Gay Community Periodic Survey Queensland Never Stand Still Faculty of Arts and Social Sciences National Centre in HIV Social Research

Transcription

1 Gay Community Periodic Survey Queensland 0 Never Stand Still Faculty of Arts and Social Sciences National Centre in HIV Social Research

2

3 Gay Community Periodic Survey QUEENSLAND 0 Evelyn Lee Limin Mao Garrett Prestage Iryna Zablotska Paul Martin Brett Stevens Peter Watts John de Wit Martin Holt National Centre in HIV Social Research The Kirby Institute Queensland Association for Healthy Communities Queensland Positive People National Centre in HIV Social Research Faculty of Arts and Social Sciences The University of New South Wales

4 Copies of this monograph or any other publications from this project may be obtained by contacting: National Centre in HIV Social Research Level John Goodsell Building The University of New South Wales Sydney NSW 05 Australia Telephone: Fax: Website: National Centre in HIV Social Research 0 ISBN (online) Cover photograph Stockbyte, reproduced under licence Layout by Judi Rainbow The National Centre in HIV Social Research is funded by the Australian Department of Health and Ageing and is based in the Faculty of Arts and Social Sciences at The University of New South Wales (UNSW). Queensland Health provided funding to UNSW for production of the Queensland Gay Community Periodic Survey 0. Suggested citation: Lee, E., Mao, L., Prestage, G., Zablotska, I., Martin, P., Stevens, B., Watts, P., de Wit, J., & Holt, M. (0). Gay Community Periodic Survey: Queensland 0. Sydney: National Centre in HIV Social Research, The University of New South Wales.

5 Contents Acknowledgments List of tables Glossary ii iii v Executive summary Key points Demographic profile HIV status and testing Sexual relationships with men Regular male partners Casual male partners Sexual health Drug use Knowledge and use of PEP and PrEP Findings 5 Reporting 5 Tables 5 Appendix A Gay Community Periodic Survey: Queensland 0 i

6 Acknowledgments We acknowledge the following individuals and organisations for contributing to the success of this project: Queensland Health who funded the project Queensland Association for Healthy Communities and Queensland Positive People for ongoing support of the study The state coordinator, Brett Stevens, and the team of peer recruiters who negotiated access to venues and events and recruited the survey participants Survey participants The men who participated in the survey Venues The management and staff of the various gay community venues 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: Queensland 0

7 List of tables Table : Recruitment venue 6 Table : Age 6 Table : HIV testing 6 Table : HIV test results 7 Table 5: Use of combination antiretroviral treatment among HIV-positive men 7 Table 6: Undetectable viral load and CD count among HIV-positive men, by treatment status 7 Table 7: Current relationships with men 8 Table 8: Agreements with regular male partners about sex within the relationship 8 Table 9: Agreements with regular male partners about sex outside the relationship 8 Table 0: Match of HIV status between regular partners 9 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 0 Table : Anal intercourse and condom use with casual partners 0 Table 5: Any unprotected anal intercourse with casual partners, by HIV status of participants 0 Table 6: Disclosure of HIV status to or from casual partners, by HIV status of participants Table 7: Consistent disclosure of HIV status to casual partners among men who engaged in unprotected anal intercourse, by HIV status of participants Table 8: Positioning in unprotected anal intercourse with casual male partners, by HIV status of participants Table 9: Men who always used risk reduction strategies when engaging in unprotected anal intercourse in the six months prior to the survey, by HIV status of participants Table 0: Where men met their male sex partners in the six months prior to the survey Table : Knowledge about syphilis Table : STI testing among HIV-positive men in the months prior to the survey Table : STI testing among HIV-negative men in the months prior to the survey Gay Community Periodic Survey: Queensland 0 iii

8 Table : Recreational drug use among all men in the six months prior to the survey Table 5: Recreational drug use among HIV-positive men in the six months prior to the survey 5 Table 6: Recreational drug use among HIV-negative men in the six months prior to the survey 5 Table 7: Injecting drug use in the six months prior to the survey, by HIV status of participants 6 Table 8: Party drug use and group sex in the six months prior to the survey 6 Table 9: Knowledge that post-exposure prophylaxis is available 6 Table 0: Use of anti-hiv medication (PrEP or PEP) to prevent HIV infection by non-hiv-positive men in the last six months 6 iv Gay Community Periodic Survey: Queensland 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 to be of different HIV statuses, e.g. HIV-positive and HIV-negative 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, i.e. HIV-negative, HIV-positive, or unknown (i.e. untested) PEP post-exposure prophylaxis, a course of antiretroviral drugs used to reduce the risk of HIV infection after potential exposure has occurred, PrEP pre-exposure prophylaxis, using antiretroviral drugs to reduce the risk of HIV infection before a potential exposure STI sexually transmissible infection UAIC unprotected anal intercourse with casual partners UAIR unprotected anal intercourse with regular partners Gay Community Periodic Survey: Queensland 0 v

