Comparison of HIV-preventive behaviour among MSM in Austria and Germany
A.J. Schmidt1, F.M. Amort2, D. Bozkurt2, M. Bochow1
1Social Science Research Center Berlin (WZB), Public Health Policy, Berlin, Germany, 2AIDS Hilfe Wien, Vienna, Austria
Objective: To compare HIV-preventive behaviour, including HIV-testing, among men who have sex with men (MSM) in Austria and Germany.
Methods: In 2007, a self-administered questionnaire was simultaneously distributed in Austria and Germany, using a variety of magazines for gay men and German-language websites for MSM. The survey was funded by AIDS-Hilfe Vienna and the German Federal Centre for Health Education. To detect differences between both countries, adjusted Odds Ratios (aOR) were calculated, controlling for age group, city size, and education in multivariate logistic regression analyses.
Results: 9.024 questionnaires were analyzed; response rates (75% completed online) were similar (nAustria=854; nGermany=8,170). Austrian respondents were more likely to have ever been tested for HIV (aOR=1.20;p=0.03) – particularly to be tested recently (aOR=1.36;p< 0.001) – and to be aware of the possibility of post-exposure prophylaxis (aOR=1.23;p=0.04). Among tested men, Austrian respondents were less likely to be diagnosed HIV-positive (aOR=0.59;p< 0.01).
No differences were observed regarding attitudes towards condoms, reported condom use in anal intercourse with steady or non-steady partners, oral exposure to seminal fluid, frequency of anal intercourse with non-steady partners, the number of sexual partners, involvement in potentially high-risk sexual networks, or a history of recent gonorrhoea/syphilis. When stratified for HIV-serostatus, no difference was found with respect to proportions of sexual partners known to be HIV-positive.
Conclusions: High rates of HIV-testing in the Austrian sub-sample are partly a consequence of the historically earlier onset of the wide-spread offer and recommendation of HIV-testing to MSM in Austria. Austrian and German MSM – despite differences in prevention policies – seem to have adapted similar safer sex cultures in their daily lives. Because of lacking data on MSM-specific HIV-prevalence in Austria, it cannot be determined with certainty whether the lower proportion of HIV-positive MSM in the Austrian sub-sample reflects a lower HIV-prevalence among Austrian MSM or results from self-selection bias.