RELATIONSHIP OF COMBINATIONS OF AIDS COUNSELLING AND TESTING TO SAFER SEX AND CONDOM USE IN HOMOSEXUAL MEN

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Abstract
In a cross‐sectional survey of 172 homosexual men in a city of one million inhabitants, questions were asked on testing for AIDS and counselling history, sexual practices, prophylactic behaviours, condom use and associations with the gay subculture along with other background variables. Respondents were divided into four groups: those who had had both HIV testing and safer sex counselling, those who had only had testing, those who had only had counselling, and those who had had neither. All but 4 per cent of respondents had heard of safer sex. Results showed that increase in comdom use for both oral and anal sex, and stopping prior to ejaculation were associated with the combined testing and counselling group, and occurred significantly more often than the counselling only and no intervention groups. The testing only group fell midway between the counselling plus testing and the counselling only, and no intervention groups. A scale constructed by summing the four measures of safer sex showed that testing only, and counselling and testing combined were significantly superior in terms of safer sex practices than the counselling and no intervention groups. Correlates of being given a condom at point of testing included increased insertive anal intercourse and stopping before ejaculation as well as increased condom use during anal intercourse. These findings suggest that provision of free condoms in a context of professional and peer support may enhance condom usage during behaviours known to transmit HIV. While these data may be interpreted with caution with regard to causality, they do imply (in the absence of evidence that such behaviours characterise individuals who present for HIV‐related interventions) that some interventions or combinations of interventions are significantly more effective than others.

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