Gay Men's Sexual Health Survey
The Gay Men's Sexual Health Survey is led by Lisa McDaid and was designed with Paul Flowers (Glasgow Caledonian University) and Graham Hart (SPHSU and now University College London). The survey has been conducted every three years since 1996. Since 2005, we have collected oral fluid samples to be tested anonymously for HIV to improve the estimate of HIV prevalence and undiagnosed infection in this population.
A 7th wave of data collection was carried out in June 2014. We surveyed 1339 men in gay bars and saunas in Glasgow and Edinburgh; 1151 provided oral fluid samples to be tested for HIV. Papers on the prevalence of HIV and undiagnosed infection and the factors associated with the frequency of HIV testing will be available in 2015.
Our first publication from the 2011 Survey was on the Awareness and Willingness to use Pre-Exposure Prophylaxis (PrEP - prescribing antiretrovirals to HIV negative people before sexual exposure to HIV to reduce transmission). Around half of the study participants were willing to take part in a PrEP study (n = 695; 49.9%) or to take PrEP on a daily basis (n = 756; 54.3%). Willingness to take PrEP was associated with lower levels of education, regular gay scene attendance, ‘high-risk’ unprotected anal intercourse (UAI) and testing for HIV or STI in the previous 12 months. Reasons for not wanting to participate in a PrEP study or take PrEP included perceptions of low personal risk of HIV and concerns with using medication as an HIV prevention method. Future biomedical HIV interventions may need to assess the links between sexual risk behaviour, testing, and potential PrEP use.
We also examined alcohol and drug use during unprotected anal intercourse (UAI) among gay and bisexual men in Scotland for the first time since the 1990s. 639 men reported UAI in the previous 12 months in 2011 and 14.4% were always and 63.4% were sometimes drunk during UAI; 36.3% always/sometimes used poppers; 22.2% always/sometimes used stimulant or other recreational/illicit drugs; and 14.1% always/sometimes used Viagra. Having UAI with more than one partner was associated with stimulant or recreational/illicit drug use during UAI and UAI with casual partners was more likely among men who reported poppers use. Men who reported always being drunk during UAI were more likely to report UAI with multiple, casual, and unknown/discordant HIV status partners than men who were not. Our study suggests alcohol and drug use could be quite common during UAI among gay and bisexual men in Scotland. Brief alcohol or drug interventions, particularly in clinical settings, have been advocated, but should be properly evaluated in this population.
Findings from the previous surveys are available on the study website - http://gaymensurvey.sphsu.mrc.ac.uk/home.html
Knussen C, Flowers P, McDaid L. Factors associated with recency of HIV testing amongst men residing in Scotland who have sex with men. AIDS Care 2014;26:297-303pubmed
Li J, McDaid L. Alcohol and drug use during unprotected anal intercourse among gay and bisexual men in Scotland: what are the implications for HIV prevention?. Sexually Transmitted Infections 2014;90:125-132open access
Wallace L, Li J, McDaid LM. HIV prevalence and undiagnosed infection among a community sample of gay and bisexual men in Scotland, 2005-2011: implications for HIV testing policy and prevention. PLoS One 2014;9:90805open access
Young I, Li J, McDaid L. Awareness and willingness to use HIV Pre-exposure Prophylaxis amongst gay and bisexual men in Scotland: implications for biomedical HIV prevention. PLoS One 2013;8:e64038open access
McDaid LM, Hart GJ. Serosorting and strategic positioning during unprotected anal intercourse: are risk reduction strategies being employed by gay and bisexual men in Scotland?. Sexually Transmitted Diseases 2012;39:735-738pubmed
McDaid LM, Hart GJ. Willingness to participate in future HIV prevention studies among gay and bisexual men in Scotland, UK: a challenge for intervention trials. AIDS & Behavior 2012;16:1420-1429pubmed open access
Knussen C, Flowers P, McDaid L M, Hart GJ. HIV-related sexual risk behaviour between 1996 and 2008, according to age, among men who have sex with men (Scotland). Sexually Transmitted Infections 2011;87:257-9pubmed open access
McDaid LM, Hart G. Increased HIV testing and reduced undiagnosed infection among gay men in Scotland, 2005-2008: support for the opt-out testing policy?. Sexually Transmitted Infections 2011;87:221-4pubmed open access
McDaid L M, Weiss H A, Hart G. Circumcision among men who have sex with men in Scotland: Limited potential for HIV prevention. Sexually Transmitted Infections 2010;86:404-6pubmed open access
McDaid LM, Hart GJ. Contact with HIV prevention services highest in gay and bisexual men at greatest risk: cross-sectional survey in Scotland. BMC Public Health 2010;10:798pubmed open access
McDaid LM, Hart GJ. Sexual risk behaviour for transmission of HIV in men who have sex with men: recent findings and potential interventions . Current Opinion in HIV/AIDS 2010;5:311-5pubmed
Williamson LM, Flowers P, Knussen C, Hart GJ. HIV testing trends among gay men in Scotland (1996-2005): implications for HIV testing policies and prevention. Sexually Transmitted Infections 2009;85:550-4pubmed open access
Williamson LM, Dodds JP, Mercey DE, Hart GJ, Johnson AM. Sexual risk behaviour and knowledge of HIV status among community samples of gay men in the UK. AIDS 2008;22:1063-70pubmed open access
Williamson LM, Hart GJ. HIV prevalence and undiagnosed infection among a community sample of gay men in Scotland, UK. Journal of Acquired Immune Deficiency Syndromes 2007;45:224-230pubmed
Williamson LM, Dodds JP, Mercey JE, Johnson AM, Hart GJ. Increases in HIV-related sexual risk behaviour among community samples of gay men in London and Glasgow: how do they compare?. Journal of Acquired Immune Deficiency Syndromes 2006;42:238-41pubmed
Hart GJ, Williamson L M. Increase in HIV sexual risk behaviour in gay men in Scotland, 1996-2002: prevention failure?. Sexually Transmitted Infections 2005;81:367-72pubmed
Hart GJ, Williamson LM, Flowers P. Good in parts: the Gay Men’s Task Force in Glasgow – a response to Kelly. AIDS Care 2004;16:159-165pubmed
Williamson LM, Hart GJ. HIV optimism does not explain increases in high-risk sexual behaviour among gay men in Scotland. AIDS 2004;18:834-835
Elford J, Hart G, Sherr L, Williamson LM, Bolding G. Peer led HIV prevention among gay men in Britain: expanding the evidence base [editorial]. Sexually Transmitted Infections 2002;78:158-159
Flowers P, Hart G, Williamson L, Frankis J, Der G. Does bar-based, peer-led sexual health promotion have a community-level effect amongst gay men in Scotland?. International Journal of STD & AIDS 2002;13:102-108pubmed
Hart G, Williamson L, Flowers P, Frankis J, Der G. Gay men's HIV testing behaviour in Scotland. AIDS Care 2002;14:665-674pubmed
Williamson LM, Hart GJ, Flowers P, Frankis J, Der G. The Gay Men's Task Force: the impact of peer education on the sexual health behaviour of homosexual men in Glasgow. Sexually Transmitted Infections 2001;77:427-432