Sexual behaviour and HIV epidemiology: comparative analysis in France and Britain. The ACSF Group

France and Britain have similar size populations, yet the incidence of AIDS is threefold higher in France. The objective of this study was to compare data from two surveys recently performed in the two countries, in order to determine whether differences in sexual and drug-use behaviour could explain the different epidemiological patterns.

Cross-sectional random sample surveys of France and Britain.

In France, 20,055 persons aged 18-69 years and in Britain, 18,876 persons aged 16-59 years were interviewed in 1990-1991. The following indicators were compared in the respondents aged 18-59 years: prevalence of homosexual experience and injecting drug use, number of sexual partners, prevalence of sexual practices, condom use and sex with prostitutes, age of sexual partners.

Very similar results were found for the prevalence of male homosexual partnerships. Slightly higher numbers of lifetime partners were reported by French than British men, but no difference was found for recent periods. Anal intercourse and sex with prostitutes was more frequent among heterosexual French people than British people. Condom use was more systematic in Britain than in France.

Only small differences were found between the two countries, although prevalence of risk indicators were higher in France. These differences combined with early development of prevention policies in Britain, together with the timing of virus introduction, may contribute to differences between the epidemics in the two countries.