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Sexual risk behaviour of men who have sex with men: emerging patterns and new challenges

Hart, Graham Ja; Elford, Jonathanb

Current Opinion in Infectious Diseases: February 2010 - Volume 23 - Issue 1 - p 39–44
doi: 10.1097/QCO.0b013e328334feb1
HIV infection and AIDS: Edited by Martin Fisher

Purpose of review Antiretroviral treatment means that an increasing number of men who have sex with men (MSM) are living with HIV. The present review focuses on continuing transmission of HIV, risk factors for HIV infection in HIV-negative MSM, risk behaviour and risk reduction interventions among HIV-positive MSM, sexually transmitted infections, HIV and ageing and new and emerging populations of MSM communities.

Recent findings Transmission of HIV infection continues in populations of MSM; transmission may be particularly high from main partners. Serosorting offers limited protection against HIV infection for HIV-negative MSM; negotiated safety and strategic positioning may be partially protective. For HIV-positive men, serosorting is a strategy to prevent HIV transmission, but has contributed to high rates of new non-HIV sexually transmitted infections. Sexual networks are important to the understanding of emerging sexually transmitted infections; ageing brings a new dimension to research on HIV.

Summary Strategies other than exclusive condom use have emerged in communities of MSM to reduce the risk of HIV transmission, including serosorting and strategic positioning. ‘Combination prevention’ – using social structural, behavioural and biomedical approaches in tandem – could reduce the risk of HIV transmission, and may be particularly suited to HIV-positive MSM.

aResearch Department of Infection and Population Health, University College London

bDepartment of Public Health, City University, London, UK

Correspondence to Professor Graham J. Hart, PhD, Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK Tel: +44 207 380 9878; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.