1. Nathan Lachowsky, PhD Candidate
Young Gay Men’s Panel
BC Gay Men’s Health Summit
4 November 2011

2.  Include map
 Auckland: 1.42 million people (2010)

3.  Background:
 New Zealand’s HIV Epidemic
 Younger Gay Men & HIV
 Objectives
 Methods: HIV sociobehavioural surveillance
 Results:
 Younger Gay Men vs Older Gay Men
 Conclusions
 Future Research & Next Steps
 Questions & Dialogue

4.  Gay men continue to be Characteristics of MSM %
Diagnosed with HIV in
disproportionately and
New Zealand, 2010
predominantly affected (n=90)
by HIV in New Zealand
Ethnicity
 71.4% of new HIV NZ European/Pakeha 71
diagnoses in 2010 Maori 10
 2010 was 2nd highest Asian 10
number of new Pacific 1
diagnoses in New Infected in New Zealand 71
Zealand’s history Late Diagnosis 48
Age 15-29 at Diagnosis 32

5.  Unique New Zealand context and experience of
younger gay men (YGM)
 Increased rights: Homosexual Law Reform 1986,
Human Rights Acts 1993, Civil Unions 2005
 Availability of effective HIV treatments: HAART 1997
 Improved prognosis for HIV-positive individuals
 Connectedness to “gay community”: less or different?
 International interest in YGM
 New generation; “post-AIDS” era
 Recent increase in HIV infection rates within USA

6.  Compare HIV-related knowledge, attitudes,
and behaviours between:
 Younger gay men (YGM) & older gay men (OGM)
▪ YMSM: 16 – 29 years of age
▪ OMSM: 30+ years of age
 Focus on and strategy of primary prevention

7.  Pooled sample of 3387 YGM and 5602 OGM from
the 2006, 2008, and 2011 rounds of New
Zealand’s sociobehavioural HIV surveillance
 Gay Auckland Periodic Sex Survey (GAPSS) and
 Gay men’s Online Sex Survey (GOSS)
 Anonymous and self-completed questionnaires
 Reproducible convenience sample
 Second-generation surveillance: “gold standard”
 World Health Organization recommended

8.  Offline recruitment (1 week in February)
 Big Gay Out: 29.4% of pooled sample
 Gay bars: 4.7% of sample
 Sex-on-site venues : 7.7% of sample
 Online recruitment (2-4 weeks following)
 Internet dating sites: 58.2% of sample
 Statistical analyses controlled for survey year
 Mantel-Haenszel chi-square and multinomial
logistic regression
 * = Statistically significant difference (p<0.05)

9. RESULTS

10. Table 1. Demographic and testing YGM OGM
comparisons (%) (%)
Demographics
Recruited: online 67.4 52.9 *
Ethnicity: NZ European/Pakeha 68.5 80.6 *
Identity: bisexual 24.0 21.5 *
Testing (in previous 12 months)
Tested for HIV (excluding known-positives) 39.9 39.5
Tested HIV positive (at last HIV test) 0.9 4.7 *
Sexual health testing/treatment 47.0 45.4
Any STI (not including HIV) 9.0 9.0
* Statistically significant difference between younger and older MSM, p<0.05

11. Figure 1. HIV-Related Knowledge in
Younger and Older Gay Men in New
Zealand, 2006, 2008, & 2011 combined
100% *
80%
* *
% of gay men who knew
statement was fact
60%
40% *
20%
Data only from
Data from 2006. Data from 2006. Data from 2006. Data from 2006.
2006 && 2011
2008, 2008 2008, & 2011 2008, & 2011 2008, & 2011
0%
“Anal sex without a “Oral sex is low risk” “HIV is more easily “HIV cannot pass
condom is very high transmitted in early through an
risk” stages” undamaged
condom”
Younger GM Older GM * p<0.05

12. Figure 2. HIV-Related Attitudes in Younger
and Older Gay Men in New
Zealand, 2006, 2008, & 2011 combined
100%
% of gay men who agreed
80%
with the statement
60%
* *
40%
20%
0%
HIV is a less Condoms are I’d rather risk I don’t like A man who
serious threat OK as part of HIV that use a condoms knew he has
that it used to sex condom during because they HIV would tell
be because of anal sex reduce me before sex
new treatments sensitivity
Younger GM Older GM * p<0.05

13. Table 2. Sexual behaviour and YGM OGM
condom use comparisons (%) (%)
Sexual Behaviour ( in previous 6 months)
Number of sex partners: None 9.8 6.8 *
Number of sex partners: >5 29.1 39.6 *
Any casual partner 71.9 75.3 *
If casual partner, % having anal sex 80.7 77.4 *
Current regular partner 42.7 50.4 *
Length of relationship <6 months 41.2 18.7 *
If regular partner, % having anal sex 89.2 82.3 *
>1 regular partner and casual partner(s) 30.6 32.5
Condom Use
High condom use with boyfriend 37.2 31.9 *
High condom use with fuckbuddy 58.9 61.3
High condom use with casual partner 73.6 77.0 *

14. Figure 5. Sexual/Relational Partnering in Last 6
Months of Younger Gay Men in New Zealand
35%
30%
% of gay men reporting
25%
20%
15%
10% *
5%
*
0%
No sex with a 1 regular >1 regular 1 regular >1 regular Casual sex
man partner only partners, no partner and partners and only
casual casual casual
Sexual/Relational Partnering Combinations (<6 months)
Younger GM Older GM * p<0.05

15.  YGM and OGM similarities and differences:
 YGM less knowledge, fewer partners, less casual
sex, more anal sex, and more condom use with
boyfriends, but less with casual partners
 Need for strategic, targeted HIV/sexual health
promotion for YGM and other YMSM
 Contributes to evidence-based health
promotion and prevention efforts

16.  Strengths:
 Novel research on YGM in New Zealand
 Gold standard HIV sociobehavioural surveillance
 Survey data collected both online and offline
 Large pooled sample allowing sub-analyses
 Limitations:
 Debate regarding “younger” definition/classification
 Impact of online venue (not online sexual activity)
 Univariate analyses presented, multivariate analyses
can take into account other confounders

17.  Disseminate this research on YGM
 Present to affected and interested groups
 Post findings to community: blogs, news stories
 Publish results: conferences and journal articles
 Continue with research plan
 Multivariate analyses on condom use and HIV
testing
 Cross-ethnic analysis
 Advocacy and pressure for greater funding to
continue and expand research efforts

18.  Expanded research into other communities
 Different geographic areas in New Zealand
 Other populations at risk of HIV infection
 Further investigation into differences
between HIV-related risks for YGM
 Sexual activity with partners met online vs offline
 Use qualitative research to help understand
and explore sexual networks and concurrency
 Investigate resiliency and protective factors

19.  University of Otago
 PJW Saxton
 NP Dickson
 New Zealand AIDS Foundation
 AJ Hughes
 University of Guelph
 CE Dewey
 AJS Summerlee

20. Nathan Lachowsky
nlachows@uoguelph.ca