HIV-Positive Gay and Bisexual Men

Abstract

Behavioral research focused on people living with HIV has shown that the minority report sexual practices that would place their partners at high risk of HIV infection. Reviews of the literature have found that about 70% of heterosexual HIV-positive persons remain sexually active after seroconversion, whereas only a third of these individuals report vaginal intercourse without the use of a condom (Crepaz and Marks, 2002; Kalichman, 2000). Similar rates of unprotected anal intercourse have been documented among HIV-positive gay and bisexual men (Kalichman et al., 2002a; Parsons et al., 2003). Recent studies have reported increases in sexual risk behaviors among gay and bisexual men in the US, Europe, and Australia (Chen et al., 2002; Ekstrand et al., 1999; Kalichman et al., 2002b; Stolte et al., 2001; Van de Ven et al., 2000). In addition, young gay and bisexual men, and particularly men of color, remain at considerable risk of HIV infection as a result of unprotected anal sex (CDC, 2002; Koblin et al., 2000). In New York City, 33% of young African American gay and bisexual men are estimated to be HIV positive and rates among Latinos are also quite high (Valleroy et al., 2000). Other studies have shown increases in HIV incidence (Calzavara et al., 2002) and sexually transmitted infection (STI) rates among young men who have sex with men (Fox et al., 2001). The number of syphilis cases in San Francisco increased from six in 1998 to 115 in 2001, and cases of rectal gonorrhea among gay and bisexual men increased from 162 in