SURVEY REVEALS INCONSISTENT CONDOM USE, LACK OF HIV DISCOURSE AMONG COHORT OF YOUNG GAY AND BISEXUAL MEN IN ROCHESTER, N.Y.

At the National Conference on Undergraduate Research in Salt Lake City today, results were released from a study of sexual risk-taking among a cohort of young gay and bisexual men in Rochester, N.Y. Results reveal inconsistent condom use and lack of discourse about HIV among participants, but stress similarities between gay and heterosexual students.

In a presentation today at the National Conference on Undergraduate Research, Sebastian White, a senior at Alfred University released findings from his research of sexual decision-making and risk-taking among a cohort of young gay and bisexual men in Rochester, N.Y.

97 men from Monroe (includes City of Rochester), Genesee, and Wayne counties participated in the Rochester Sex Study between October 2002 and January 2003. The study revealed inconsistent condom use among men who have sex with men (MSM) and a lack of discourse about HIV between partners in Rochester, findings which mirror trends found in similar samples of heterosexual college and college-age individuals.

The average age of respondents was 20. 90% reported being sexually active during the 12 months prior to surveying. 82% self-identified as gay and 16% as bisexual. 13% had only one sexual partner in the past year while 45% had 2-5 partners.

Average condom usage rates
46% of participants reported always using condoms during receptive anal intercourse. During insertive anal intercourse, 35% said they always used condoms. A recent study reported in the Chronicle of Higher Education reported that 50% of all college students use condoms inconsistently.

HIV and STD testing
51% of participants reported having been tested for HIV. Only one individual reported being HIV-positive, and 7% reported having been diagnosed with an STD, most commonly gonorrhea. The men who had never been tested for HIV offered many reasons: "I don't know where to test" (31%), "I am afraid of the results" (24%), and "I don't worry about HIV" (24%).

Those most likely to be tested for HIV were men who scored high on the Rosenberg Self-Esteem Scale and who scored higher than average on the study's risk-taking index. Age and family income did not correlate. Those who took more sexual risks were also more likely to have been tested for STDs.

When Unprotected Sex Happens
The data collected in this study suggests that familiarity may foster risk. Men who met their partners through friends and coworkers, in class, and at gay community events were more likely to have engaged in risky sexual behavior. Interestingly, men who met their partners in more anonymous settings such as through personal ads or online took less sexual risks. Among a number of options, half of respondents reported meeting through friends, a traditional source of partners, and half reported meeting partners online, an alternative venue.

Men who had sex under the influence of drugs or alcohol were more likely to engage in unprotected sex. Similarly, men who had sex with a significantly older partner were more likely to have unprotected sex.

About the sample
The sample was overwhelmingly white (84%) and largely middle- to upper-income (more than half reported families incomes of $55,000 per year or more). In addition, participants were primarily urban/suburban with 43% of participants coming from the center city and 48% from the immediate suburbs of Monroe County.

Discussion & Conclusions
These data corroborate previous public health research that young gay and bisexual men are more likely to have unprotected sex when drinking, when using drugs, and when having sex with a boyfriend or someone they know. Furthermore, in many cases they are more likely to have unprotected sex when they have low self-esteem or are feeling depressed.

Because drinking and drug use can exacerbate risk-taking, the need for the development of positive gay community institutions and social outlets that are alternatives to bars and nightclubs must be emphasized in any risk-reduction strategy. Likewise, new ways of thinking about and discussing sexuality are necessary in order to reduce the heavy social stigma still attached to homosexuality in the United States today.

The places where young gay and bisexual men meet their partners are places not unlike those where young heterosexuals meet as well. Most met their partners through friends, and like heterosexuals, an increasingly substantial number are meeting their partners online.

Because of low condom usage rates found in this study and in studies of heterosexual college students, messages about the importance of condoms and their promotion and distribution needs to be renewed for all students.

High rates of multipartnerism should compel sexual health education programs to emphasize the importance of limiting one's lifetime sexual partners as one risk prevention strategy.

Low rates of HIV testing among the sample underscores the need for HIV testing to become a routine part of health office visits for all sexually active young people.

The success of public health prevention messages is unclear. While no young men reported "I don't think I can get HIV" as the reason they had not been tested for HIV--perhaps a testament to the success of prevention efforts--one-quarter said "I don't worry about HIV." With an additional one-quarter reporting that they had never been tested because they are afraid of the results, the need for creative methods of encouraging HIV testing persists.

Though continually stigmatized for their sexual attraction and behavior, young gay and bisexual men are more like their heterosexual peers than previously thought. Addressing young people's risk-taking rather than marginalizing young gay men for their sexual behavior is a public health strategy that may be effective in reducing sexual risk. Public health officials should refocus efforts away from sexual orientation and toward youth as a way to identify at-risk populations.

The study was funded in part by the Alfred University Division of Social Sciences and the Alfred University Research Grants for Undergraduate Students (ARGUS) program.