Results of the Gay Men’s Health Crisis (GMHC) Sexual Health Survey— with more than 7,000 respondents, New York City’s largest ever—offer strong evidence that the much-debated “second wave” of infections is more fear than fact. In contrast to mid-’80s estimates that one half of the city’s gay men have HIV, GMHC put the current figure at 13 percent, or one in seven. Reflecting similar reports from other cities, this suggests that HIV will continue as an endemic, rather than epidemic, condition among the nation’s urban gay men.
The first survey of its size to focus on incidence of risk reduction (like pulling out before ejaculation) rather than risk elimination (“a condom every time”), the study found such “negotiated safety” to be a routine practice, despite scant support from prevention programs. While experts generally agree that risk reduction is the trend, some aren’t cheering. “We shouldn’t settle for the lowest common denominator,” said Brian Byrnes of Boston’s AIDS Action Committee. “We should support these decisions but continue to encourage condom use.”
While The New York Times’ front-page coverage echoed GMHC’s own risk-reduction views, the city’s tabloids spun the data differently: 39 percent of men surveyed reported unprotected anal intercourse (UAI) in the previous year. (This sensational angle dropped the study’s distinction between unsafe sex—no condom between serodiscordant partners—and unprotected sex—no condom between same-status partners.) Eleven percent reported UAI with some-one of a different or unknown HIV status; 10 percent said they’d had UAI but didn’t specify partner status. While GMHC attributed this oversight to the self-administered survey, it’s possible that many men skipped the question to avoid a “taboo” answer, Byrnes said.
Also noteworthy was the finding that only 2 percent of positive men had engaged in serodiscordant UAI. An all-volunteer initiative of GMHC’s B2K program, the report is the first of a multiyear study for the embattled and downsizing ASO.