10

11 Executive summary The Queensland Community Periodic Survey is a cross-sectional survey of gay and homosexually active men recruited at a range of gay community sites around Queensland. The major aim of the survey is to provide data on sexual, drug use and testing practices related to the transmission of HIV and other sexually transmissible infections (STIs) among gay men. The most recent survey, the fifteenth in Queensland, was conducted in May and September 0 to coincide with the Gold Coast Gay Day, Central Queensland Fair Day (Rockhampton) and Brisbane Pride. The data presented in this report are from the period 008 to 0. From its start in 998, the project has been funded by Queensland Health. The National Centre in HIV Social Research coordinates the survey, with support from the Kirby Institute. Recruitment is conducted locally with support from Queensland gay community organisations. For reasons of timing, in 0 participants were not recruited in Cairns. The overall sample size in 0 is lower than that in 00 and 0, but similar to the rounds in 008 and 009. Had recruitment occurred in Cairns in 0, it is unlikely to have made much difference to the overall sample size, although men from the Cairns area are not represented in the 0 round. This should be borne in mind when interpreting the results. In 0, recruitment was conducted at data collection sites in the Gold Coast, Rockhampton and Brisbane (gay community events, social venues, sex-on-premises venues and sexual health clinics). A total of one thousand three hundred and thirtytwo men (n =,) participated in the survey. The response rate was 7.9%. Key points The proportion of men ever tested for HIV increased significantly between 0 and 0 to 89% of men in the survey. Among those previously tested for HIV, the proportion who were recently tested (within the last year) remained stable at 7%. The proportion of HIV-positive men on treatment remained stable at 70%. The proportion of men with regular partners who reported any unprotected anal intercourse (UAIR) increased to 57% in 0. The proportion of men with casual partners who reported any unprotected anal intercourse (UAIC) increased to 9% in 0. The recent increase in UAIC is primarily among HIV-positive men, untested men and men in their forties. While recreational drug use remains common within the sample, it continues to decline over time (in 0, 55% of men reported any drug use and 5% reported no drug use in the six months prior to survey). There has been a rapid increase in the use of mobile phone applications to meet sex partners, reported by 5% of men in 0. Demographic profile As in previous surveys, the men in the sample were primarily of Anglo-Australian background, lived in metropolitan (urban) areas, were well educated and in full-time employment. In 0,.8% of men reported an Aboriginal or Torres Strait Islander Gay Community Periodic Survey: Queensland 0

12 Executive summary background. There has been no significant change in the proportion of Aboriginal or Torres Strait Islander men in the survey over the last five years. Since 008, there has been a significant decrease in the proportion of men recruited from sexual health clinics and sex-on-premises venues and a corresponding increase in the proportion of men recruited at gay community events. The proportion of men recruited from gay social venues (e.g. bars and gyms) has remained stable during the reporting period. From 008 to 0, there has been an increase in the proportion of men aged above 50 years old and a corresponding decrease of men aged below 5 years old. The proportions of men in other age categories have not changed significantly. HIV status and testing In 0 nearly nine out of ten men reported having ever been tested for HIV (89.0%). The proportion of men reported being tested for HIV increased between 0 and 0. Among non-hiv-positive men, in 0 the proportion who reported testing for HIV in the previous months remained stable at 70.7%. Between 008 and 0, the proportions of HIV-negative and HIV-positive men in the survey did not change significantly. The majority of men in the 0 survey who had been tested for HIV reported that their HIV status was HIV-negative (89.8%). Smaller proportions reported being HIV-positive (8.%) or not knowing their results (.0%). In 0, more than two-thirds of HIV-positive men (69.9%) reported taking combination antiretroviral treatment (ART) at the time of the survey. This proportion has remained stable during the reporting period. Most of the HIV-positive men on ART reported an undetectable viral load (9.%) and just under half reported a CD count of more than 500 (7.7%). Conversely, HIV-positive men who were not using ART were much less likely to report undetectable viral load but were more likely than men on treatment to report a CD count of 500 or more. This suggests that the majority of men not currently on treatment had not yet reached the CD count threshold (500) below which treatment would be considered. Sexual relationships with men There were similar proportions of men (nearly 0%) who reported being in monogamous relationships or having both regular and casual partners in the 0 survey. Close to a quarter of men said they had only casual male partners (.9%) and about one fifth of men reported having no sexual relationships with men (8.7%). All the relationship types have remained stable during the reporting period. In 0, over a third (7.7%) of men reported having had sex with men they met through the internet. Other commonly reported ways to meet male sex partners were gay bars (0.9%) and gay saunas (5.%). The use of saunas increased between 0 and 0. More than a third of men (5.%) said they had used a mobile application like Grindr to meet sex partners in 0. There has been a rapid increase in the use of mobile applications between 0 and 0 (from 6.% to 5.%). Between 0 and 0 there were also increases in the proportions of men who reported travelling within Australia or overseas and meeting male partners. The use of bars, gyms, dance parties, beats and other sex-on-premises venues to meet men has declined significantly since 009. Regular male partners Among men with regular partners in 0, over half (57.%) reported an agreement with their regular partner about sex within the relationship and a similar proportion (5.%) reported an agreement about sex outside the relationship. In 0, the most commonly held agreements about sex within the relationship were that anal Gay Community Periodic Survey: Queensland 0

13 Executive summary intercourse could occur without a condom (.%) or that condoms must always be used for anal intercourse (0.9%). The most commonly held agreements about sex outside a relationship specified that casual sex was not allowed (5.%) or that condoms must always be used for anal intercourse with casual partners (.%). Agreements between regular partners specifying that casual sex is not permitted became more common between 0 and 0. In 0, HIV-negative men with regular partners were more likely to be in seroconcordant relationships than HIV-positive men. More than three-quarters of HIV-negative men with regular partners (76.%) were in seroconcordant relationships and one fifth were in serononconcordant relationships (9.9%). Since 008, there has been an upward trend of HIV-negative men in seroconcordant relationships and a corresponding decrease in serononconcordant relationships. In 0, more than half of men with a regular partner reported some unprotected anal intercourse (UAIR) with their partner (56.7%) while slightly more than one fifth reported that condoms were always used for anal intercourse (.%). Between 008 and 0, the proportion of men who always used condoms for anal intercourse with their regular partner decreased significantly. Among HIV-positive men with regular partners in 0, 7.% reported UAIR with seroconcordant partners,.% reported UAIR that was not concordant and another 0.7% reported no UAIR. Conversely, HIV-negative men with regular partners were more likely to restrict UAIR to seroconcordant partners or avoid UAIR. Among HIV-negative participants with regular partners in 0, close to half reported seroconcordant UAIR (5.%), over two-fifths avoided UAIR (.%) and a small proportion reported UAIR that was not concordant (.7%). In 0, among HIV-negative men who reported UAIR with partners who were not seroconcordant,.0% reported always being the insertive partner (strategic positioning) and about one in ten reported consistent withdrawal before ejaculation by their partner (9.%). Between 008 and 0, there was an upward trend in the proportion of HIV-negative men who reported strategic positioning (being insertive only) when practising UAIR. Casual male partners Use of condoms for anal intercourse remains more common with casual partners than with regular partners. In 0, there were similar proportions of men with casual partners (around 0%) who reported always using condoms for anal intercourse or any unprotected anal intercourse (UAIC) in the six months prior to the survey. While trends in consistent condom use and UAIC have remained stable over time, between 0 and 0 there was a significant increase in the proportion of men reporting UAIC (from.% to 9.%). This is the highest level of UAIC ever recorded in the survey. HIV-positive men with casual partners remain the most likely to report any UAIC (7.%), compared with HIV-negative men (.9%) and untested/unknown status men (.7%). The proportions of HIV-positive, HIV-negative and untested men reporting UAIC have not changed significantly since 008. However, when we combined the HIV-positive and untested categories we found that UAIC significantly increased among HIV-positive and untested men with casual partners between 0 and 0 (from 6.% to 58.0%) while it remained stable among HIV-negative men. We also looked at UAIC by age category and found that between 0 and 0, UAIC increased among men with casual partners aged 0-9 (from.6% to 8.9%). UAIC in the other age groups was stable. Thus the recent increase in UAIC is primarily among HIV-positive men, untested men and men in their forties. In 0, disclosure of HIV status before sex to any casual partner continued to be more commonly reported by HIV-positive men (78.%) than by HIV-negative men (55.6%). While HIV disclosure by HIV-positive men and their casual partners remains stable over time, HIV disclosure has become more common among HIV- Gay Community Periodic Survey: Queensland 0

