by Matt Rosenberg November 16th, 2011
The Seattle area is tied for first among 21 major U.S. metro regions in casual and unprotected anal intercourse between men who have sex with men, or MSM, and that is “the sexual behavior that carries the highest risk” among this group for HIV – the virus which can lead to AIDS. These findings come in a new report by the National HIV Behavorial Surveillance System published October 28 in a prominent medical journal of the U.S. Centers for Disease Control, Morbidity and Mortality Weekly Review. Seattle respondents in the national survey of MSM also reported a higher and often pace-setting prevalence of certain types of drug and alcohol use compared to their counterparts in other regions.
For self-reported use of amyl nitrate and marijuana, Seattle respondents in the study ranked first nationally, on a percentage basis. They tied for first place in self-reported use of both methamphetamine and binge drinking; and tied for second place in use of Ecstasy and cocaine. Use of alcohol and drugs, particularly meth, have been correlated by health experts with unprotected anal intercourse between casual male partners that increases risk of HIV.
The 21 regions surveyed included virtually all of the major population centers of the U.S. Using local public health officials across the nation who are familiar with the gay community, including four researchers from Washington state, the federal study reached out to gay men at bars, dance clubs, and other community venues. More than 8,100 were surveyed after meeting screening requirements, in the latter half of 2008. Overall, the group was not exceptionally young, and was well-educated, two variables which might tend to mitigate somewhat against risky behaviors. The two largest age cohorts were 30-39 and 40-49, and 71 percent had some college education or more. The survey results were analyzed by variables including region.
Risky sexual practices
Nationally, only 45 percent of MSM respondents reported having had unprotected anal sex with a casual partner in the last 12 months, but in both Seattle and Dallas, 57 percent did, exceeding all other regions in the survey. (Table 2 in study, linked above). A casual partner was defined as “someone with whom the participant had sex but with whom he did not feel committed, did not know very well, or had sex in exchange for something such as money or drugs.”
Drug, alcohol use
Respondents also were asked to report whether they had abused drugs in the last 12 months. The Seattle region was far and away the leader in percentage of respondents who reported using marijuana; 58 percent versus a national average of 38 percent. Twenty-three percent of Seattle-area respondents reported use of amyl nitrate, known on the street as “poppers” – higher than in any of the 20 other regions surveyed, and exceeding by ten points the survey average. Seattle survey-takers shared a first-place ranking with respondents from the Los Angeles area in percentage reporting use of methamphetamine. Metro Seattle was tied for first at 61 percent with Denver in percent of respondents who self-reported heavy or binge drinking within the last 30 days. Seattle also tied for second place in self-reported use of cocaine and Ecstasy. (Tables 6 and 7 of study, linked above).
Seattle-area respondents did better with respect to HIV testing and related vaccinations, compared to those from the other 20 U.S. major metro regions included in the national survey. They matched the national average of 62 percent who reported having been tested for HIV in the last 12 months; ranked first in percent getting vaccinated for Hepatitis B; and third in percent being vaccinated for Hepatitis A and tested for syphilis.
Dr. Matthew R. Golden, Director of the HIV/STD program for Public Health – Seattle King County, and a professor of medicine at the University of Washington said he was familiar with the findings of the new study and that in general, “too many men who have sex with men continue to engage in high-risk behavior” in the Seattle region including unprotected anal intercourse and methamphetamine use. But he said without knowing more about the specific make-up of the respondent pool for each of the 21 regions, it is difficult to compare the results between them.
UPDATE, 3:00 p.m., 11/16/11: In a written reply to a request for an interview two epidemiologist with the HIV/AIDS Program of Public Health – Seattle King County, Richard Burt and Hanne Thiede, noted that in an earlier report from the same sample, Seattle respondents had an HIV prevalence rate of 15 percent compared to 19 percent nationally, and had the highest percent aware of their HIV status, 85 percent, versus 56 percent overall.
Earlier studies here have zeroed in on risky sex and meth
Dating back to early last decade, public health officials in Seattle-King County have issued data-driven reports and related exhortations warning of ongoing HIV risk-related behaviors here. A 2009 study in the American Journal of Public Health authored by researchers from Public Health – Seattle and King County and the University of Washington expresses concerns about the influence on HIV risk here of unprotected anal sex with casual partners and methamphetamine use, particularly in sexually-focused venues. A late 2010 study from researchers at Harborview Medical Center and University of Washington also focused on meth use and high-risk unprotected anal intercourse between gay men in the Seattle area, and found that an experimental intervention strategy which used gift card vouchers to reward lower-risk behaviors failed to show significant benefits.