98 (.5) 86 (8.5) 80 (8.6) 7 (5.8) 97 (7.6) ns p <.05 Viagra (8.9) 6 (8.) (.) 7 (0.8) (0.6) ns ns Total (not mutually exclusive) Number of drugs used None 7 (6.0) 5 (6.9) (.6) 50 (7.) 77 (.9) ns ns One or two drugs 9 (.) 9 (0.8) 97 (.6) 88 (0.7) 0 (.) ns ns More than two drugs 5 (5.6) 58 (5.) (50.7) 9 (5.9) 55 (.0) ns ns Total 9 (00) 0 (00) 80 (00) 87 (00) 5 (00) ns ns Table 9: Recreational drug use among HIV-negative men in the six months prior to the survey Change from 00 test (p-value) test for trend (p-value) Marijuana 600 (.5) 59 (.0) 59 (0.7) 678 (.5) 657 (6.9) p <.00 p <.00 Amyl 759 (.) 76 (.) 755 (.7) 9 (.8),05 (.9) ns ns Ecstasy 76 (.6) 68 (9.) 707 (.9) 778 (6.) 776 (.7) p <.0 p <.00 Amphetamine (speed) 9 (8.9) 6 (5.) 67 (5.8) 0 (.0) 85 (.7) p <.05 p <.0 Crystal methamphetamine 67 (.9) 0 (.8) 85 (.0) (0.8) 5 (9.6) ns p <.0 Viagra 5 (8.7) (9.) 5 (9.8) 5 (.0) 505 (0.7) ns ns Total (not mutually exclusive),79,76,689,5,5 Number of drugs used None 590 (.9) 608 (5.0) 56 (.) 70 (.) 9 (7.7) p <.05 p <.0 One or two drugs 58 (8.9) 5 (0.) 5 (0.) 668 (.) 7 (0.) ns ns More than two drugs 68 (8.) 60 (.8) 6 (6.) 7 (.5) 78 (.0) ns p <.00 Total,79 (00),76 (00),689 (00),5 (00),5 (00) 6 Gay Community Periodic Survey: Sydney, February 0

27 Findings Table 0: Injecting drug use in the six months prior to the survey, by HIV status of participants Change from 00 test (p-value) test for trend (p-value) All men 0 (6.0) (5.5) 5 (6.) 6 (.6) 6 (.9) ns p <.0 Total, (00), (00),6 (00),79 (00),9 (00) HIV-positive men 56 (9.) 5 (7.) 57 (0.) 7 (6.) 50 (.) ns ns Total 9 (00) 0 (00) 80 (00) 87 (00) 5 (00) HIV-negative men 67 (.7) 6 (.5) 68 (.0) 7 (.) 65 (.7) ns p <.05 Total,79 (00),76 (00),689 (00),5 (00),5 (00) Table : Party drug use and group sex in the six months prior to the survey Change from 00 test (p-value) test for trend (p-value) Used party drugs for sex 6 (7.) 65 (7.7) 579 (.7) 676 (.9) 669 (0.9) p <.00 p <.0 Engaged in group sex during or after drug use 88 (6.6) 57 (6.) 50 (.7) 77 (.9) 0 (.6) ns Total (not mutually exclusive),,,6,79,9 Since 007, there has been a significant decrease in the proportion of men who report using party drugs for sex. In 0,.6% of men surveyed said they had engaged in group sex during or after drug use, a significant decrease since 009. Table : Knowledge that post-exposure prophylaxis is available 00 0 Change from 00 test (p-value) All men,690 (6.),80 (57.0) p <.00 Total,79 (00),9 (00) Non-HIV-positive men,55 (59.8),5 (5.) p <.00 Total, (00),8 (00) Gay Community Periodic Survey: Sydney, February 0 7