14 Executive summary negative men and their casual partners. Similarly, the proportion of HIV-positive men who consistently disclosed their HV status to all casual partners with whom they had UAIC has remained stable over time, while there has been an increase in the proportion of HIV-negative men who consistently disclose to partners with whom they have UAIC. HIV-positive and HIV-negative men now appear to be equally likely to consistently disclose to partners with whom they have UAIC (0% of both groups reported consistent disclosure in 0). Among HIV-positive men who reported UAIC in the six months prior to the survey, slightly more than one third said that they only had UAIC when they knew their partners were seroconcordant (serosorting) (5.%). Very few reported always using strategic positioning or withdrawal during UAIC. Among HIV-negative men who engaged in UAIC,.6% of them said that they had UAIC with partners who they knew to be seroconcordant, with smaller proportions (about one in ten) reporting consistent strategic positioning or ejaculation. Between 0 and 0, the proportions of HIV-positive men and HIV-negative men reporting serosorting remained stable. Sexual health As in previous surveys, in 0 a higher proportion of HIV-positive men (9.8%) reported having had any sexual health test (including a blood test for syphilis) compared with HIV-negative men (69.7%). Compared to the previous survey, the proportions of HIV-positive and HIV-negative men reporting anal swabs, throat swabs or urine tests in the months prior to the survey have remained stable. In 0, 8.5% of HIV-positive men and 57.% of HIV-negative men reported a blood test for syphilis. The majority of participants were aware that syphilis can be symptomless (7.%) and that it is transmissible through oral sex (7.8%). There were significant improvements in these syphilis knowledge indicators between 0 and 0. In 0, 67 men (.5%) reported a diagnosis with any STI (other than HIV) in the months prior to the survey. Among these men, close to three quarters (7.%) told some of their sex partners about their diagnosis and under half (.%) told all their sex partners. Drug use Recreational drug use remains common within the sample, with the most frequently used drugs being marijuana (0.%), amyl/poppers (6.0%), ecstasy (9.7%), Viagra (6.0%), amphetamine (.7%), cocaine (0.%) and crystal methamphetamine (0.%). However, over time the proportion of men who say they haven t used any drugs in the six months prior to the survey has increased significantly (to 5.% of all men in 0). The use of marijuana, ecstasy and amphetamine has declined over time. Only Viagra use has increased during the reporting period. The proportion of men who say they have used drugs for sex has remained stable (at 7.9% of all men in 0). In general, HIV-positive men remain more likely to report drug use compared with HIV-negative men. HIV-positive men remain considerably more likely than HIVnegative men to report any injecting drug use (.% vs.% in 0). Knowledge and use of PEP and PrEP Between 0 and 0 there was a significant increase in the proportion of participants who reported that they knew post-exposure prophylaxis (PEP) was available (to 55.6% in 0). PEP awareness has otherwise remained stable over time. In 0, new questions were added about the use of anti-hiv (antiretroviral) drugs for the prevention of HIV before and after unprotected sex pre-exposure prophylaxis (or PrEP) and PEP. Unlike PEP, PrEP is not currently available in Australia through the health system. In 0, men (.8%) said they had used anti-hiv drugs before Gay Community Periodic Survey: Queensland 0

15 Findings unprotected sex as PrEP and men (.%) said they had used anti-hiv drugs as PEP. These proportions did not change significantly between 0 and 0. Reporting Data are shown for the period Each table includes the statistical significance, if any, of the change between 0 and 0 and the trend over time (008 0). An alpha level of.05 was used for all statistical tests. Changes between 0 and 0 were assessed with logistic regression (comparing one category with all the others). In tables where there are mutually exclusive categories (shown on separate rows), the p-value of the logistic regression test (if shown) indicates a statistically significant change within that category compared with all the others. For statistically significant trends over time, tested with logistic regression, the direction of the change (an increase or decrease) is indicated. Where there is no significant change, ns (non-significant) is shown. Where there are low frequencies or data over time are not comparable, tests have not been performed and are marked NA (not applicable). Please exercise caution when interpreting results where there are low frequencies. 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 0 below. Gay Community Periodic Survey: Queensland 0 5

