Sigma Research

Relative safety II: risk and unprotected anal intercourse among gay men with diagnosed HIV - qualitative study

Duration: February 2008 - February 2009

This study included 42 qualitative, in-depth, face-to-face interviews with gay men with diagnosed HIV who had engaged in unprotected anal intercourse (UAI) in the previous year. Men were recruited from areas of high HIV prevalence (London and Manchester) and low to medium HIV prevalence (Staffordshire, South Wales, South West England and West Yorkshire). The sample was stratified by length of time since first HIV diagnosis. The focus of the interviews was accounts of the most recent incident of unprotected anal intercourse. Fieldwork took place between March and August 2008. This research was funded by Terrence Higgins Trust on behalf of CHAPS.

Much changed in the ten years since we first undertook Relative safety, a quantitative and qualitative study of the sexual risk behaviour of gay men with diagnosed HIV. For example, improvements in treatment efficacy has meant that HIV is increasingly normalised as a chronic manageable condition. This has affected men’s perceptions of risk and the diversity and the quality of intimate relations open to them. In addition, the increased capacity for online interaction has transformed the contexts within which sexual risk is negotiated among gay men with HIV. Furthermore, a range of risk reduction tactics (such as sero-sorting and strategic positioning) have been identified and criminal convictions for reckless transmission of HIV have challenged our views on the central tenets of ‘responsibility’ and ‘disclosure’ within the risk practices of gay men with HIV.

The final report, Relative safety II, was published in February 2009. We have since prepared several journal articles arsising from the study. The first has already been published in Reproductive Health Matters and is available here as a free download (as a PDF for professional or academic use). It concerns men's views on criminal prosecutions for HIV transmission and shows that considerable confusion about the law was very common. Although criminalisation has prompted some men to take steps to reduce their chances of being involved in HIV transmission, others changed their behaviour in ways likely to have adverse effects, or reported no change.

Key contact: Adam Bourne

The partner agencies collaborating on this programme are:
The Armistead Project
Body Positive North West
The Eddystone Trust
George House Trust
Leeds Skyline
Staffordshire Buddies
Terrence Higgins Trust Cymru
Terrence Higgins Trust West
Yorkshire MESMAC