Differing trends in sexual risk behaviours in three Australian states: New South Wales, Victoria and Queensland, 1998–2006
Iryna B. Zablotska A C , Garrett Prestage B , Andrew E. Grulich B and John Imrie AA National Centre in HIV Social Research, University of New South Wales, Sydney, NSW 2052, Australia.
B National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW 2010, Australia.
C Corresponding author. Email: i.zablotska@unsw.edu.au
Sexual Health 5(2) 125-130 https://doi.org/10.1071/SH07076
Submitted: 4 October 2007 Accepted: 24 January 2008 Published: 2 June 2008
Abstract
Background: In Australia, the HIV epidemic is concentrated among gay men. In recent years, the number of new diagnoses stabilised in New South Wales (NSW), but increased in other states. We reviewed the trends in sexual behaviours to explain this difference. Methods: We used the Gay Community Periodic Surveys in NSW, Victoria and Queensland during 1998–2006 and restricted analyses to the 30–49 year olds who contribute most of the HIV cases. We used the χ2-test for trends in unprotected anal intercourse with casual partners (UAIC) and regular partners, number of partners, type of relationships, knowledge of HIV serostatus and its disclosure. We compared behaviours of HIV-positive and -negative men and men across states using logistic regression adjusted for the year of report. Results: Trends in behaviours differed across the states: following a period of increase, UAIC prevalence declined in NSW since 2001, but continued to increase in Victoria and Queensland. There were other changes in NSW that were not observed in Victoria and Queensland: a decline in factors increasing HIV risk (the proportions of men with multiple sex partners and men engaging in UAIC and not knowing or not disclosing HIV serostatus) and an increase in behaviours reducing it (the proportions of men in monogamous relationships and men disclosing HIV serostatus while having UAIC). Conclusion: There were patterns of declining HIV risk behaviours in NSW, and increasing risk behaviours elsewhere, that mirrored recent changes in HIV case notifications in Australia. These data suggest that behavioural surveillance can predict changes in HIV epidemiology.
Additional keywords: HIV, HIV serostatus disclosure, knowledge of HIV serostatus, regular relationships, unprotected sex with casual partners.
Acknowledgements
The authors would like to acknowledge the key community partners – the Australian Federation of AIDS Organisations, the National Association of People Living with HIV/AIDS, the AIDS Council of New South Wales and People Living with HIV/AIDS for being instrumental in the establishment of the behavioural surveillance in Australia and being a part of the partnership in HIV response. Many thanks go to all study participants for sharing their life experiences with the research team. We are also grateful to the New South Wales State Health Department, for their financial support to the studies and committed efforts in HIV prevention; and our thanks also go to the Victoria Department of Human Services and Victorian AIDS Council, the Queensland Health and Queensland Association for Healthy Communities for the ongoing work in HIV prevention and their support of the behavioural surveillance in Australia.
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