Changes in Prevalence of HIV Infection and Sexual Risk Behavior in Men Who Have Sex With Men in San Francisco: 1997-2002

The authors assessed differences in sexual risk behavior and HIV prevalence among San Francisco men who have sex with men (MSM) between 1997 and 2002. They used two population-based random-digit-dial telephone surveys of MSM households in 1997 (n=915) and 2002 (n=879).

Between 1997 and 2002, measures of sexual risk increased along with estimated HIV prevalence, which rose from 19.6 percent to 26.8 percent. Reports of unprotected anal intercourse with a partner of different or unknown HIV serostatus increased from 9.3 percent to 14.6 percent. The mean number of male sex partners climbed from 10.7 to 13.8. The largest reported increase was for serosorting, choosing partners for unprotected anal sex who are believed to be of the same HIV status as oneself, from 18.9 percent to 26.8 percent. The largest increase in unprotected anal intercourse was reported by men ages 30 to 50. The largest increase in serosorting was reported by men ages 18 to 29. Changes in the age distribution did not explain the increase in risky behavior.

The authors concluded: "Both HIV prevalence and sexual risk increased substantially among MSM in San Francisco between 1997 and 2002. Serosorting is being adopted more frequently than condom use by young MSM, but its effectiveness as a harm reduction strategy is not known."

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