Barebacking among HIV-positive gay men in London.
OBJECTIVE
The objectives of this study were to examine the extent to which HIV-positive gay men in London intentionally seek unprotected anal intercourse ("barebacking") and the contribution this makes to total sexual risk.


METHODS
In 2002 to 2003, HIV-positive gay men surveyed in an HIV outpatient clinic or on the Internet were asked whether they had intentionally looked for anal sex without a condom in the previous 12 months.


RESULTS
Of 481 men in the clinic, 59 (12.3%) said they had intentionally looked for anal sex without a condom, 34 (7.1%) only with another HIV-positive man and 25 (5.2%) with a man of unknown or discordant HIV status. Overall, 85 men reported unprotected anal intercourse (UAI) with a casual partner of unknown or discordant HIV status; 20 (23.5%) had intentionally looked for UAI with such a partner, whereas the remaining 65 (76.5%) had not. Of 66 men surveyed on the Internet, 32 (48.5%) said they had intentionally looked for anal sex without a condom.


CONCLUSIONS
Although barebackers made a disproportionate contribution to sexual risk, three-fourths of high-risk sex reported by HIV-positive gay men in London was not intentional. The Internet sample overestimated the prevalence of barebacking among HIV-positive gay men because of sampling bias.
Elford
Jonathan
J
City University, London, U.K. j.elford@city.ac.uk
Bolding
Graham
G
Davis
Mark
M
Sherr
Lorraine
L
Hart
Graham
G
D000328:Adult; D006678:HIV / Q000254:growth & development*; D015658:HIV Infections / Q000635:transmission*; D018451:Homosexuality, Male; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008131:London; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000523:psychology*