Trends in sexual behaviour and HIV incidence in homosexual men.

Data from Edinburgh Scotland on the incidence of sexually transmitted diseases in homosexual men between 1980-1987 suggest that this high-risk population is effectively adopting "safer sex" practices. The incidence of early syphilis in homosexual men presenting to the department of genitourinary medicine at the Edinburgh Royal Infirmary peaked at 20 cases in 1984 and then began precipitous decline; no such cases were diagnosed in 1986 and 1987. The incidence of rectal gonorrhea reached a high of 58 cases in 1982 and has fallen steadily since then; there were 5 such cases diagnosed in 1987. Since unprotected anoreceptive intercourse is the main risk factor for human immunodeficiency virus (HIV) in homosexual men trends in the incidence of rectal gonorrhea provide reliable information about the extent to which safe sex practices are being followed. Diagnoses of all types of gonorrhea peaked in 1982 at 120 cases at which point they began a steady decline to 10 cases in 1987. Since this clinic does not have a policy of random anonymous testing for HIV infection information on trends in the incidence of this infection are not available for this population. In general these incidence trend date imply that the homosexual community in Edinburgh adopted sexual practices aimed at reducing the risk of sexually transmitted infection even before government health education campaigns were launched. While declines in the incidence of syphilis and gonorrhea were not recorded in the heterosexual population in Edinburgh until 1985 homosexual men began demonstrating this trend around 1982.