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AIDS Education and Prevention, 16(1), 112, 2004 2004 The Guilford Press
Against a background of increasing unprotected anal intercourse (UAI) in the Sydney gay community (and internationally), complementary cross-sectional surveys of sexual practice were conducted among gay men of Asian background in 1999 (N = 319) and 2002 (N = 457). Self-complete questionnaires were used with recruitment at gay bars, gay social functions, and gay sex-on-premises venues. In 2002, self-report HIV status was 73.7% HIV-negative, 3.6% HIV-positive, and 22.8% unknown status (no significant change from 1999). Over time, the proportion of gay Asian men who reported any UAI with regular partners (in the previous 6 months) did not change significantly: 27.9% in 1999; 24.3% in 2002. Similarly, rates of any UAI with casual partners remained steady: 16.3% in 1999; 14.4% in 2002. Only one factor, more extensive engagement in esoteric practices (fisting, sadomasochism, group sex, rimming), was independently associated with sexual risk practice. This suggests that risk in this population of gay men, as in others, has more to do with the sexual cultures in which men are embedded rather than individual-level differences.
A number of studies conducted in North America point to high rates of unprotected anal intercourse (UAI) among Asian (and Pacific Islander) men who have sex with men (MSM), though not necessarily higher than among other sections of the MSM population. These studies come from both the United States (Choi, Coates, Catania, Lew, & Chow, 1995; Choi, Han, Hudes, & Kegeles, 2002; Lemp et al., 1994; Matteson, 1997; Seage et al., 1997; Shapiro & Vives, 1999) and Canada where South Asian origin MSM were indeed more likely to report UAI than their European-origin counterparts (Ratti, Bakeman, & Peterson, 2000). High risk was variously associated with younger age and less education (Shapiro & Vives, 1999); self-identification as gay or bisexual (Choi et al., 2002); less acculturation to the majority culture (Ratti et al., 2000); multiple sex partners (Shapiro & Vives, 1999; Choi et al., 2002); having a steady partner, having been tested for HIV, and not perceiving peer norms support-
Paul Van de Ven and Limin Mao are with the National Centre in HIV Social Research, University of New South Wales, Sydney, Australia. Garrett Prestage is with the National Centre in HIV Epidemiology...