16 Findings Table : Recruitment venue Change from 0 Gay community events 7 (5.) 56 (9.5) 6 (7.5) 7 (.) 59 (.) ns Increase p <.00 Sexual health clinics 77 (6.) (.) 57 (.) 5 (.) (.8) Decrease p <.05 Decrease p <.00 Sex-on-premises venues 80 (.5) 70 (.0) 80 (0.9) 55 (9.) 7 (.8) Increase p <.0 Decrease p <.0 Social venues and events 59 (.) 578 (.) 798 (8.) 7 (.) 55 (.0) ns ns Total, (00),06 (00),657 (00),67 (00), (00) In 0, these included the Gold Coast Gay Day, Central Queensland Fair Day and the Brisbane Pride Festival Fair Day. Table : Age Change from 0 Under 5 years 0 (6.) 9 (0.0) 5 (7.5) 9 (.7) 6 (9.9) Decrease p <.05 Decrease p < years 89 (5.5) (7.6) 9 (7.9) 9 (7.5) (6.9) ns ns 0 9 years (7.) 0 (.0) 80 (.) 05 (.) 56 (7.0) ns ns 0 9 years (9.9) (9.) (8.9) 8 (0.) 8 (.) ns ns 50 years and over 9 (.) 5 (.) 06 (.5) (.0) 96 (.9) ns Increase p <.0 Total, (00),58 (00),6 (00),660 (00),8 (00) Table : HIV testing Change from 0 All participants Ever tested,5 (9.8),77 (90.),5 (8.7),6 (85.),85 (89.0) Increase p <.0 Decrease p <.00 Total, (00),06 (00),657(00),67 (00), (00) Non-HIV-positive participants Tested in the previous months 7 (70.) 750 (68.7) 86 (7.) 95 (7.) 760 (70.7) ns ns Total,060 (00),09 (00),5 (00),79 (00),075 (00) 6 Gay Community Periodic Survey: Queensland 0

17 Findings Table : HIV test results Change from 0 HIV-positive 85 (7.8) 76 (6.8) (9.) 5 (8.8) 97 (8.) ns ns HIV-negative 96 (87.9) 97 (87.8),89 (88.),59 (88.5),06 (89.8) ns ns Unknown 8 (.) 60 (5.) 5 (.6) 8 (.7) (.0) ns Decrease p <.00 Total,096 (00),0 (00),8 (00), (00),8 (00) Note: This table only includes data from men who have been tested for HIV. Table 5: Use of combination antiretroviral treatment among HIV-positive men Change from 0 On treatment 59 (70.) 8 (67.6) 86 (7.) 89 (76.7) 65 (69.9) ns ns Total 8 (00) 7 (00) (00) 6 (00) 9 (00) Table 6: Undetectable viral load and CD count among HIV-positive men, by treatment status Change from 0 Men using ART Undetectable viral load 9 (8.) (9.7) 78 (90.7) 8 (9.0) 60 (9.) ns ns CD count > (7.7) NA NA Total 59 (00) 8 (00) 86 (00) 89 (00) 65 (00) Men not using ART Undetectable viral load 8 (.0) (9.) 7 (0.6) 5 (8.5) 6 (.) ns ns CD count > (5.6) NA NA Total 5 (00) (00) 5 (00) 7 (00) 8 (00) Gay Community Periodic Survey: Queensland 0 7

18 Findings Table 7: Current relationships with men Change from 0 None (0.0) 6 (.0) 8 (6.0) 8 (0.8) 6 (8.7) ns ns Casual only 89 (5.0) 60 (.0) 8 (9.0) (0.9) 0 (.9) ns ns Regular plus casual 8 (9.) 70 (9.8) 09 (7.7) 90 (.0) 67 (9.) ns ns Regular only (monogamous) 99 (5.8) 50 (8.) 0 (7.) (7.) 57 (8.) ns ns Total,58 (00), (00),78 (00),580 (00),6 (00) Table 8: Agreements with regular male partners about sex within the relationship Change from 0 No agreement about sex within the relationship 9 (50.) 67 (50.5) 8 (.5) 8 (.) 8 (.9) ns Decrease p <.00 No anal intercourse permitted (.9) (.6) 6 (.) 0 (.6) 7 (.0) ns Decrease p <.05 Anal intercourse permitted only with a condom 8 (.) 69 (8.) 8 (.0) 00 (6.) 86 (0.9) Decrease p <.0 increase p <.05 Anal intercourse permitted without a condom 08 (.8) 55 (7.6) 7 (.) (9.0) 96 (.) Increase p <.05 Increase p <.00 Total 87 (00) 9 (00),079 (00), (00) 89 (00) Table 9: Agreements with regular male partners about sex outside the relationship Change from 0 No agreement about casual sex 78 (5.7) 5 (56.) 9 (5.5) 5 (7.) 09 (5.9) ns Decrease p <.00 No sex with casual partners permitted 88 (.5) 8(9.9) 5 (.5) (.0) 6 (5.) Increase p <.05 ns No anal intercourse with casual partners permitted 6 (.) 6 (.9) (.0) (.8) 6 (.0) ns ns Anal intercourse with casual partners permitted only with a condom 60 (8.) 5 (6.6) 5 (.7) 97 (6.0) 89 (.) Decrease p <.05 Increase p <.00 Anal intercourse with casual partners permitted without a condom (.) 0 (.) 6 (.) (.8) (.6) ns Increase p <.05 Total 87 (00) 9 (00),079 (00), (00) 89 (00) 8 Gay Community Periodic Survey: Queensland 0

