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Update June 17 2004 CTV Many gay Ontario men have HIV and don't know it
Canadian Press
TORONTO — An estimated one-quarter of homosexual and bisexual men in Ontario who have the AIDS virus may not know they are infected, a survey that provides a snapshot of sexual behaviours in the gay community suggests.
The Ontario Men's Survey, conducted by the University of Toronto, surveyed more than 5,000 gay and bisexual men in bars, bathhouses and through community groups in 13 cities across the province, including Toronto, Ottawa, Windsor and Thunder Bay.
Ted Myers, a professor of public health sciences and the study's lead investigator, said up to 27 per cent of respondents who reported being HIV-negative were actually found to be carrying the AIDS virus through testing of voluntary saliva samples given at the time of the survey.
"Twenty-seven per cent either reported that they were HIV-negative or indicated that they had never been tested for HIV or said that they did not know the results," Myers said in an interview Wednesday. That figure is in line with the approximate 30 per cent identified by other studies of gay men elsewhere in Canada, he added.
The Ontario Men's Survey, conducted in 2002, is the largest study of homosexual and bisexual men ever undertaken in Canada and is the first in-depth look at the gay/bisexual community in Ontario since a Canada-wide survey in 1991, he said.
"It was a bit of a catch-up to find out where and what was happening to behaviour of gay men, what was happening within the gay community and to gay communities and how men viewed HIV and AIDS," said Myers.
The Ontario survey provided more depth than the national survey, he said, because it not only broadened the age range of respondents -- involving more men under age 20 and those 50 or older -- but also encompassed an increased number of ethnic members of the gay community by providing questionnaires in seven languages.
The survey showed that while the majority of respondents reported practising only safe sex, about 25 per cent said they had participated in unprotected intercourse with a casual male partner at least once in the three months prior to the survey, Myers said.
Another disturbing trend revealed since the national study was a doubling of the proportion of gay men in Toronto who reported at least one episode of unprotected anal intercourse; in the rest of Ontario, the proportion was almost double, compared with a decade ago. Statistics show that gay and bisexual men are making up a rising proportion of all new cases of HIV in Ontario.
Survey results on respondents who admitted to making assumptions about a sexual partner's HIV status also raised alarm bells.
John Maxwell, a spokesman for the AIDS Committee of Toronto, said some men may assume a partner is HIV-negative if the subject of a condom is not initiated by the other person or he "might think `He'd tell me if he was positive' or `He'd tell me if he were negative,"' Maxwell said.
"Often, these are assumptions that are made in the heat of the moment and may, in fact, be false assumptions," he said. "Clearly some men are putting themselves at risk from HIV -- either getting HIV or transmitting HIV -- based on false assumption."
The survey also showed that about 45 per cent of the men said they never disclose their HIV status, either positive or negative, to a casual partner.
"I think it (the survey) gives us a wake-up call that we need to be much more vigilant, we need more attention to what may be happening in the gay community," Myers said. "I don't think we can rely on education and prevention campaigns that were developed and given 10 years ago."
"We need to keep the prevention message alive, and I guess the message to governments is we need to increase funding for this."
Condom use was also an issue in the study. About 14 per cent of men surveyed reported problems with slippage and a similar percentage said condoms had broken.
"Condoms are not perfect," said Myers. "Despite the fact that HIV and AIDS has been around (more than two decades), very little has been done to increase the effectiveness of condoms or to look for alternative methods for protection."
Still, Myers said the survey provides some encouraging signs.
"If you look back at the early '80s, you see dramatic increases in the use of condoms," he said. "Prior to 1983, basically the use of the condom was unheard of for gay sex. And here we have the majority of gay men having safer sex."
As well, the Ontario study showed more gay/bisexual men are seeking HIV testing since the national study was conducted: about 80 per cent in Toronto were screened for HIV, compared to 65 per cent in 1991; in the rest of the province, figures range from 73 to 82 per cent, compared to 61 per cent a decade earlier.
Maxwell said the survey is important for those working in public health and prevention education "because it's able to provide us with a snapshot and help us to tailor programs and services."
