Asian gay men’s sex survey reports high levels of sex without condoms

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The world’s second-largest sex survey of men who have sex with men, focusing mainly on men in East and Southeast Asia, has found that 46% of those who had anal intercourse reported inconsistent condom use with casual partners, and higher levels of unprotected sex with regular partners.

The survey has produced findings across a wide range of indicators that are remarkably similar to the world’s largest survey of gay men's sexual behaviour, the UK's annual Gay Men’s Sex Survey (GMSS) conducted by Sigma Research.

The success of the English-language survey, hosted by the gay Asian website www.fridae.com, has led to a larger 2010 survey in nine languages ranging from Hindi to Japanese – see below.

Glossary

stigma

Social attitudes that suggest that having a particular illness or being in a particular situation is something to be ashamed of. Stigma can be questioned and challenged.

cost-effective

Cost-effectiveness analyses compare the financial cost of providing health interventions with their health benefit in order to assess whether interventions provide value for money. As well as the cost of providing medical care now, analyses may take into account savings on future health spending (because a person’s health has improved) and the economic contribution a healthy person could make to society.

insertive

Insertive anal intercourse refers to the act of penetration during anal intercourse. The insertive partner is the ‘top’. 

receptive

Receptive anal intercourse refers to the act of being penetrated during anal intercourse. The receptive partner is the ‘bottom’.

The 2009 survey was answered by nearly 8000 gay men. Twenty per cent of respondents were from the three non-Asian countries of the USA, Australia and the UK, and this may have influenced some results such as the HIV testing figures.

A quarter were from Singapore, where Fridae is based, 13% from Malaysia, 8% from Hong Kong and 6% from mainland China, six per cent from Thailand and about 3% each from Indonesia, the Philippines and Taiwan. There were also significant proportions from Japan, South Korea and Vietnam.

Findings that significantly differed from those of the UK GMSS included:

  • A higher proportion of men had ever taken an HIV test than in the UK (74%, versus 65% in the GMSS), though slightly fewer had tested in the last twelve months (51% versus 54%);
  • Five per cent who had tested and 3.7% of the whole group knew they had HIV, compared with 11.6% of testers and 9.8% of the whole group in the UK survey;
  • A lower proportion had high numbers of partners than in the UK (13% had had more than ten partners in the last year, compared with 19.5% with more than twelve partners in the last GMSS);
  • A higher proportion met partners on the internet and fewer in bars and clubs than in the UK, though the proportion meeting partners in saunas was identical.

Apart from these findings, the findings of the Asian and the UK surveys are remarkably similar.

The report on the survey – see www.msmsexsurvey.com– notes that 31% of men having sex with a regular partner and 21% having casual sex in the last year did not always use a condom. However this includes the 13% of men who had not had sex with a man at all in the last year plus 12% who did not have anal sex with regular partners and 17% who did not anal sex with casual partners.

This therefore understates the proportion of anal sex that was unprotected. In the full findings:

  • Fifty-eight per cent of men had had a regular partner and 62% had had casual sex;
  • Seventy-nine per cent of those with regular partners and 72% of those with casual partners had had anal sex;
  • Fifty-three per cent of those who had regular partners and 33% of those with casual partners had not consistently used condoms;
  • Sixty-seven per cent of those who had anal sex with regular partners, and 46% of those who had anal sex with casual partners, had not consistently used condoms.

For comparison, in the last GMSS, 53% of those who had had receptive anal sex and 52% who had had insertive anal sex had not always used a condom in the last year.

The age profile of the respondents was very similar to the GMSS, with a median age of 33 (34 in GMSS). This was an educated and well-travelled group, with two-thirds having had university education (61% in GMSS) and 64% of them having travelled out of their country of residence in the last year.

Eighty-two per cent identified as gay (86% in GMSS) and 15% as bisexual (8.5% in GMSS), with 7% reporting sex with a woman in the last year, the same proportion as in GMSS. Five point five per cent were married to a woman (in the GMSS 4.3% were married or in a primary relationship with a woman). Three quarters said they were comfortable with their sexuality, and about a third appeared socially isolated, saying they had “few or no” gay friends.

As noted above, the proportion having a large number of partners (over 10) was lower and the proportion who had been sexually abstinent was higher than in the GMSS (13% having had no sex with men versus 7% in GMSS).

Forty-five per cent of men were in a committed relationship (48% in GMSS) and 42% only had sex with their regular partner.

The internet was the most common way for men to meet each other: 72% had met someone through the internet in the last year (62% in the last GMSS, whose data was collected in 2007), 38% at saunas (the same as GMSS) and 28% in a club (52% in the GMSS at a “bar, pub or club”).

As indicated above, 5% of those tested for HIV tested positive. Of these 62% were taking antiretroviral medication and 51% had an undetectable viral load. HIV status made no difference to relationship status, with the same proportion reporting a regular partner; 70% of partners were not HIV positive themselves.

Although two-thirds agreed that “the best time to talk about HIV is before sex” only 20% had actually discussed HIV status before sex: this compares with 40% ‘sometimes’ and 10-20% ‘always’ doing so in the GMSS.

The last section of the survey asked about HIV stigma. Nearly 40% of respondents knew someone with HIV and 14% had had sex with someone they knew had HIV. Three-quarters of respondents said they would befriend someone with HIV but only 60% would share food with them and 30% would have sex with them (these results included the HIV positive respondents).

Fridae’s founder, Dr Stuart Koe, commented:

“Our survey started in 2004 mostly as an adjunct to the local study done in Singapore. By 2006, we were collecting not only far more results than the pen and paper studies, but were more cost-effective to market, and had more candid answers about sensitive topics.”

The 2010 survey, the 2010 Asia Internet MSM Sex Survey, is currently online at www.2010aimss.comand will run until 28 February.