19 Findings Table 0: Match of HIV status between regular partners Change from 0 HIV-positive men Seroconcordant 6 (.8) (0.0) 8 (8.) 8 (5.) 7 (.6) ns ns Serodiscordant 5 (5.9) 6 (9.) 5 (.7) (9.) 0 (.) ns ns Serononconcordant 7 (9.) 7 (0.9) 6 (0.) (5.5) 5 (.) ns ns Total 58 (00) 55 (00) 79 (00) 8 (00) 6 (00) HIV-negative men Seroconcordant 7 (7.6) 9 (55.0) 600 (7.) 67 (7.) 568 (76.) ns Increase p <.00 Serodiscordant 0 (.) (.8) 7 (.5) 8 (5.) 9 (.9) ns ns Serononconcordant 0 (8.0) 87 (0.) 9 (.) 8 (0.) 8 (9.9) ns Decrease p <.00 Total 687 (00) 7 (00) 89 (00) 90 (00) 75 (00) Table : Anal intercourse and condom use with regular partners Change from 0 No anal intercourse 50 (7.) 76 (9.) (9.6) 7 (.9) 88 (.) ns Increase p <.0 Always uses a condom 5 (9.0) 5 (6.5) 65 (.6) 06 (6.8) 98 (.) Decrease p <.05 Decrease p <.0 Sometimes does not use a condom 7 (5.9) 50 (5.) 60 (55.9) 56 (9.) 506 (56.7) Increase p <.0 ns Total 87 (00) 9 (00),079 (00), (00) 89 (00) Table : Unprotected anal intercourse with regular partners, by match of HIV status Change from 0 HIV-positive men Seroconcordant positive UAIR 0 (.5) 5 (7.) 8 (5.) 0 (5.7) (7.) ns ns Not concordant UAIR 9 (.8) 0 (6.) 5 (9.0) 8 (.) 0 (.) ns ns No UAIR 9 (.8) 0 (6.) 6 (5.6) 6 (.9) 9 (0.7) ns ns Total 58 (00) 55 (00) 79 (00) 8 (00) 6 (00) HIV-negative men Seroconcordant negative UAIR 05 (9.8) 5 (.) 75 (5.) 66 (0.5) 7 (5.) ns Increase p <.00 Not concordant UAIR 6 (.9) 5 (.) 00 (.) 9 (0.) 87 (.7) ns Decrease p <.00 No UAIR 8 (6.) 7 (.5) 5 (.7) 5 (9.) (.) Decrease p <.05 ns Total 687 (00) 7 (00) 89 (00) 90 (00) 75 (00) Gay Community Periodic Survey: Queensland 0 9

20 Findings Table : HIV-negative men who engaged in UAIR and always used risk-reduction strategies with partners who were not concordant Change from 0 Took insertive position during UAIR (0.7) 8 (5.) (.0) (5.5) 7 (.0) ns Increase p <.05 Partner withdrew before ejaculation when participant was receptive (5.0) 5 (.) (.0) 6 (7.) 8 (9.) ns Decrease p <.0 Total (not mutually exclusive) Table : Anal intercourse and condom use with casual partners Change from 0 No anal intercourse 57 (8.) 58 (8.) 6 (.) (.) 6 (9.) ns ns Always uses a condom 9 (5.) 90 (5.) (.7) 6 (.6) 5 (.7) ns ns Sometimes does not use a condom 7 (6.5) (6.) 76 (7.0) 5 (.) (9.) Increase p <.05 ns Total 868 (00) 86 (00),06 (00) 07 (00) 86 (00) Table 5: Any unprotected anal intercourse with casual partners, by HIV status of participants Change from 0 HIV-positive men 7 (6.7) 5 (69.) 5 (5.8) 5 (6.6) 57 (7.) ns ns Total 60 (00) 65 (00) 9 (00) 86 (00) 78 (00) HIV-negative men 0 (.7) (.) 75 (6.) 6 (.) 5 (.9) ns ns Total 69 (00) 659 (00) 759 (00) 807 (00) 67 (00) Untested/unknown status men 7 (.5) (7.8) (.5) (.0) 0 (.7) ns ns Total 69 (00) 659 (00) 759 (00) 807 (00) 67 (00) 0 Gay Community Periodic Survey: Queensland 0

21 Findings Table 6: Disclosure of HIV status to or from casual partners, by HIV status of participants Change from 0 HIV-positive men Told casual partners 6 (76.7) 7 (7.) 6 (68.8) 68 (79.) 6 (78.) ns ns Told by casual partners (68.) 5 (69.) 58 (6.) 50 (58.) 5 (68.0) ns ns Total (not mutually exclusive) HIV-negative men Told casual partners 0 (7.8) 5 (5.7) 0 (5.) 8 (5.) 75 (55.6) ns Increase p <.0 Told by casual partners 8 (8.9) 5 (5.6) 07 (5.6) 9 (55.6) 87 (57.) ns Increase p <.0 Total (not mutually exclusive) Table 7: Consistent disclosure of HIV status to casual partners among men who engaged in unprotected anal intercourse, by HIV status of participants Change from 0 HIV-positive men who disclosed to all (5.) (6.7) 6 (.) 9 (5.9) (0.) ns ns Total 7 (00) 5 (00) 5 (00) 5 (00) 57 (00) HIV-negative men who disclosed to all 6 (6.) 66 (.) 87 (.6) 99 (7.9) 9 (0.0) ns Increase p <.00 Total 0 (00) (00) 75 (00) 6 (00) 5 (00) Table 8: Positioning in unprotected anal intercourse with casual male partners, by HIV status of participants Change from 0 HIV-positive men Receptive only UAIC 0 (7.0) 7 (5.6) 8 (5.7) (.6) 9 (5.8) ns ns Total 7 (00) 5 (00) 5 (00) 5 (00) 57 (00) HIV-negative men Insertive only UAIC 7 (9.6) 7 (.0) 78 (8.) 78 (9.9) 6 (6.) ns ns Total 0 (00) (00) 75 (00) 6 (00) 5 (00) Gay Community Periodic Survey: Queensland 0

