Patterns of change in sexual behavior among gay men in New York City

In the absence of a vaccine or effective treatment for AIDS, health education remains the most effective strategy for stemming the spread of the epidemic. Among homosexual and bisexual men, who continue to account for the majority of AIDS cases, sexual practices have been identified as the principal risk factor. Consequently, public health efforts aimed at this population have focused on raising awareness of the potential risks of HIV infection associated with certain sexual practices. A sample of 162 asymptomatic gay and bisexual men were studied to examine patterns of change and stability in sexual behavior. The data reveal that while the large majority (84%) had adopted at least modification in their sexual behavior, primarily in the form of reducing their total number of partners and their number of anonymous partners, a significant proportion (48%) continued to engage in risky sexual behavior; this, despite high levels of knowledge concerning risk-reduction guidelines. The findings suggest that the mere transfer of information concerning safer sex practices is not sufficient to induce the desired behavior changes in a substantial proportion of gay men. Alternative strategies for achieving behavior change are suggested.