Trends in sexual risk behaviour and HIV incidence among MSM in North America

Published: July 20, 2010

Trends in sexual risk behaviour and HIV incidence among MSM in North America

P. Hoong1, F. Fahim2, A. Kuang1, R.S. Hogg3, K. Vasarhelyi3

1Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada, 2Langara College, Faculty of Psychology, Vancouver, Canada, 3BC Centre for Excellence in HIV/AIDS, Vancouver, Canada

Background: Incidence of HIV among men who have sex with men (MSM) has recently been increasing in North America. We hypothesize that this is indicative of changes in sexual practices. The goal of the study is to conduct a systematic review of the literature to assess trends in HIV incidence and unprotected anal intercourse (UAI) among MSM.

Methods: Peer-reviewed English language literature from January 1, 1980 to Dec. 31, 2008 were obtained using a MEDLINE search on HIV incidence and sexual risk behaviours among MSM. Data on HIV incidence and UAI were extracted and summarised using ANOVA. Trend lines were fitted using a quadratic fit line.

Results: Thirty-one articles were reviewed. Several studies reported incidence and risk behaviour data over multiple years. HIV incidence decreased initially, but has been increasing since about 1998 (p< 0.001) (Fig.1A). Similarly, the proportion of MSM reporting UAI has increased since 1995, after an initial decrease (p< 0.001) (Fig 1B). Trends for receptive and insertive UAI showed similar patterns, although these were not significant.

Conclusions: MSM continue to be at high risk for HIV infection. We found that HIV incidence and frequency of UAI have been increasing in North America over approximately the same period. This suggests that UAI may continue to be an important factor contributing to HIV infection. In the future, we will repeat these analyses on other sexual risk behaviours, including recreational non-injection drug use and extreme sexual risk behaviours. Our findings point to continued need for prevention of sexual risk behaviour among MSM.

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