ju s t o u t ▼ m a rc h 3 , 1 0 9 9 ▼ 17
Despite an array of outreach efforts, risk-taking behaviors
among gay male communities are on the rise
Story by Inga Sorensen • Photos by Linda Kliewer
D
It’s been roughly 15 years since the AIDS
ata from an ongoing study involving
epidemic began in the United States. Tens of
1,600 Portland men who identify as
thousands of gay men have died of complications
gay or bisexual show up to 30 percent
from the disease, which ravages the immune sys
are engaging in extremely high-risk
tem, thousands more will continue todie each year.
sex on a regular basis—this despite
Three into
thousand Oregonians have died of AIDS;
the millions of dollars that have been poured
gay men account for an estimated 80 percent of
safe-sex education campaigns that clearly tel 1 them
those deaths.
if they have unprotected sex, they and their part
Yet researchers are finding that neither that
ners could die.
painful reality nor an explicit safe-sex campaign
“Despite all of our prevention efforts, studies
are deterring large numbers of men from engaging
indicate there is enough sexual risk-taking going
in high-risk sex. Though many, if not most, men
on to reproduce the AIDS epidemic generation
who identify as gay or bisexual say they have been
after generation,” says Ron Stall, an associate
exposed to some type of HIV-prevention mate
professor of epidemiology with the University of
rial—a brochure, billboard or poster, for instance—
California at San Francisco. With funding from the
numerous studies show that population appears to
National Institute of Mental Health, Stall has been
be involved in risky sexual practices at higher rates
tracking trends in sexual risk-taking behaviors
in the mid-1990s than it was in the late-1980s.
among gay and bisexual men in Portland and
Stall is in the fourth year of his five-year study
Tucson, Ariz.
involving 2,600 men: 1,600 from Portland and
“There isn’t a cure for AIDS, and the best thing
1,000 from Tucson. He selected the two cities
we can do to protect ourselves is to practice safe
because he found them “more representative of
sex all the time,” he says. “It’s very difficult
America, unlike a New York City or a San Fran
because we are human, but, at this point, it’s all we
have.”
............................. ........................... cisco.” He found his subjects by going to vanous
gay bars around town and through a random tele
phone survey. Of the Portland segment, 1,200 are
part of the “bar sample”; the remaining 400 com
prise the telephone or “household sample.” The
samples consist of both men who claim they are
seropositive and those who say they are
seronegative. (Stall estimates 40 percent of gay
men in Portland don’t actually know their status
because they have never been tested or they have
had unsafe sex since their last test.) Stall, who has
been tracking his subjects since 1992, interviews
the men via telephone or mail survey on an annual
basis. He questions them about their sexual prac
tices. If the men say they are HIV-positive, Stall
asks them about the type of health care they are
accessing.
“What we found the first year is that one in
three men in the bar sample said they had engaged
in unprotected anal sex with a nonmonogamous
partner during the past month. For the household
sample, it was about one in six,” explains Stall,
who was in Portland last month to share his most
recent findings with the Cascade AIDS Project,
Oregon’s largest AIDS service organization.
“Results of three years of interviews with these
men show that the rate—one in three for the bar
sample and one in six for the household sample—
has remained steady,” he says.
It is also important to remember that for the
purposes of his study Stall has defined high-risk
sex perhaps in the most extreme context possible:
unprotected anal sex with a nonmonogamous part
ner within the past month. Other sexual prac
tices— including oral sex without a condom— may
increase one’s chances of contracting HIV. Thus,
one could surmise that even greater levels of men
are partaking in some form of risky behavior.
“What’s also very disturbing is that compared
to much of the nation, Portland has a nationally
recognized CBO (community-based organiza
tion— in this case, CAP] that has been conducting
community outreach around HIV/AIDS issues for
years,” Stall says. “It makes me wonder what’s
going on in places that don’t have established
CBOs or an organized gay community.”
Even areas that have been saturated with “play
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