22 Findings Table 9: Men who always used risk reduction strategies when engaging in unprotected anal intercourse in the six months prior to the survey, by HIV status of participants 0 0 Change from 0 HIV-positive men Ensured partners were seroconcordant before UAIC (serosorting) 6 (0.) 0 (5.) ns Took receptive position during UAIC when partners were not concordant 5 (9.) (5.) NA Participant withdrew before ejaculation when he was insertive (.8) (5.) NA Partner withdrew before ejaculation when participant was receptive (.8) (5.) NA Total (not mutually exclusive) 5 57 HIV-negative men Ensured partners were seroconcordant before UAIC (serosorting) 85 (.6) 79 (.6) ns Took insertive position during UAIC when partners were not concordant 6 (.8) 8 (.9) NA Participant withdrew before ejaculation when he was insertive 9 (7.) (9.) NA Partner withdrew before ejaculation when participant was receptive (.) (.0) NA Total (not mutually exclusive) 6 5 Table 0: Where men met their male sex partners in the six months prior to the survey Change from 0 Internet 89 (7.) 65 (7.) 65 (9.) 50 (7.7) ns ns Mobile app e.g. Grindr (6.) 7 (5.) Increase p <.00 - Gay bar 8 (6.9) 55 (.) 506 (0.) (0.9) ns Decrease p <.00 Dance party 5 (9.5) 6 (5.9) 0 (.8) 80 (.5) ns Decrease p <.00 Beat 7 (0.9) 7 (6.5) 6 (5.6) 05 (5.) ns Decrease p <.00 Gay saunas 57 (7.) 6 (.0) 9 (0.9) 6 (5.) Increase p <.0 ns Other sex-on-premises venues 7 (0.9) 8 (.) 60 (5.6) 96 (.7) ns Decrease p <.00 Sex workers - 5 (.7) 5 (.) (.) ns ns In other Australian citites - 75 (.6) 8 (9.0) 99 (.5) Increase p <.05 ns Elsewhere in Australia - 66 (6.) 5 (.) 6 (7.0) Increase p <.05 ns Private sex parties (9.5) 8 (7.7) 9 (7.) 0 (8.) ns ns Gym 98 (7.5) 09 (6.6) 9 (5.) 7 (5.6) ns Decrease p <.05 Overseas 0 (5.) 65 (6.0) 09 (.5) (6.0) Increase p <.0 ns Total (not mutually exclusive),06,657 67, Gay Community Periodic Survey: Queensland 0

23 Findings Table : Knowledge about syphilis Change from 0 Aware that syphilis can have no physical symptoms,8 (7.),5 (67.9) 975 (7.) Increase p <.0 ns Aware that syphilis can be transmitted through oral sex,8 (68.),05 (66.) 996 (7.8) Increase p <.00 Increase p <.00 Total (not mutually exclusive),657,67, Table : STI testing among HIV-positive men in the months prior to the survey Change from 0 Anal swab (50.0) 55 (7.) 7 (56.8) 80 (6.0) 65 (67.0) ns ns Throat swab 6 (5.5) 56 (7.7) 7 (59.) 85 (68.0) 7 (7.) ns Increase p <.05 Penile swab 5 (0.7) (5.0) 5 (.6) 6 (8.8) 8 (9.5) ns ns Urine sample 5 (6.8) 58 (76.) 90 (7.0) 9 (75.) 7 (75.) ns ns Blood test for syphilis 6 (80.) 98 (78.) 9 (7.6) 8 (8.5) ns ns Blood test other than for HIV 65 (75.6) 6 (8.) 0 (80.8) 99 (79.) 77 (79.) ns ns Any STI test (not including blood tests) 56 (65.) 6 (8.6) 9 (7.) 97 (77.6) 77 (79.) ns ns Any STI test (including blood tests) 7 (8.6) 7 (9.) 09 (87.) 07 (85.6) 90 (9.8) ns ns Total (not mutually exclusive) Note: From 009, Blood test for syphilis was added to the question about sexual health testing and was subsequently included in the calculation for any STI test (including blood tests). Table : STI testing among HIV-negative men in the months prior to the survey Change from 0 Anal swab (5.) 56 (6.) 77 (9.8) 8 (7.8) 05 (8.0) ns ns Throat swab 06 (.9) 8 (.7) 557 (6.) 55 (.) 7 (.) ns ns Penile swab (.) (.9) 0 (.7) (.) 9 (.7) ns ns Urine sample 57 (5.) 5 (5.) 706 (58.8) 78 (56.) 596 (55.9) ns ns Blood test for syphilis 579 (59.) 70 (6.7) 7 (56.7) 609 (57.) ns ns Blood test other than for HIV 557 (57.) 580 (59.) 7 (60.) 7 (58.) 579 (5.) ns ns Any STI test (not including blood tests) 555 (57.) 57 (58.5) 78 (6.5) 758 (59.5) 68 (59.8) ns ns Any STI test (including blood tests) 655 (67.5) 69 (70.8) 86 (7.0) 90 (7.0) 7 (69.7) ns ns Total (not mutually exclusive) ,00,7,067 Note: From 009, Blood test for syphilis was added to the question about sexual health testing and was subsequently included in the calculation for any STI test (including blood tests). Gay Community Periodic Survey: Queensland 0

24 Findings Table : Recreational drug use among all men in the six months prior to the survey Change from 0 Marijuana 60 (7.0) 57 (5.0) 605 (6.5) 585 (5.0) 05 (0.) Decrease p <.0 Decrease p <.0 Amyl 7 (6.0) 5 (.8) 595 (5.9) 566 (.9) 79 (6.0) ns ns Ecstasy 07 (.7) 0 (0.7) 9 (7.) 58 (.) 6 (9.7) ns Decrease p <.00 Amphetamine (speed) 08 (6.7) 05 (5.7) (.7) (.5) 69 (.7) ns Decrease p <.0 Crystal methamphetamine 9 (.) 06 (8.) 7 (8.) 6 (8.7) (0.) ns ns Viagra 5 (.) 7 (.) 0 (.5) 5 (5.) (6.0) ns Increase p <.0 Cocaine 56 (.6) (.0) 7 (.) 86 (.) 6 (0.) ns ns Ketamine (special K) 6 (5.0) 55 (.) 7 (.) 79 (.7) 8 (.6) ns ns LSD 90 (7.) 97 (7.) 5 (8.) GHB 98 (7.9) 55 (.) 06 (6.) (6.6) 65 (.9) Decrease p <.05 ns Heroin 8 (.) (.8) 5 (.) 9 (.7) (0.9) NA NA Steroids 8 (.) 8 (.) 7 (.) Mephedrone (meow meow) 5 (.) (.8) ns Other drugs 98 (7.9) 0 (7.8) (8.6) 57 (9.) 07 (8.0) ns ns Total (not mutually exclusive),,06,657,67, Number of drugs used None 87 (9.) 556 (.6) 69 (.9) 76 (.) 60 (5.) ns Increase p <.0 One or two drugs 9 (.7) 9 (0.) 5 (.0) 550 (.9) 0 (.) ns ns More than two drugs 6 (9.) 57 (7.) 50 (7.) 96 (.7) 00(.5) ns Decrease p <.00 Total, (00),06 (00),657 (00),67 (00), (00) Gay Community Periodic Survey: Queensland 0

