• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of straninfSexually Transmitted InfectionsCurrent TOCInstructions for authors
Sex Transm Infect. Oct 2005; 81(5): 367–372.
PMCID: PMC1745039

Increase in HIV sexual risk behaviour in homosexual men in Scotland, 1996–2002: prevention failure?


Objective: To investigate trends in homosexual men's sexual risk behaviour for HIV infection in Scotland.

Methods: Cross sectional surveys in 1996, 1999, and 2002 were carried out in "gay" bars in Glasgow and Edinburgh, Scotland. 6508 men—2276 (79% response rate) in 1996, 2498 (78%) in 1999, and 1734 (62%) in 2002.

Results: In 1996, 10.7% of men surveyed and in 1999, 11.2% reported unprotected anal intercourse (UAI) with casual partners, compared with 18.6% in 2002 (p<0.001). There was also a significant increase in men reporting that they "knew" their casual partners' HIV status, despite no increase in HIV testing among men who reported UAI with casual partners. In 2002, increases in UAI with more than one partner, in UAI with casual partners and in reporting seroconcordance remained significant after adjusting for confounding factors including HIV testing status and demographic characteristics.

Conclusions: High risk sexual behaviour among homosexual men in Scotland increased between 1999 and 2002. Men showed increased confidence of shared antibody status, despite no increase in HIV testing, or evidence of discussion of HIV status. Explanations for this must include consideration of a cultural shift in the perception of HIV and "prevention failure" on the part of governments and health agencies.

Full Text

The Full Text of this article is available as a PDF (77K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Wolitski RJ, Valdiserri RO, Denning PH, Levine WC. Are we headed for a resurgence of the HIV epidemic among men who have sex with men? Am J Public Health. 2001 Jun;91(6):883–888. [PMC free article] [PubMed]
  • Van de Ven P, Prestage G, Crawford J, Grulich A, Kippax S. Sexual risk behaviour increases and is associted with HIV optimism among HIV-negative and HIV-positive gay men in Sydney over the 4 year period to February 2000. AIDS. 2000 Dec 22;14(18):2951–2953. [PubMed]
  • Dodds JP, Nardone A, Mercey DE, Johnson AM. Increase in high risk sexual behaviour among homosexual men, London 1996-8: cross sectional, questionnaire study. BMJ. 2000 Jun 3;320(7248):1510–1511. [PMC free article] [PubMed]
  • Dodds JP, Mercey DE, Parry JV, Johnson AM. Increasing risk behaviour and high levels of undiagnosed HIV infection in a community sample of homosexual men. Sex Transm Infect. 2004 Jun;80(3):236–240. [PMC free article] [PubMed]
  • Elford Jonathan, Bolding Graham, Sherr Lorraine. High-risk sexual behaviour increases among London gay men between 1998 and 2001: what is the role of HIV optimism? AIDS. 2002 Jul 26;16(11):1537–1544. [PubMed]
  • Calzavara Liviana, Burchell Ann N, Major Carol, Remis Robert S, Corey Paul, Myers Ted, Millson Peggy, Wallace Evelyn. Increases in HIV incidence among men who have sex with men undergoing repeat diagnostic HIV testing in Ontario, Canada. AIDS. 2002 Aug 16;16(12):1655–1661. [PubMed]
  • Dukers Nicole H T M, Spaargaren Joke, Geskus Ronald B, Beijnen Jos, Coutinho Roel A, Fennema Han S A. HIV incidence on the increase among homosexual men attending an Amsterdam sexually transmitted disease clinic: using a novel approach for detecting recent infections. AIDS. 2002 Jul 5;16(10):F19–F24. [PubMed]
  • Katz Mitchell H, Schwarcz Sandra K, Kellogg Timothy A, Klausner Jeffrey D, Dilley James W, Gibson Steven, McFarland William. Impact of highly active antiretroviral treatment on HIV seroincidence among men who have sex with men: San Francisco. Am J Public Health. 2002 Mar;92(3):388–394. [PMC free article] [PubMed]
  • Murphy G, Charlett A, Brown AE, Gill ON, Parry JV. Is HIV incidence increasing in homo/bisexual men attending GUM clinics in England, Wales and Northern Ireland? Commun Dis Public Health. 2004 Mar;7(1):11–14. [PubMed]
  • Hart GJ, Flowers P, Der GJ, Frankis JS. Homosexual men's HIV related sexual risk behaviour in Scotland. Sex Transm Infect. 1999 Aug;75(4):242–246. [PMC free article] [PubMed]
  • Hart GJ, Williamson LM, Flowers P, Frankis JS, Der GJ. Gay men's HIV testing behaviour in Scotland. AIDS Care. 2002 Oct;14(5):665–674. [PubMed]
  • Flowers P, Hart GJ, Williamson LM, Frankis JS, Der GJ. Does bar-based, peer-led sexual health promotion have a community-level effect amongst gay men in Scotland? Int J STD AIDS. 2002 Feb;13(2):102–108. [PubMed]
  • Williamson LM, Hart GJ, Flowers P, Frankis JS, Der GJ. The Gay Men's Task Force: the impact of peer education on the sexual health behaviour of homosexual men in Glasgow. Sex Transm Infect. 2001 Dec;77(6):427–432. [PMC free article] [PubMed]
  • Elford Jonathan, Hart Graham. If HIV prevention works, why are rates of high-risk sexual behavior increasing among MSM? AIDS Educ Prev. 2003 Aug;15(4):294–308. [PubMed]
  • Vanable PA, Ostrow DG, McKirnan DJ, Taywaditep KJ, Hope BA. Impact of combination therapies on HIV risk perceptions and sexual risk among HIV-positive and HIV-negative gay and bisexual men. Health Psychol. 2000 Mar;19(2):134–145. [PubMed]
  • Williamson Lisa M, Hart Graham J. HIV optimism does not explain increases in high-risk sexual behaviour among gay men in Scotland. AIDS. 2004 Mar 26;18(5):834–835. [PubMed]

Articles from Sexually Transmitted Infections are provided here courtesy of BMJ Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...