By 2007, two-thirds of gay men in the UK had taken an HIV test at least once, a rise from below 50% in 2002. However this has not led to widespread disclosure of HIV status with sexual partners, according to the findings of the most recent Gay Men’s Sex Survey.
The survey also found that while the number of men aware of post-exposure prophylaxis has risen dramatically, only 3% of men had actually tried to access it after taking a sexual risk.
The annual Gay Men’s Sex Survey uses a questionnaire that is available online (promoted by a number of commercial gay, health promotion and gay community websites) and in a booklet version (distributed by health promotion organisations). In 2007 6,205 valid responses were received from gay or bisexual men living in the UK.
The researchers warn that an annual cross-sectional (snap-shot) survey is not ideal for measuring change over time. The organisations promoting the survey and the venues where it is distributed have changed from year to year, as have the relative proportions of surveys completed online and in booklet form.
Nonetheless, the online sample is less subject to these variations and is considered more representative of the wider gay population than the booklet sample. For these reasons, the following data on testing only reflects the men recruited online.
In 2001, 46% of men had ever taken an HIV test. This rose to 49% in 2002, before rising steadily to 62% in 2006 and 66% in 2007.
The men least likely to have ever had an HIV test were of white British or Asian ethnicity, younger, not in a relationship, and tended to live away from the larger gay cities.
As the number of men ever tested has increased, the proportion of men diagnosed with HIV has too. It has risen from 4% in 2001 to just under 10% in 2007.
It has sometimes been suggested that there could be an HIV-prevention benefit to more men testing, and then disclosing their HIV status to sexual partners. However these data do not suggest that such discussions are widespread.
Looking only at those men who had casual sex in the past year, over half of men never ask casual partners about their HIV status (57%) or talk about their own status (54%).
Men who have not been diagnosed with HIV were less likely to either ask or tell than men with diagnosed HIV. A total of 21% of men with HIV always disclose their status to casual partners, 46% sometimes do and 32% never do.
Men with a higher number of sexual partners were more likely to sometimes ask or tell.
The survey also shows that 56% of the respondents had heard of post-exposure prophylaxis (PEP). This figure has risen from 22% in the 2003 survey and 38% in 2005, probably as a result of a number of awareness campaigns.
While over half of respondents knew the purpose of PEP and that it should be started within hours of a sexual exposure, only a third knew that it is a one month-course of anti-HIV drugs.
Moreover, even fewer were aware of the practicalities of getting access to it. Most respondents did not know that it should be available in most UK hospitals, or that in practice, it can be hard to get hold of.
Furthermore, the number of men actually attempting to get PEP remains limited. Only 3.4% of respondents (212 men) had tried to do so, and 2.4% (146 men) had actually taken it. However these figures have risen since the 2003 and 2005 surveys.
The researchers note that this is not because men do not think PEP would be acceptable to them. When they asked respondents if they would consider trying to get PEP if they thought they had been exposed to HIV, only 4% said no.