28 Appendix Sydney Gay Community Periodic Survey 0 Conducted by This is a survey of sexual practices of men who have had sex with another man in the last five years. This survey is completely anonymous please do not write your name on the questionnaire. Your responses are very important, they provide valuable information that assists in HIV health promotion efforts. PLEASE COMPLETE THE SURVEY ONCE ONLY. Section A About you. How many of your friends are gay or homosexual men? None A few Some Most. How much of your free time is spent with gay or homosexual men? None A little Some A lot. Do you think of yourself as: Gay/Homosexual Bisexual 5 All Heterosexual Other (please specify). How old are you? Years 5. Are you of Aboriginal or Torres Strait Islander origin? No Yes 6. What is your ethnic background? (e.g. Dutch, Greek, Vietnamese, Lebanese) Anglo-Australian Other (specify) 7. Where do you live? Postcode Suburb/Town 8. Are you: Employed full-time Employed part-time On pension/social security OR A student 5 Unemployed 6 Other 9. What is your occupation? (e.g. bartender, teacher, welder) Section B Your sex partners In this survey we distinguish between REGULAR (boyfriend/lover) and CASUAL partners.... Do you currently have sex with casual male partners? No Yes. Do you currently have sex with a regular male partner? No Yes. How would you describe your sexual relationship with your current regular male partner? (choose one) We are monogamous neither of us has casual sex Both my partner and I have casual sex with other men I have casual sex with other men but my partner does not My partner has casual sex with other men but I do not 5 I have several regular male partners 6 No current regular male partner Go to Section C. If you are in a regular relationship with a man, for how long has it been? Less than 6 months 6 months years More than years 5 Not in a regular relationship with a man 5. Do you have a clear (spoken) agreement with your regular partner about anal sex (fucking) within your relationship? No agreement Agreement: No sex at all Agreement: No anal sex at all Agreement: All anal sex is with a condom 5 Agreement: Anal sex can be without a condom (specify) 0. What is the highest level of education you have had? Less than or up to years of high school / Year 0 Year / HSC / SACE / TEE / VCE Tertiary diploma or trade certificate / TAFE University degree or CAE Go to section B 6. Do you have a clear (spoken) agreement with your regular partner about sex with casual partners? No agreement Agreement: No sex at all Agreement: No anal sex at all Agreement: All anal sex is with a condom 5 Agreement: Anal sex can be without a condom Go to section C Page SGCPS 0/ - Gay Community Periodic Survey: Sydney, February 0 A

29 Section C Sex in the last 6 months 7. How many different men have you had sex with in the last 6 months? None One 5 men 6 0 men 5 0 men 6-50 men 7 More than 50 men 8. In the last 6 months how often have you had sex with men you met at or through: Never Occasionally Often Internet Mobile app e.g. Grindr Gay bar Dance party Gym Beat Gay sauna Other sex venue Sex workers Private sex parties In other Australian cities Elsewhere in Australia Overseas 9. In the last 6 months, how often did you have group sex involving at least two other men? 7. I fucked him without a condom but pulled out before I came. Never In this survey woccasionally e distinguish betweoften REGULAR (boyfriend/lover) and CASUAL partners He fucked me without a condom but pulled out before he came. Never Occasionally Often 9. I fucked him without a condom and came inside. Never Occasionally Often 0. He fucked me without a condom and came inside. Never Occasionally Often Section E Casual male partners last 6 months. Have you had any sex with any casual male partner/s in the last 6 months? Yes No Go to section F In the last 6 MONTHS which of the following have you done with any of your CASUAL male partner/s? Oral sex casual partner/s:. I sucked his cock but he did NOT come in my mouth. Never Occasionally Often. He sucked my cock but I did NOT come in his mouth. Never Occasionally Often Every Week Monthly Once / A few times Never Go to section D. I sucked his cock and he came in my mouth. Never Occasionally Often Section D Regular male partners last 6 months 0. Have you had sex with regular male partner/s in the last 6 months? Yes No Go to section E In the last 6 MONTHS which of the following have you done with any of your REGULAR male partner/s? Oral sex regular partner/s:. I sucked his cock but he did NOT come in my mouth. Never Occasionally Often. He sucked my cock but I did NOT come in his mouth. Never Occasionally Often. I sucked his cock and he came in my mouth. Never Occasionally Often. He sucked my cock and I came in his mouth. Never Occasionally Anal sex regular partner/s: 5. I fucked him with a condom. Never Occasionally 6. He fucked me with a condom. Never Occasionally Often Often Often 5. He sucked my cock and I came in his mouth. Never Occasionally Anal sex casual partner/s: 6. I fucked him with a condom. Never Occasionally 7. He fucked me with a condom. Never Occasionally Often Often Often 8. I fucked him without a condom but pulled out before I came. Never Occasionally Often 9. He fucked me without a condom but pulled out before he came. Never Occasionally Often 0. I fucked him without a condom and came inside. Never Occasionally Often. He fucked me without a condom and came inside. Never Occasionally Often HIV disclosure casual partner/s. How many of your casual partners did you tell your HIV status before sex? None Some All. How many of your casual partners told you their HIV status before sex? None Some All Page SGCPS 0/ - A Gay Community Periodic Survey: Sydney, February 0

