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How are HIV-negative and HIV-positive gay men changing over time and what does it mean for health promotion?
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How are HIV-negative and HIV-positive gay men changing over time and what does it mean for health promotion?

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Martin Holt (NCHSR) discusses the findings of the Gay Periodic Surveys and concludes that support services will increasingly face ageing and sexuality issues with HIV-positive gay men, and that …

Martin Holt (NCHSR) discusses the findings of the Gay Periodic Surveys and concludes that support services will increasingly face ageing and sexuality issues with HIV-positive gay men, and that tradtionally oriented services may find it harder to engage with HIV-negative gay men. This presentation was given at the AFAO/NAPWA Gay Men's HIV Health Promotion Conference in May 2012.

Published in: Health & Medicine
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  • 1. How are HIV-negative and HIV-positive gaymen changing over time and what does it meanfor health promotion? Martin Holt, Evelyn Lee, Garrett Prestage, Iryna Zablotska, John de Wit, Limin Mao National Centre in HIV Social Research
  • 2. Rationale• Gay men are not a static population; their social and sexual relationships (with each other & other people) change over time• This challenges health promotion and HIV prevention in: – Understanding gay men as a target group – Identifying their needs – Reaching out and engaging gay men• The Gay Community Periodic Surveys provide a mechanism to monitor changes over time.
  • 3. Analysis• A comparison of HIV-negative and HIV-positive men in 2000/01 and 2008/09: – Comparing negative and positive men within each time period – Comparing neg-neg and pos-pos over ten years• Allowed identification of shared changes and those specific to each group• Data from all GCPS were included (ACT, NSW, QLD, SA, VIC, WA)• A total of 21,620 responses were analysed.
  • 4. Mean age (in years)5045 42.140 39.235 34.9 35.73025 HIV-positive men are significantly older in both periods HIV-positive (p<0.001). HIV-negative2015 The age difference is growing over time.1050 2000-2001 2008-2009
  • 5. Paid employment100% HIV-negative men are significantly more likely to have paid work in both periods (p<0.001). However, the gap has closed over time. 82% 81%80% 70% 66%60% HIV-positive40% HIV-negative20% 0% 2000-2001 2008-2009
  • 6. University education100% HIV-negative men are significantly more likely to have a university degree in both periods (p<0.001).80% There has been a dramatic increase in university participation over time in both groups.60% However, the gap has widened over time. 53% HIV-positive 42%40% HIV-negative 24%20% 17% 0% 2000-2001 2008-2009
  • 7. Extensive social engagement with gay men HIV-positive men are more likely to have gay friends and spend time with gay men in 2000-2001 (p<0.01) and 2008-2009 (p<0.001).100% 95% 93% The decline in social 81% engagement is80% much greater 73% among HIV-negative men.60% HIV-positive40% HIV-negative20% 0% 2000-2001 20008-2009
  • 8. 10+ partners in last 6 months100% HIV-positive men are more likely to have 10+ partners in the six months prior to survey in both periods (p<0.001).80% There have been declines in no. of partners in both groups over time, and both groups have become more similar.60% HIV-positive 42%40% HIV-negative 34% 27% 23%20% 0% 2000-2001 2008-2009
  • 9. Men in seroconcordant relationships100% HIV-positive men are less likely to be in a seroconcordant relationship in both periods (p<0.001).80% Both groups have become more likely to be in a seroconcordant relationship, and the gap has narrowed slightly.60% 43% HIV-positive 40%40% HIV-negative 27% 22%20% 0% 2000-2001 20008-2009
  • 10. Unprotected anal intercourse with casual partners100% HIV-positive are more likely to report UAIC in both periods (p<0.001). 80% HIV-positive men have become much more likely to report UAIC, compared with HIV-negative men (the gap has widened). 60% HIV-positive 45% HIV-negative 40% 38% 20% 20% 18% 0% 2000-2001 2008-2009
  • 11. Any HIV disclosure to casual partners100% Although HIV disclosure has become more common in both groups, the gap has widened over time.80%60% 55% 48% HIV-positive40% HIV-negative 32% 25%20% 0% 2000-2001 20008-2009
  • 12. Summary• Gay men in the GCPS have become: – More likely to attend university – Less likely to exclusively spend time with gay men or have gay friends – Less likely to have 10+ male sex partners – More likely to be in a seroconcordant relationship – More likely to engage in UAIC – More likely to disclose HIV status to casual partners
  • 13. Summary• HIV-positive men have become more similar to HIV- negative men in: – Paid employment (increasing) – No. of male partners (declining) – Being in a seroconcordant relationship (increasing)• The two groups have diverged in: – Age – University education – Social engagement with gay men – Unprotected anal intercourse with casual partners – HIV disclosure
  • 14. Conclusions• Workforce participation and educational attainment have improved among HIV-positive gay men, but they still lag behind their HIV-negative peers.• Support services will need to address issues of HIV, sexuality and ageing among HIV-positive men.• HIV-negative men appear to be a diversifying group and may become more difficult to engage.• Promoting effective relationship negotiation, HIV disclosure and risk reduction strategies with all gay men appears warranted.
  • 15. Acknowledgments/further information• Thanks to: the participants, the recruiters, AIDS Councils, state/territory health departments.• Paper co-authors: Holt, M., Lee, E., Prestage, G. P., Zablotska, I., De Wit, J., & Mao, L. (in press). The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian Gay Community Periodic Surveys, 2000-2009. AIDS Care.• For a copy, please email m.holt@unsw.edu.au

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