crystal meth they used and also decreased sexual risk
taking.
Microbicides and gay men
There has been much excitement about the tasteless, odourless,
"invisible condom" barrier methods known as microbicide gels.
Most microbicide research has concentrated on vaginal transmission, but
transmission via the rectum is the major route in the developed world.
Dr Charles Lacey of Imperial College School of Medicine in London said
that research is much further behind than vaginal microbicides, and there
has only been one published phase I trial.
The lining of the rectum is only one cell thick and much more porous than
the vaginal lining, and a rectal microbicide has to cover a much larger
space. Exactly what happens in anal intercourse and where body fluids
end up remains an unresearched area. Microbicides might never be sufficient
to prevent rectal HIV transmission.
Of more concern, however, was a study reported by the US Centers for Disease
Control, which showed that 41 per cent of gay men in San Francisco had
UAI in 2001 using the discredited microbicide, Nonoxynol-9 (N-9), because
they thought that it would be protective against HIV. This is despite
the discovery that N-9 may increase the risk of HIV transmission, and
a US recommendation two years ago that N-9 not be used during anal sex.
Education, counselling and testing
Studies from Spain, Thailand, Mexico, the Philippines and the UK showed
that educational programmes for adolescents can decrease risky sexual
behaviour. Also from the UK, the effectiveness of www.youchoose.org.uk,
the interactive web site launched last January allowing gay men to explore
issues around testing in their own time at home, was reported on here.
While youchoose.org reached a lot of people, and about a third went on
to search for a place to test for HIV, a significant number of men who
had UAI did not perceive themselves to be at risk, suggesting that gay
men's health promotion in the UK is failing to convince them of the real
risks of barebacking.
page 3 of 5
contents
of issue 82
back
issues
the
gazette
recipes
small
ads
contacting
us
weblinks
'Before and after' pills
Data on the use of antiretrovirals to prevent HIV transmission after sexual
exposure was
