Session 115 Poster Abstracts
Risk Behavior
Tuesday, 1:30 - 3:30 pm
Poster Hall

844
Increases in Rates of Unprotected Anal Intercourse and Sexually Transmitted Diseases in Asian MSM in San Francisco
H M Truong*^1,2, W McFarland^1,3, K Folger⁴, C Owen⁴, S Chen³, R Kohn³, and J Klausner³
¹Univ. of California, San Francisco, USA; ²Gladstone Inst. of Virology and Immunology, San Francisco, CA, USA; ³San Francisco Dept. of Publ. Hlth., CA, USA; and ⁴Stop AIDS Project, San Francisco, CA, USA

Background: Worldwide, studies of men who have sex with men (MSM) have reported recent increases in HIV infection and risk-related behavior. Less is known about trends within minority sub-populations of MSM, particularly those of Asian/Pacific Islander ethnicity. We evaluated trends in unprotected anal intercourse and incidence of rectal gonorrhea and early syphilis in Asian/Pacific Islander MSM and white MSM in San Francisco.

Methods: Data on sexual risk behavior originate from interviews (n = 12,507) conducted from 1999 to 2002 through the course of HIV prevention outreach activities by the STOP AIDS Project, San Francisco. Gonorrhea and syphilis data are from citywide sexually transmitted diseases (STD) surveillance by the San Francisco Department of Public Health. STD incidence rates are reported per 100,000 MSM using denominators from previously published studies. Analysis uses the chi-square trend test.

Results: From 1999 to 2002, levels of sexual risk behavior and STD in Asian/Pacific Islander MSM (n = 818) increased at a faster rate than in white MSM (n = 8080). In Asian/Pacific Islander MSM, unprotected anal intercourse with multiple partners increased steadily each year, starting from 12% in 1999 and rising to 20% in 2002 (p = 0.005), compared to an increase from 19% to 20% (p <0.01) in white MSM. Unprotected anal intercourse with multiple partners of unknown HIV serostatus increased from 6% to 16% (p = 0.01) in Asian/Pacific Islander MSM compared with an increase from 12% to 14% (p <0.01) in white MSM. During the same period, incidence rates of rectal gonorrhea increased from 259 to 489 per 100,000 in white MSM and from 175 to 919 per 100,000 in Asian/Pacific Islander MSM. Early syphilis incidence rates increased from 54 to 714 per 100,000 in white MSM and from 88 to 1575 per 100,000 in Asian/Pacific Islander MSM.

Conclusions: Asian/Pacific Islander MSM are under-represented among cumulative AIDS cases (2.7%) with respect to their estimated make-up in the gay community of San Francisco. However, between 1999 and 2002, levels of sexual risk behavior and STD in Asian/Pacific Islander MSM had caught up to or exceeded those of white MSM. These trends suggest the need to monitor HIV incidence in Asian/Pacific Islander MSM and enhance ongoing risk reduction and STD control activities.

Keywords: men who have sex with men (MSM); sexually transmitted diseases (STDs); sexual risk behavior