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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
AUSTRALIA: Versatility and HIV Vulnerability: Investigating the Proportion of Australian Gay Men Having Both Insertive and Receptive Anal Intercourse
Anthony Lyons, PhD; and others
November 7, 2011
Journal of Sexual Medicine Vol. 8; No. 8: P. 2164-2171

The purpose of the current study was to investigate the extent to which gay men are versatile with regard to having insertive anal intercourse (IAI) and receptive anal intercourse (RAI). The authors noted that these data are needed to accurately assess the overall risk of HIV and other STIs, "because versatile men who engage in both roles have heightened vulnerability for becoming infected and infecting others." The subjects of the study were 856 Australian gay men who completed an online survey to retrospectively report their sexual practices during the past 12 months. The main outcomes measures were the percentages of men who reporting IAI, RAI or both in the past 12 months, and in their most recent sexual encounter.

Among men having anal intercourse in the past 12 months, 83 percent reported both IAI and RAI, with 57 percent being "highly versatile" in that they reported roughly equal numbers of partners for both IAI and RAI. Among men who reported anal intercourse with their most recent partner, "as many as one in five (20 percent) had reciprocal anal intercourse, having both IAI and RAI with the same partner in a single encounter." The results showed condom use was significantly less likely with reciprocal (38 percent) than nonreciprocal anal intercourse (50 percent, P=0.04). "While highly versatile men were less likely to know their HIV status, practices at most recent sexual encounter such as reciprocal anal intercourse and condom use were not significantly related to either their HIV status or that of their partner," the authors wrote.

"Engaging in both IAI and RAI appears to be common among gay men," the team concluded. "HIV/STI prevention strategies would benefit from paying attention to the implications of high rates of versatile sexual practices, particularly the tendency for condoms to be used less often when having reciprocal anal intercourse."

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