Gay sex and relationships in Melbourne in 2016: a snapshot

Melbourne Gay Community Periodic SurveyRecently published by the Victorian AIDS Council (VAC), the results of this year’s Melbourne Gay Community Periodic Survey offer a snapshot of sex and relationships in our communities.

Recruited throughout Melbourne’s Midsumma Festival, and at gay venues and events, the survey captured the responses of 2886 gay and same-sex attracted men to a broad set of questions about sex, relationships and sexual health.

Conducted by the University of NSW in conjunction with partner organisations around the country, like VAC in Victoria, the gay community periodic surveys have been running since 1998, giving not just a snapshot but a picture of how trends change over time.

Just one highlight of the 2016 survey is the effect of pre-exposure prophylaxis (PrEP) on what sex and sexual health in our communities looks like, and how gay men are becoming more aware of ways to reduce the risk of HIV transmission.

Some key findings for 2016:
• A drop in men who have tested for HIV at all over the past year (down from 69.9% in 2012 to 65.6% in 2016), but a big increase in men who have had three or more HIV tests in the past year (up from 11.9% in 2012 to 22.8% in 2016).
• A large increase over time in the proportion of HIV-positive men on treatment and with an undetectable viral load, up from 65.1% in 2008 to 95.2% in 2016. Having an undetectable viral load makes HIV transmission during sex very unlikely.
• A gradual increase over time of the proportion of gay men in open relationships to 32% in 2016—it’s now the most common type of relationship.
• An increase over the past year in the proportion of gay men not using condoms during anal sex with casual partners, up from 38.9% in 2015 to 42.6% in 2016.
• However, the past year has also seen a huge increase in the proportion of men on PrEP, up from 1.4% in 2015 to 5.6% in 2016. This largely accounts for the increase in condomless anal sex with casual partners.
• An increase over time in awareness and use of undetectable viral load as a strategy for avoiding HIV transmission, both among HIV-positive men (up from 67.6% in 2013 to 76.2% in 2016) and among HIV-negative men (up from 12.2% in 2013 to 15.4% in 2016).

VAC CEO Simon Ruth said the findings from this year’s survey were particularly interesting for the light they shed on PrEP use in the community. PrEP is a highly effective HIV-prevention method, where HIV-negative people take HIV medication to significantly reduce their risk of contracting HIV.

“This is really the first time we’ve been able to see the way PrEP is protecting our community,” said Mr Ruth. “The results around PrEP and undetectable viral load show us what we’ve known for a long time now, that gay men in Victoria are smart, aware, and willing to engage with new and often complex information about sexual health and HIV prevention.”

“Grass-roots initiatives like PrEPaccessNOW and PrEP’d for Change have shown us how gay men are taking the lead on educating and informing the community.”

VAC’s Director of Health Promotion, Policy and Communications Colin Batrouney pointed to the results around HIV and STI testing as an indication of positive change. “Since it began, the Drama Downunder campaign has encouraged people to get tested to maintain their sexual health, and for almost a year now we’ve been encouraging gay men to test every three months through our seasonal campaign,” said Mr Batrouney.

“In these results we can see how testing behaviour is changing—the proportion of gay men who have had at least three HIV tests in the previous 12 months has almost doubled over the past five years. That’s an impressive result. Testing every three months is particularly important if you’re having sex with a lot of different guys, and these look like the kind of men who are testing more frequently.”

“We’re also working to make testing easier and more convenient with peer-led services like rapid HIV-testing at the PRONTO! clinic,” added Mr Batrouney.

Following are just some of the facts and figures in this year’s results.

We can see what the relationship statuses of gay men in Melbourne look like:
• 31% are in monogamous relationships
• 32% are in open relationships
• 23% are only having casual sex
• 15% aren’t having sex with any male partners

We can also see what men’s condom use looks like for anal sex within relationships:
• 57.5% are having condomless anal sex with a regular male partner
• 19.3% are consistently using condoms for anal sex with a regular male partner
• 23.2% aren’t having anal sex with their regular male partner(s)

For men having sex with casual partners, we have information on a whole range of ways gay men reduce the risk of transmitting HIV, which shows us that almost 80% are doing something to reduce the risk of transmission:
• 40.7% are consistently using condoms during anal sex
• 5.6% are HIV-negative and on PrEP (pre-exposure prophylaxis for HIV)
• 6.1% are HIV-positive and on treatment with an undetectable viral load
• 16.7% aren’t having anal sex
• 9.3% are HIV-negative or untested, aren’t consistently using condoms and aren’t on PrEP, but are tops only

We can even see where men are meeting other men for sex:
• 48% of men have met other men on mobile apps like Grindr or Scruff
• 32% of men have met other men on websites
• 29% of men have met other men in gay bars
• 28% of men have met other men at saunas and sex-on-premises venues
• 12% of men have met other men at dance parties
• 11% of men have met other men at beats
• 7% of men have met other men at private sex parties

For more information, or to read the full report, visit: www.vac.org.au for details.

Image: Melbourne Gay Community Periodic Survey