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Our survey said...

Gay Men's Health carried out a survey in all the gay bars in Edinburgh to gather information about gay men's attitudes to HIV testing. It’s all to inform the work of the Testing Barriers Project - tackling HIV stigma/discrimination and other barriers which prevent gay men from having an HIV test.

A higher percentage of men reported having had an HIV test than when previous research was carried out in 1999. However, almost 40% of the gay men who took part in the survey had never had an HIV test.

The men who took part tended to agree that there were many benefits to testing, with over 70% agreeing that having an HIV test can put your mind at rest and 55% agreeing that having a test can help you plan your life.

The main reason that men gave for not having a test was fear of getting a positive result. Men who thought a positive result was probable were more likely to avoid having a test.

Discrimination on the gay scene towards people with HIV was also given as an important reason for not having a test. Many men believed that stigma and discrimination could be avoided by not having a test, therefore not knowing their HIV status.

The vast majority of men thought that gay men with HIV were discriminated against on the gay scene, by potential sex partners and by other gay men.

Over half of the men who took part in the survey said they were unsure if their friends had had an HIV test, indicating that having a test is not something that most gay men talk about with their friends. There appears to be stigma attached even to having a test.

There was a discrepancy between what men believed their HIV status to be and their reported risk behaviour. Of the men who thought they were definitely HIV negative, almost 40% said they had had unprotected anal intercourse (UAI) in the past year. Of the men who thought they were probably HIV negative, almost half reported having UAI in the past year. 63% of men who did not know their status said they had had at least one UAI partner in the past year.

One third of the men surveyed said they assumed their sexual partners were HIV negative unless told otherwise. Three quarters of the sample thought that HIV positive men should disclose their status to sex partners and 84% said that HIV positive men were responsible for ensuring that safer sex occured.

The last finding is of particular concern when considering negotiated safety with sexual partners. People with HIV may choose not to disclose their status to potential partners for many reasons. These include fear that potential partners might react badly or tell other people. It is simply unrealistic to expect someone with HIV always to disclose their status.

Men who expect sexual partners with HIV to disclose, potentially place themselves at risk. A large proportion of gay men cannot disclose their status accurately because they have engaged in risky sexual behaviour in the past, have never had an HIV test and therefore do not know their HIV status. Men often overlook the fact that large numbers of infected men do not know they have HIV.

As the findings show, perceived HIV status does not always reflect whether men engage in risky sexual behaviour. There are a number of men who are having UAI with men of unknown status. Many of these men do not know their own status and some of them do not believe their sexual behaviour is putting them at risk.

The only way to be sure of your HIV status is to have an HIV test. However, the findings above show that men identify many barriers to having a test not least the existence of stigma and discrimination against people with HIV.

The Testing Barriers Project at Gay Men's Health will continue to tackle these issues through a programme of peer education on the gay scene in Edinburgh and on the internet, providing training for bar staff and others involved on the commercial scene, producing leaflets on the pros and cons of HIV testing and organising various health promotion events. LIFE STUFF 03 is being organised to take place over the Pride weekend (18th 20th July) which you can read more about elsewhere in this mag.

We would like to thank all the bars who allowed us to carry out the research in their venues and all the men who took the time to complete the questionnaires.