High-Risk Sex on Rise, Conference Told

An alarming increase in high-risk sexual behavior among young gay males, once thought to be restricted largely to San Francisco, is spreading rapidly throughout North America and Europe, researchers said here Monday at the 11th International Conference on AIDS.

Gay males are the group most at risk of HIV infection in industrialized countries and account for just under half of all new HIV infections in the United States. The increase in high-risk sex threatens to reverse hard-won gains made by AIDS prevention efforts, experts said. The risk is especially high among young African American and Latino males, who have recently shown the greatest increase in infection rates.

“The epidemic of HIV [the human immunodeficiency virus that causes AIDS] among young gay men is not only an individual tragedy but is certainly also a major public health concern,” said psychologist John de Wit of the University of Utrecht in the Netherlands.

“Young gay males have not seen their friends and lovers die of AIDS, which is a powerful stimulus to behavioral change, and are not taking precautions,” said Dr. Michael Rekart of the University of British Columbia.

“Who’s going to tell them what to do?” added Stephen Leblanc of ACT UP Golden Gate, an activist group. “Their parents won’t. The government won’t.”

Canadian researchers found that gay males who were abused as children were twice as likely to engage in high-risk activity as those who had not been abused. “These results suggest that sexual-abuse counseling should be integrated into HIV-prevention efforts,” said Dr. Steffanie Strathdee, also of the University of British Columbia.

Studies in San Francisco have shown that young gay males are two to three times more likely to be HIV-positive than those older than 30. Typically, about a quarter of them had engaged in unprotected anal sex in the year before the surveys. Now, however, similar results are being found elsewhere.

Epidemiologist Linda Valleroy of the U.S. Centers for Disease Control and Prevention will report today on a new study from six urban areas, including Dade County in Florida, Dallas County in Texas and Los Angeles. She found that 7% of gay males between the ages of 15 and 22 were HIV-positive and that 39% had unprotected anal sex in the previous six months.

“The figures are high, very high, especially if we consider that these young men have become sexually active in an era in which massive effort was exerted to increase awareness of HIV risk behaviors and to promote safer sex,” De Wit said.

Similar results were found independently in studies in Pittsburgh, Boston, Vancouver and Amsterdam, De Wit said.

But the trend can be reversed, according to researchers.

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Dr. Susan M. Kegeles of UC San Francisco will report Wednesday at the conference in this British Columbia city on the success of intervention measures in three small West Coast communities. The Mpowerment project included the creation of a young gay men’s community center run by gay males. Its program involved informal outreach efforts among friends, formal outreach at social events and small-group intervention.

After six months, the researchers reported a 32% drop in participants’ high-risk behavior with casual partners and a 26% reduction in such behavior by the participants with their steady boyfriends.

AIDS Project Los Angeles today is scheduled to unveil the first major advertising campaign aimed specifically at young gay men. Called “There’s Life After Sex,” the television, print and billboard ads go beyond the “use a condom” message of earlier campaigns, presenting a positive message of self-esteem and worth to the community.