HIV and hepatitis B infection and risk behavior in young gay and bisexual men

Objectives. To estimate the prevalence of and identify risk factors for human immunodeficiency virus type I (HIV-I) and hepatitis B virus (HBV) infections and unprotected anal intercourse among young homosexual and bisexual men. Methods. The authors performed a cross-sectional analysis of data from a prospective cohort of 508 young gay and bisexual men ages 18-29. Results. HIV-I seroprevalence was 2.4%, with five (1.3%) of 390 college students and seven (6.0%) of 117 non-students infected. After adjusting for confounders, HIV-I infection was associated with having a history of a sexually transmitted disease other than HIV-I or hepatitis B. The prevalence of hepatitis B markers in unvaccinated men was 12.9%. The presence of hepatitis B markers in unvaccinated men was significantly associated with Asian ethnicity, off-campus residence, and history of a sexually transmitted disease other than HIV-I or hepatitis B and inversely associated with recent non-intravenous drug use. Eighteen percent of the participants reported having had sex with women during the previous 12 months, and 26.4% reported a history of unprotected anal intercourse during the previous six months. Men who reported unprotected anal intercourse were more likely to have at least one steady partner, to have met their partners in anonymous settings, and to be identified as probably alcohol dependent. Conclusions. Although the prevalence of HIV-I infection among young homosexual and bisexual men in Boston was relatively low, the high rates of unprotected anal intercourse suggest a potential for future HIV-I and hepatitis B transmission. Interventions should focus on young men with histories of sexually transmitted diseases, alcohol abuse, and depression.