title: Trends in sexual behaviour among London homosexual men 1998-2003: implications for HIV prevention and sexual health promotion.
abstract: OBJECTIVE
  To examine changes in sexual behaviour among London homosexual men between 1998 and 2003 by type and HIV status of partner.
  
  
  METHODS
  Homosexual men (n=4264) using London gyms were surveyed annually between 1998 and 2003 (range 498-834 per year). Information was collected on HIV status, unprotected anal intercourse (UAI) in the previous 3 months, and type of partner for UAI. High risk sexual behaviour was defined as UAI with a partner of unknown or discordant HIV status.
  
  
  RESULTS
  Between 1998 and 2003, the percentage of men reporting high risk sexual behaviour with a casual partner increased from 6.7% to 16.1% (adjusted odds ratio (AOR) 1.36 per year, 95% confidence interval (CI) 1.26 to 1.46, p <0.001). There was no significant change in the percentage of men reporting high risk sexual behaviour with a main partner alone (7.8%, 5.6%, p=0.7). These patterns were seen for HIV positive, negative and never tested men alike regardless of age. The percentage of HIV positive men reporting UAI with a casual partner who was also HIV positive increased from 6.8% to 10.3% (AOR 1.27, 95% CI 1.01 to 1.58, p <0.05).
  
  
  CONCLUSIONS
  The increase in high risk sexual behaviour among London homosexual men between 1998 and 2003 was seen only with casual and not with main partners. STI/HIV prevention campaigns among London homosexual men should target high risk practices with casual partners since these appear to account entirely for the recent increase in high risk behaviour.
authors.affiliation: City University, Institute of Health Sciences, St Bartholomew School of Nursing and Midwifery, 24 Chiswell Street, London EC1Y 4TY, UK. j.elford@city.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Elford
authors.forename: G
authors.initials: G
authors.lastname: Bolding
authors.forename: M
authors.initials: M
authors.lastname: Davis
authors.forename: L
authors.initials: L
authors.lastname: Sherr
authors.forename: G
authors.initials: G
authors.lastname: Hart
mesh_terms: D000328:Adult; D015658:HIV Infections / Q000517:prevention & control*; D006293:Health Promotion; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008131:London; D008297:Male; D012309:Risk-Taking; D012747:Sexual Partners; D047568:Unsafe Sex