25 Findings Table 5: Recreational drug use among HIV-positive men in the six months prior to the survey Change from 0 Marijuana 56 (65.) 9 (5.) 69 (55.) 77 (6.6) 5 (5.6) ns ns Amyl 5 (59.) 6 (60.5) 79 (6.) 7 (56.8) 58 (59.8) ns ns Ecstasy 6 (.9) 0 (9.5) 5 (6.0) 7 (9.6) 7 (7.8) ns Decrease p <.05 Amphetamine (speed) (6.7) (9.0) 6 (0.8) 8 (.) (.) NA NA Crystal methamphetamine 5 (9.) 6 (.) 0 (.0) 7 (.6) 8 (8.6) ns Decrease p <.05 Viagra 6 (0.) (.) 9 (9.) 8 (0.) 8 (9.) ns ns Total (not mutually exclusive) Number of drugs used None 7 (0.0) (5.8) 0 (6.0) 6 (0.8) 8 (8.6) ns ns One or two drugs (5.6) 0 (9.5) 6 (6.8) 8 (0.) 7 (8.) ns ns More than two drugs 7 (5.7) (.7) 59 (7.) 6 (8.8) (.) ns ns Total 86 (00) 76 (00) 5 (00) 5 (00) 97 (00) Table 6: Recreational drug use among HIV-negative men in the six months prior to the survey Change from 0 Marijuana 9 (5.0) 0 (.7) 50 (7.5) (.) 09 (9.0) Decrease p <.0 Decrease p <.0 Amyl 5 (6.5) (.9) 5 (7.8) (.6) 8 (5.8) ns ns Ecstasy 5 (.5) (.8) 5 (8.9) 79 (.9) 07 (9.) ns Decrease p <.00 Amphetamine (speed) 8 (5.) 9 (5.) 76 (.7) 86 (.6) (.6) ns ns Crystal methamphetamine 97 (0.0) 6 (6.5) 90 (7.5) 0 (8.) 95 (8.9) ns ns Viagra (.7) 6 (.9) 7 (.) 9 (5.) 59 (.9) ns Increase p <.0 Total (not mutually exclusive) ,00,7,067 Number of drugs used None 79 (9.) 05 (.) 66 (8.8) 5 (.8) 8 (5.) ns Increase p <.0 One or two drugs (.) 07 (.) 0 (.6) (.9) 56 (.) ns ns More than two drugs 69 (7.7) 68 (7.) (7.6) 97 (.) 7 (.) ns Decrease p <.00 Total 970 (00) 980 (00),00 (00),7 (00),067(00) Gay Community Periodic Survey: Queensland 0 5

26 Findings Table 7: Injecting drug use in the six months prior to the survey, by HIV status of participants Change from 0 All men 59 (.8) 7 (5.) 95 (5.7) 70 (.) 56 (.) NA NA Total, (00),06 (00),657 (00),67 (00), (00) HIV-positive men 5 (7.) 6 (.) 0 (6.0) 9 (5.) (.) ns ns Total 86 (00) 76 (00) 5 (00) 5 (00) 97 (00) HIV-negative men 5 (.6) (.) 5 (.8) 9 (.) (.) NA NA Total 970 (00) 980 (00),00 (00),7 (00),067 (00) Table 8: Party drug use and group sex in the six months prior to the survey Change from 0 Used party drugs for sex 0 (8.5) 5 (8.0) (9.5) 00 (7.9) 9 (7.9) ns ns Engaged in group sex during or after drug use 69 (.6) 86 (.) 89 (.) 60 (9.6) (0.6) ns Decrease p <.00 Total (not mutually exclusive),,06,657,67, Table 9: Knowledge that post-exposure prophylaxis is available Change from 0 Aware of PEP among all men 68 (5.9) 698 (5.5) 88 (5.) 88 (50.) 70 (55.6) Increase p <.0 ns Total, (00),06 (00),657 (00),67 (00), (00) Aware of PEP among non-hiv-positive men 607 (5.5) 66 (5.7) 77 (50.) 78 (7.7) 656 (5.) Increase p <.0 ns Total,57 (00),0 (00),5 (00),57 (00),5 (00) Table 0: Use of anti-hiv medication (PrEP or PEP) to prevent HIV infection by non-hiv-positive men in the last six months 0 0 Change from 0 Use of PrEP before UAI 0 (.6) (.8) ns Use of PEP after UAI 56 (.6) (.) ns Total (not mutually exclusive),57,5 6 Gay Community Periodic Survey: Queensland 0

27 Appendix Queensland Gay Community Periodic Survey 0 Conducted by This is a survey of sexual practices of men who have had sex with w 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 ONCEE ONLY. Section A About you. How many of your friends are gay or homosexual men?. How much of your free time is spent with gay or homosexual men?. Do you think of yourself as: Gay/Homosexual Bisexual Other. How old are you? Years 5. Are you of Aboriginal or Torres Strait Islander origin? 6. What is your ethnic background? (e.g. Dutch, Greek, Vietnamese, Lebanese) 7. Where were you born? 8. Where do you live? Postcode OR Suburb/Town 9. Are you:. What is the highest level of education you have had? Page None None No AA few AA little Anglo-Australian Australia Yes Employed full-time Employed part-time Other On pension/ /social security 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 Some Some Overseas Most A lot A student 5 Unemployed 6 Other 5 Heterosexual (please specify) 0. What is your occupation? (e.g. bartender, teacher, welder) (specify) All Go to sectionn B Section B Your Y sex partners In this survey s we distinguish between REGULAR (boyfriend/lover) and CASUAL partners. Do you currently have sex x with casual male partners? No Yes. Do you currently have sex x with a regular male partner? No Yes. How would you describe your sexual relationship with your current regular male partner? (choose one) 5 We are monogamous neither of us has casual sex Both my partner p and I have casual sex s with other men I have casual sex with other men but my partner does not My partner has casual sex with otherr men but I do not 5 I have several regular male partnerss 6 No currentt regular male e partner Go to Section C 5. 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 6. 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 sexx at all Agreement: All anal sexx is with a condom 5 Agreement: Anal sex can be without a condom 7. 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 sexx at all Agreement: All anal sex is with a condom Agreement: Anal sex cann be without a condom Go to section C QGCPS 0/ _ Gay Community Periodic Survey: Queensland 0 A

