Martindale, S.L., Strathdee S.A., Hogg R.S.,
Craib K.J.P., Pitchford W., Montaner J.S.G.,
O'Shaughnessy M.V., Schechter M.T.,
the Vanguard Project Team
BC Centre for Excellence in HIV/AIDS
and University of British Columbia
Vancouver, B.C., Canada
Funded by the National Health Research Development Program, Health Canada.

We.C.563

Risk Behaviours and HIV Prevalence Among a Cohort of Young Men Who Have Sex with Men in Vancouver

Objective

To describe sexual behaviour, substance use and HIV prevalence at baseline among a prospective cohort of young men who have sex with men (MSM) in the Greater Vancouver Region, British Columbia, Canada.

Methods

Eligible subjects are MSM aged 18 to 30 who have not previously tested positive for HIV. Subjects are recruited via publicity, community outreach, physicians and medical clinics. On an annual basis, participants are tested for HIV antibodies and complete self-administered questionnaires. Data collected include demographics, social support, depression, substance use, sexual activity with men and women, paid sex, and non-consensual sex.

Results

As of 12/31/95, a total of 497 eligible subjects had been recruited. Current HIV test results and completed questionnaires were available for 194 participants. Mean age was 25.6. Ethnic diversity: 82% Caucasian, 10% Asian/South Asian, 5% Aboriginal, and 1.5% Latino. Most participants (72%) were single; 28% were same-sex common-law relationships. The majority (93%) reported currently having sex only with men, and 4% with both sexes. Mean numbers of male sex partners: 12 in previous year (range: 1-120); and 56 in lifetime (range: 1-400). Most (88%) reported at least one casual male sex partner (<once/month) within previous year (mean: 15). Of these, 14% reported having unprotected insertive anal sex without ejaculation (10% with); and 12% reported having unprotected receptive anal sex without ejaculation (6% with). Of the 155 men with regular male sex partners („ once/month) in the previous year, 30% reported unprotected insertive anal sex without ejaculation (19% with); and 37% reported unprotected receptive anal sex without ejaculation (25% with). One-sixth had received money, goods or drugs in exchange for sex; half of them had done so within the previous year. Nearly a third reported having been forced to have sex at some point in their lives, of whom 38% were under the age of 12 at the time. Those reporting non-consensual sex in childhood or adolescence were much more likely to have been paid for sex (39% vs 11%, p=0.001). Drug use in previous year included poppers (32% of participants), cocaine (26%), and heroin (2%). Only 1% had injected drugs. Baseline HIV prevalence was 1% (2/194 reactive and 2 indeterminate).

Conclusions

A sizable proportion of young MSM in Vancouver are having unprotected sex, especially with their regular partners. Our preliminary data may underestimate the scope of these behaviours, as they likely represent men at lower risk in the spectrum. Sexual abuse in childhood and adolescence is clearly associated with subsequent sex trade activity; the relationship between sexual abuse and risk behaviours warrants further attention.

Steve Martindale
Vanguard Project Coordinator
BC Centre for Excellence in HIV/AIDS
St. Paul's Hospital
608 - 1081 Burrard Street
Vancouver, BC, V6Z 1Y6
Tel: (604) 687-2469; Fax: (604) 631-5464
E-mail: stevem@hivnet.ubc.ca