Changes in sexual behaviour and the fall in incidence of HIV infection among homosexual men
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G J van Griensven1, E M de Vroome, J Goudsmit
1Department of Infectious Diseases, Municipal Health Service, Amsterdam, The Netherlands.
Abstract:
To investigate the epidemiology and normal course of infection with HIV the prevalence and incidence of the infection were studied among two cohorts of homosexual men in Amsterdam in 1980-7. The cumulative incidence of infection increased from a weighted 2.2% in 1980 to 39.0% in 1987. The estimated yearly incidence of HIV was 3.0% in 1981, rose to 8.8% in 1984, and fell gradually to 0% in 1987. During the study the sexual behaviour of the cohorts was examined. The number of men with whom anopenetrative intercourse was practised fell from a mean of 10.6 to 1.4 for those positive for HIV antibody, whereas the number with whom anoreceptive intercourse was practised fell from a mean of 3.7 to 0.5 for those negative for the antibody. In addition, there was a reduction in the number of cases of hepatitis B and syphilis among men in general. The decline in infection with HIV was assumed to be linked to changes in sexual behaviour. Such changes practised early in the course of the epidemic probably had a strong effect on the number of cases of AIDS among homosexual men in Amsterdam.
Insights
HIV infection rates in homosexual men in Amsterdam surged initially but declined by 1987 due to safer sexual practices. This shift in behavior significantly impacted the Human Immunodeficiency Virus (HIV) epidemic.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- The early 1980s saw a rise in Human Immunodeficiency Virus (HIV) infections among homosexual men.
- Understanding the transmission dynamics and natural course of HIV infection was critical.
Purpose of the Study:
- To investigate the epidemiology and natural progression of HIV infection.
- To analyze prevalence and incidence within specific cohorts.
- To correlate sexual behavior changes with infection rates.
Main Methods:
- Longitudinal study of two homosexual male cohorts in Amsterdam (1980-1987).
- Tracking of HIV antibody seroconversion rates.
- Analysis of self-reported sexual behaviors, including number of partners and types of intercourse.
- Monitoring of co-infections like Hepatitis B and syphilis.
Main Results:
- Cumulative HIV incidence rose from 2.2% in 1980 to 39.0% in 1987.
- Annual HIV incidence peaked in 1984 (8.8%) and declined to 0% by 1987.
- Significant reduction in the number of sexual partners reported by HIV-positive and negative individuals.
- Concurrent decrease in Hepatitis B and syphilis cases observed.
Conclusions:
- Changes in sexual behavior, including reduced partner numbers, were strongly associated with the decline in HIV incidence.
- Early adoption of safer sex practices likely mitigated the spread of HIV and subsequent Acquired Immunodeficiency Syndrome (AIDS) cases.
- Public health interventions targeting behavioral change are crucial during epidemics.