active) and 5.1 times (if you're passive) regardless of whether you know your partner's status.
However, a study from Sydney appeared to show that, although
UAI is common among long-term partners with the same HIV status, doing
it with casual partners remains rare. Whether this is true of other countries
remains to be seen.
Dipping
A new phenomenon amongst MSM - 'dipping' - was documented for the first
time in two studies at Barcelona. 'Dipping' means briefly inserting and
removing the penis before using a condom. It now appears many men who
report using condoms 100 per cent of the time actually engage in dipping.
Since HIV can
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Dr Helene Gayle
be transmitted during UAI through pre-cum alone, it could
be a reason we are seeing new HIV infections among MSM.
A study from Toronto found that dipping was not perceived to be risky
by gay men, but was associated with recent seroconversion. A San Francisco
study found that 29 per cent of HIV positive MSM reported dipping with
an HIV- or unknown status partner, and that 100 per cent of those who
'dipped' had at some time had full UAI, compared with only around a quarter
of those who never did.
Recreational drugs
The Vancouver study also showed that as well as injection drug use, marijuana,
crystal meth, cocaine, crack, heroin and poppers were all associated with
becoming HIV positive. There is growing concern that the use of club drugs
is becoming a major factor in new HIV infections. Crystal meth (methamphetamine)
has raised particular concerns amongst MSM in North America.
A study from San Diego found that MSM who binged on crystal meth were
more likely to use the drug to meet sex partners and had significantly
more acts of UAI with HIV- and unknown status partners.
There was better news from Los Angeles, where innovative incentives and counselling interventions for gay male methamphetamine users significantly reduced the amount of
