Younger Australian men in same sex relationship tend to be reckless and hence are at risk of HIV infection, new study regrets.
Compared with older men who have sex with men (MSM), those aged under 35 were found to be more likely to have never previously been tested for HIV and more likely to report not knowing the HIV status of regular partners.
They were also more likely to report inconsistent condom use with casual and regular partners, according to the study published in the latest edition of the Medical Journal of Australia.
Ms Carol El-Hayek, Epidemiologist at the Centre for Population Health at the Burnet Institute, Melbourne, and co-authors reviewed the age of HIV diagnoses in MSM in Victoria to determine whether younger MSM are at increasing risk of HIV infection.
Between 2000 and 2009, 1635 MSM were diagnosed with HIV in Victoria. The median age at HIV diagnosis in MSM declined significantly, from 38.8 years in 2007 to 35.3 years in 2008 and 35.9 years in 2009. In 2009, the number of HIV diagnoses among MSM aged 25-29 years was 62 per cent higher than in 2007. The median age of MSM testing for HIV remained constant at 33 years between 2006 and 2009.
Ms El-Hayek said that there were multiple factors thought to be contributing to increased rates of HIV diagnoses in MSM, including increased rates of unprotected anal intercourse, an increase in other sexually transmitted infections that facilitate HIV transmission, and increased numbers of sexually active HIV-positive MSM since the introduction of highly active antiretroviral treatment (HAART).
"Recent focus group data have shown that younger MSM are less likely to discuss HIV and other sexually transmitted infections with peers," Ms El-Hayek said.
"It has also been suggested that younger gay men may be more susceptible to engaging in risky sexual behaviour because they are less aware or less concerned about the implications of HIV since the introduction of HAART.
Ms El-Hayek said that deciding how to respond to increasing HIV diagnoses in younger MSM was difficult. Any response developed would need to consider more diverse health promotion strategies to ensure that prevention messages reached young MSM.
In an accompanying editorial, Mr William Bowtell, Director of the HIV/AIDS Project at the Lowy Institute for International Policy, Sydney, reviewed the history of the global HIV/AIDS pandemic and the economic and political impact of the emergence of HIV/AIDS.
Mr Bowtell said that since the introduction of effective antiretroviral therapy, deaths from AIDS have declined and HIV has become a more manageable chronic condition. However, although the number of global deaths from AIDS had fallen, the number of those living with HIV had increased.
"There are now some 33.4 million people living with HIV infection," Mr Bowtell said.
The Medical Journal of Australia is a publication of the Australian Medical Association.