Gay Asian men in Sydney resist international trend: no change in rates of unprotected anal intercourse, 1999-2002.

Against a background of increasing unprotected anal intercourse (UAI) in the Sydney gay community (and internationally), complementary cross-sectional surveys of sexual practice were conducted among gay men of Asian background in 1999 (N = 319) and 2002 (N = 457). Self-complete questionnaires were used with recruitment at gay bars, gay social functions, and gay sex-on-premises venues. In 2002, self-report HIV status was 73.7% HIV-negative, 3.6% HIV-positive, and 22.8% unknown status (no significant change from 1999). Over time, the proportion of gay Asian men who reported any UAI with regular partners (in the previous 6 months) did not change significantly: 27.9% in 1999; 24.3% in 2002. Similarly, rates of any UAI with casual partners remained steady: 16.3% in 1999; 14.4% in 2002. Only one factor, more extensive engagement in esoteric practices (fisting, sadomasochism, group sex, rimming), was independently associated with sexual risk practice. This suggests that risk in this population of gay men, as in others, has more to do with the sexual cultures in which men are embedded rather than individual-level differences.