28 Section C Sex in the last 6 months 8. How many different men have you had sex with in the last 6 months? None One 6 0 men 5 0 men 7 More than 50 men 5 men 6-50 men 9. In the last 6 months how often have you had sex with men you met at or through: Never Occasionally 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 0. In the last 6 months, how often did you have group sex involving at least two other men? Section D Regular male partners last 6 months. Have you had sex with regular male partner/s in the last 6 months? Yes No Go to section E Page In the last 6 MONTHS which of the following havee 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 5. He sucked my cock and I came in his mouth. Never Occasionally Often Anal sex regular partner/s: 6. I fucked him with a condom. Never Occasionally 7. He fucked me with a condom. Never Occasionally Every Week Monthly Once / A few times t Never Go to sectionn D Often Often Often 8. I fucked him without w a condom but pulled out before I came. Never In this survey we Occa distinguish asionally between Often REGULAR (boyfriend/lover) and CASUAL partners He fucked mee without a condom but pulled out beforee he came. Never Occasionally Often 0. I fucked him without w a condom and came inside. Never Occasionally Often. He fucked mee without a condom and came inside. Never Occasionally Often Section E Casual C malee partners last 6 months. Have you hadd any sex with any casual male partner/s in the last 6 months? m Yes No Go to section F In the last 6 MONTHS which of the following have you done with any a of your CASUAL male partner/s? Oral sex casual partner/s:. I sucked his cock c but he didd NOT come in my mouth. Never Occasionally Often. He sucked myy cock but I did NOT come in his mouth. Never Occasionally Often 5. I sucked his cock c and he came in my mouth. Never Occasionally Often 6. He sucked myy cock and I came in his mouth. Never Occasionally Often Anal sex casual partner/s: : 7. I fucked him with w a condom. Never Occasionally Often 8. He fucked mee with a condom. Never Occasionally Often 9. I fucked him without w a condom but pulled out before I came. Never Occasionally Often 0. He fucked mee without a condom but pulled out beforee he came. Never Occasionally Often. I fucked him without w a condom and came inside. Never Occasionally Often. He fucked mee without a condom and came inside. Never Occasionally Often HIV disclosuree 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 QGCPS 0/ _ A Gay Community Periodic Survey: Queensland 0

29 The following questions are for men who have had any anal sex without w 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 too section F 5. 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 passingg on HIV? I made sure we weree the same HIV status before we fuckedd without a condom I chose to take the top role (I fucked him) because his HIV status was different or unknown to me I chose to take the bottom role (he fucked me) ) because his HIV status was different or unknown to me When I fucked him, I chose to pull out before cumming because his HIV status was different or unknown to me When he fucked me, I made sure he pulled out before cumming because his HIV status was different or unknown to me Go to section F Never Never Never Never Never Occasionallyy Occasionallyy Occasionallyy Occasionallyy Occasionallyy Often Often Often Often Often Always Always Always Always Always Section F HIV testing 6. Have you ever had an HIV antibody test? No 7. When were you last tested for HIV antibodies? Never tested Less than a week ago weeks ago 6 months ago 8. Based on the results of your HIV antibody tests, what is your HIV status? No test/don tt know Negative Positive 9. If you have a regular partner, do you know the t result of his HIV antibody test? Positive 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? Undetectablee Detectable Don t know / unsure Yes 5 7 months ago 6 years ago 7 years ago 8 More than years ago Negative If you are HIV-positiveH e please complete the next four 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 Detectablee Don t knoww / unsure 5. What was your last CD count? < >500 5 Don t know/unsure Go to section G Surveyy continues on next page Page QGCPS 0/ _ Gay Community Periodic Survey: Queensland 0 A

30 Section G STI testing 55. 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 56. Where did you go the last time you had a syphilis s test? My regular GP Another GP Sexual healthh clinic HIV clinic 5 Never tested 57. Were you aware that someonee could have syphilis s without any physical symptoms? Yes, I was aware No, I wasn't aware 58. Were you aware you could get syphilis through oral sex? Yes, I was aware No, I wasn't aware 59. Were you diagnosed with any sexually transmitted infection (other than HIV) in the last months? Yes Noo 60. 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 AA few Some All Not been diagnosed with an STI in the last monthss 5 Go to section H Section H HIV medication to preventt HIV 6. 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 6. In the last 6 months, have you taken any anti-hiv medication to prevent HIV infection: Before anal sex without a condom Yes No After anal sex without a condom e.g.. PEP Yes No Section I Drug use 6. How often have you used t Amyl/poppers Marijuana Viagra/Cialis etc e Ecstasy Speed Cocaine Crystal meth GHB Ketamine (special K) Heroin Meow meow (mephedrone) Any other drugg Never 6. How often have you injected drugs in the last 6 months? Every week Once or twice At least monthly Never 65. In the last 6 months, m how often have you used party drugs for the purpose of o sex? Every week Once or twice At least monthly Never 66. In the last 6 months, m 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, QAHC, and QPP websites for the results of this survey these drugs in Once/ twice n the last 6 months? At least Every monthly week Go to section I Page QGCPS 0/ _ A Gay Community Periodic Survey: Queensland 0