Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000

men presenting for voluntary counselling and testing, nearly tripling from 1.3% in
1997 to 3.7% in 1999.

Figure 25.

Rectal gonorrhoea and sexual risk behaviour among men who
have sex with men, San Francisco, USA, 1994-1998

100

cases of rectal gonorrhoea
per 100 000 population

O.
a)
CU
0
L.
CL

80
60
40

38

20

1990 1991 1992 1993 1994 1995 1996 1997 1998
- multiple partners in the past six months = unprotected anal sex in the past six months -- rectal gonorrhoea rate
Source: San Francisco Department of Public Health (California), USA, 1999
The San Francisco surveys show that risk behaviour is increasing most rapidly
among men under 25. In this age group, the percentage who had had unprotected
anal sex and multiple partners in the past six months rose from 22% in 1994 to 32%
in 1997. In 1997, 68% of the young men reporting unprotected anal sex with more
than one partner in the previous six months did not know the HIV status of at least
one of their partners. Alarming rates of continuing HIV infection have been detected
elsewhere in the country too, with the help of methods that allow public health officials to calculate what proportion of HIV tests are recent infections. Among nearly
3500 young gay men aged 15-22 in seven US cities, nearly 3% became newly
infected with HIV each year between 1994 and 1998, with the highest rate of new
infections seen in African-American men.
Complacency may not be the only factor involved in these worrying trends among
men under 25. It is possible that some young men are not using condoms because
they do not identify with the group of HIV-positive gay men, or because information
programmes have failed to reach or convince them. The time may have come for

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