30 The following questions are for men who have had any anal sex without a condom with casual male partner(s) in the last 6 months. If you have not had any anal sex without a condom with casual male partners, go to section F. In the last 6 months, if you had anal sex without a condom with any casual male partner(s), did you do any of the following to avoid getting or passing on HIV? I made sure we were the same HIV status before we fucked without a condom Never Occasionally Often Always I chose to take the top role (I fucked him) because his HIV status was different or unknown to me Never Occasionally Often Always I chose to take the bottom role (he fucked me) because his HIV status was different or unknown to me Never Occasionally Often Always When I fucked him, I chose to pull out before cumming because his HIV status was different or unknown to me Never Occasionally Often Always When he fucked me, I made sure he pulled out before cumming because his HIV status was different or unknown to me Never Occasionally Often Always Go to section F Section F HIV testing 5. Have you ever had an HIV antibody test? No Yes 6. When were you last tested for HIV antibodies? Never tested Less than a week ago weeks ago 6 months ago 5 7 months ago 6 years ago 7 years ago 8 More than years ago 7. Based on the results of your HIV antibody tests, what is your HIV status? No test/don t know Negative Positive If you are HIV-positive please complete the next three questions. If not, go to section G 5. When were you first diagnosed as HIV-positive? Year 5. Are you on combination antiretroviral therapy? Yes No 5. What was your last viral load test? Undetectable Detectable Don t know / unsure Go to section G 8. Rapid HIV tests can provide results in a single visit. If you could have a rapid test in the following places would you be more or less likely to get tested for HIV? Less likely About the same More likely At home At a clinic/gp Through a gay community organisation 9. If you have a regular partner, do you know the result of his HIV antibody test? Positive Negative I don t know/he hasn t had a test 50. If your regular partner is HIV positive, what was his last viral load test? Undetectable Detectable Don t know / unsure Page SGCPS 0/ - Gay Community Periodic Survey: Sydney February 00 Lee, Holt, Mao, Zablotska, Prestage, Wong, Lake, Honnor and de Wit A

31 Section G STI testing 5. Which of these sexual health tests have you had in the last months? None Once Twice or more Anal swab Throat swab Penile swab Urine sample Blood test for HIV Blood test for syphilis Other blood test 55. Where did you go the last time you had a syphilis test? My regular GP Another GP Sexual health clinic HIV clinic 5 Never tested 56. Were you aware that someone could have syphilis without any physical symptoms? Yes, I was aware No, I wasn't aware 57. Were you aware you could get syphilis through oral sex? Yes, I was aware No, I wasn't aware 58. If you were diagnosed with a sexually transmitted infection in the last months, how many of your sex partners did you tell about your diagnosis? None A few Some All 5 Not been diagnosed with an STI in the last months Go to section H Section H PEP and PREP 59. What do you know about post-exposure prophylaxis (PEP)? It s readily available now It will be available in the future I ve never heard about it If you are HIV-positive you can skip the next question and go to section I Section I Drug use 6. How often have you used these drugs in the last 6 months? Once/ At least Every Never twice monthly week Amyl/poppers Marijuana Viagra/Cialis etc Ecstasy Speed Cocaine Crystal meth GHB Ketamine (special K) Heroin Meow meow (mephedrone) Any other drug 6. How often have you injected drugs in the last 6 months? Every week Once or twice At least monthly Never 6. In the last 6 months, how often have you used party drugs for the purpose of sex? Every week Once or twice At least monthly Never 6. In the last 6 months, how often have you had group sex after or while using party drugs? Every week Once or twice At least monthly Never The survey concludes here. Thank you for your time. As this survey is anonymous, feedback cannot be provided directly. Please check the NCHSR and ACON websites for the results of this survey In the last 6 months, have you taken any anti-hiv medication to prevent HIV infection: Before anal sex without a condom After anal sex without a condom e.g. PEP Go to section I Yes Yes No No Page SGCPS 0/ - A Gay Community Periodic Survey: Sydney, February 0