London School of Hygiene & Tropical Medicine

More gay and bisexual men than ever are getting tested for HIV, according to new data from the National Gay Men's Sex Survey. The survey is the largest of its kind in the UK and sheds light on the sexual health of men who have sex with men.

The survey found that 77% of gay and bisexual men have been tested for HIV, more than in surveys from previous years (in 2010, this stood at 72%). Over half (55%) of gay and bisexual men had been tested in the past 12 months, compared to 36% in the 2010 survey.

However, one in four gay and bisexual men have never had an HIV test, while one in three (36%) are not definite about their HIV status.

The research also found that only 60% of those surveyed were happy with their sex life, with the over 65s most likely to be happy with their sex lives, and men in their 40s least likely to be happy.

The major new survey was carried out by researchers at the London School of Hygiene & Tropical Medicine. More than 15,300 men took part to build a picture of sex between men in the UK and what men need to stay safe. The UK's leading HIV and sexual health charity Terrence Higgins Trust commissioned the report as part of the HIV Prevention England programme, funded by Public Health England.

Lead researcher Dr Ford Hickson, Lecturer in Public Health at the London School of Hygiene & Tropical Medicine, said: "Yet again in this survey the gay and bisexual men of England have been incredibly generous with their time and information to help us generate a unique national picture of their HIV prevention and sexual health needs. This kind of research is a community effort that could not be done any other way.

"Our findings show that not all men having gay sex are accessing sexual health services regularly. Half of the men we surveyed didn't know that doctors in the UK recommend they test for HIV at least once a year. More positively, the vast majority of men are confident they could access an HIV test if they chose to, and HIV testing services in England are very highly regarded among gay and bisexual men."

Cary James, Head of Health Promotion at Terrence Higgins Trust, said: "The Gay Men's Sex Survey gives us a well rounded view of the landscape in which we're working, since the data comes from gay and bisexual men themselves. These findings will help shape future sexual health promotion and HIV prevention tactics.

"We're concerned that a third of gay men are not definite about their HIV status - particularly as we know that one in seven men who have sex with men are undiagnosed. Knowing your HIV status is key to tackling the HIV epidemic, as people who are on treatment are highly unlikely to pass on the virus, so it's really important to get tested. Testing is fast, easy and confidential."

Ignorance about how HIV is and is not transmitted was fairly common. One in five men were not confident that even deep kissing cannot pass on HIV, and one in four were not aware that effective HIV treatment reduces the risk of HIV being transmitted.

The survey showed that condom use continues to be an issue. One-in-three sexually active gay men had unprotected anal sex with at least one non-steady partner in the past 12 months.

Cary James said: "Studies have suggested that condoms have prevented 80,000 infections since the start of the HIV epidemic. But this survey shows that perfect condom use is not a reality for everyone. We must continue to champion safe sex messages to gay men, but we also need to tackle prevention on all fronts if we are to beat this epidemic. That means regular testing, successful treatment and, critically, PrEP - in addition to condoms."

PrEP is a treatment that, if taken correctly, is almost 100% effective in preventing HIV. NHS England has recently refused to make it available for people at high risk of HIV.

The survey also shed new light on the extent of drug use among gay men: 7% of the respondents had taken the drugs mephedrone, GBH/GBL and/or crystal meth in the past 4 weeks. These drugs are associated with sexualised drug use or 'chemsex'. 

Meanwhile, a significant proportion (42%) of men living with HIV felt alcohol/drugs played a part in acquiring HIV, although the majority said neither played a part.

Dr Hickson said: "Although chemsex remains a reality for a relatively small proportion of gay and bisexual men, the potential for harm from it is very high. It is important to provide specialist support for men on the chemsex scene. Combining sex and drugs can easily become compulsive and can increase sexual risk taking. That a large proportion of men say alcohol or drugs played a part in their becoming infected with HIV means everyone on the scene and in services needs to think about how we can help men get better sex with less harm."

Publication

• State of Play: Findings from the England Gay Men's Sex Survey 2014. Sigma Research, London School of Hygiene & Tropical Medicine, May 2016.

Related links

• Sigma Research
• Sex in the UK: how culture and society can define your sexual health - read our special feature

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• MSc Demography & Health
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