KING COUNTY, WASHINGTON - This week, health officials from Public Health - Seattle & King County presented new local data and findings at the 2004 National STD Prevention Conference in Philadelphia, Pennsylvania. Notable among the findings was that the community norm among gay men is to engage in safe sexual practices.

Included in the local presentations were two reports that looked at the sexual practices of gay and bisexual men, including condom usage and disclosure of HIV status. One of the studies is a random telephone survey of 400 gay men in Seattle, believed to be representative of the gay community. The survey found that most normally engage in practices that protect them from infection by HIV or STDs.

Almost all survey participants were sexually active with male partners, but only about 20 percent had unprotected anal sex with partners of unknown or opposite HIV status in the year before the survey.

Public Health recommends that all gay men know and disclose their HIV status to their partners. "These results suggest that many men, maybe a large majority, are following this advice," said Dr. Hunter Handsfield, STD Program Director and one of the authors of the study. "Those who don't know and disclose their HIV status at least are having safe sex." Handsfield described the survey results as heartening, because they suggest that community norms are in line with Public Health recommendations.

"There are two important take-home messages from this survey," said Dr. Alonzo Plough, Director and Health Officer for Public Health - Seattle & King County. "First, for the public at large, this research counters the notion that most gay men are not sexually responsible. What we're seeing is that most really try to avoid getting or spreading infection."

The second message, according to Dr. Bob Wood, Public Health's HIV/AIDS Program Director, is for gay men themselves. "The survey shows that sexual safety really is the norm for our community," said Wood, an HIV-positive gay man. "Knowing this should help other gay men-those who continue to take risks and to put others at risk-make safer choices."

Last year, Public Health and community partners developed recommendations for sexually active MSM to best protect themselves and the community. These recommendations included:

A second study from Public Health looked at HIV status disclosure among 149 newly diagnosed HIV positive gay men and a comparison group of HIV negative men attending public HIV testing sites. Fifty-nine percent of the men discussed HIV status with their most recent anal sex partner, and 36 percent knew their partner's status before first sex. This study also identified some of the factors that contributed to less safe sexual practices, including substance abuse, sexual desire, and getting incomplete information about partners' risks for HIV since testing.

"This study shows that non-disclosure among some gay men continues to be an area of concern," said Rebecca Hutcheson of Public Health's HIV/AIDS Program, and lead author of the report. "Knowing the motivations behind disclosure and high risk behaviors is crucial to guide development of effective prevention messages," she said.

Also presented at the conference was a study, co-authored by Dr. Handsfield, on the rise of antibiotic-resistant gonorrhea in the Seattle area. For several years, ciprofloxacin and related drugs have been a mainstay of gonorrhea treatment. Ciprofloxacin-resistant gonorrhea has been increasing in other areas, but was rare in Washington. However, the Public Health investigators reported a four-fold increase in the proportion of gonorrhea that was ciprofloxacin-resistant in late 2003, from 3.8 percent to 16.5 percent of gonorrhea cases. Ninety percent of the resistant cases are occurring among gay and bisexual men. As a result, local gonorrhea treatment recommendations were modified last year to exclude ciprofloxacin and other fluoroquinolone antibiotics.

Dr. Handsfield also led a symposium on the growing awareness of genital herpes as an important public health problem. Herpes simplex virus type 2 (HSV-2), the main cause of genital herpes, appears to be the most important sexually transmitted disease worldwide in enhancing sexual transmission of HIV. The symposium highlighted the need for local public health agencies to implement systematic prevention strategies to address the spread of the disease. Public Health's STD Clinic at Harborview Medical Center now offers routine herpes testing and is active in research on herpes diagnosis, treatment and prevention.

The 2004 National STD Prevention Conference is organized every two years by the Centers for Disease Control and Prevention and is the leading U.S. conference focusing entirely on STDs. The conference presents the latest data on national and local STD trends and highlight new STD prevention strategies, research and treatment options. Participants include more than 1300 delegates from academia, public health, nongovernmental and policy organizations.

For more information about Public Health - Seattle & King County's STD Program, visit www.metrokc.gov/health/apu/std

For more information about Public Health - Seattle & King County's HIV/AIDS Program, visit www.metrokc.gov/health/apu

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