RISK BEHAVIOR, ANTI-HIV AND ANTI-HEPATITIS-B CORE PREVALENCE IN CLINIC AND NON-CLINIC SAMPLES OF GAY MEN IN ENGLAND, 1991-1992

Objective: To describe the sexual risk behaviour of and HIV and hepatitis B antibody prevalence in gay men in England. Design: Cross-sectional. Respondents: Gay men recruited from community settings (bars, clubs, gay organizations) and genito-urinary clinics in London, Manchester, the Midlands and Bristol; men who participated in an earlier study. Methods: Interview including demographic information, sexual behaviour, partner type and health service use. Subjects donated saliva, which was screened for antibodies to HIV-1 by immunoglobulin G (IgG) antibody capture enzyme-linked immunosorbent assay (GACELISA) and to hepatitis B core (HBc) antigen by IgG antibody capture radioimmunoassay (GACRIA). Results: Ninety-four out of 580 (16.2%) men were HIV-antibody-positive; 6.2% of men aged less-than-or-equal-to 25 years were positive versus 19.5% of men aged greater-than-or-equal-to 26 years. HIV-antibody prevalence was highest in London (21.1%), and twice that previously reported outside London (10.5%). Ninety-four out of 568 (16.5%) men were HBc-antibody-positive; 6.9% of men aged less-than-or-equal-to 25 years were positive versus 19.7% of men aged greater-than-or-equal-to 26 years. Anti-HBc prevalence was highest in London (19.8 versus 12.7% outside London). Manual workers were more likely to be anti-HBc-positive, as were men who reported recent high-risk intercourse. Sexually transmitted diseases associated with frequent partner change (gonorrhoea, non-specific urethritis) were reported. Conclusion: The HIV epidemic in gay men in England continues, particularly outside London, where prevalence was double that of previous studies. We found relatively high rates of infection in young men whose main sexual experience has been in a time of unprecedented awareness of AIDS. Our data on hepatitis B suggests that further pro-active immunization programmes are urgently required. These findings add to concerns about provision of interventions targeting gay men.