Knowledge and practice of sexual safety in Melbourne gay men in the nineties

Despite the impact of education programs, the ability of gay men to sustain sexual safety still comes under public scrutiny. A self‐administered questionnaire was distributed in 1990 to a convenience sample of 284 gay‐identified Melbourne men recruited from gay groups, health clinics, gay pubs and nightclubs, sex‐on‐premises venues, and the social networks of these men. The questionnaire measured the perceived safety of various sexual practices and the practice of unprotected anal intercourse over the previous three months. These results were compared with results from other Australian studies. Whereas nearly all the men were sexually active, only a small proportion considered activities such as oral sex without ejaculation and anal sex with condoms to be‘totally safe’. The majority considered these activities to be ‘more safe than unsafe’, suggesting a risk‐reduction rather than a ‘no‐risk’ approach to sex. Comparisons with other Australian studies suggest that gay men are becoming more confident in the safety of sexual activities labelled as ‘safe’ by the AIDS Council. There was no elevated practice of unprotected anal sex at ‘sex‐on‐premises’ venues. Most men who had anal sex used condoms all of the time, whether sexual partnerships were ‘once only’ or were ‘ongoing’, suggesting that ‘condoms always’ is still a viable option in various partnerships. There was some evidence that a minority of men abandoned condoms in ongoing partnerships. If specific education campaigns are developed to promote ‘negotiated safety’ in partnerships, then such campaigns should not contradict the ‘condoms always’ strategy.