Study Shows AIDS Changing Sexual Behavior

The AIDS epidemic has had a chilling effect on the sex lives of Los Angeles County residents, according to an unprecedented look at their sexual behavior contained in a RAND report released Friday.

The researchers reported that the virus has significantly reduced sexual promiscuity. Nearly one-quarter of those questioned reported having had no sex partners during a one-month survey period.

Researchers conducted two separate surveys, one of gay and bisexual men, and one of the adult population, regardless of sexual orientation.

Four of five of the homosexual and bisexual men said they have reduced their number of sexual partners in response to the AIDS epidemic. More than half reported increased use of condoms, and one-third said they now avoid high-risk anal intercourse. Eleven percent said they have become celibate.

A companion survey of the sex habits of the county’s population at large--touted as the first such survey here--found that only 30% of sexually active adults have modified their behavior in response to the AIDS epidemic, but most of them are not at risk because they are monogamous.

The vast majority of sexually active adults in the general population said they were involved with a single partner. Only 4% had more than one sex partner.

As a whole, Los Angeles residents “lead rather conservative sex lives,” said the study’s principal author, David Kanouse.

“This study belies the image of Los Angeles as the land of highly active sexual adventurers,” Kanouse said. The local findings, he said, are “in line with national data that shows a low number of people with simultaneous multiple sex partners.”

A nationwide New York Times/CBS poll in June reported that 20% of all adults nationwide said the AIDS epidemic had prompted them to change their sexual behavior--mainly by using condoms and limiting the number of sexual partners. More than 50% of single adults under 45 had modified their sexual habits.

Similarly, most Los Angeles County residents who said they had changed their sexual behavior did so by becoming more selective in choosing partners. Moreover, 9% said they had discontinued having anal intercourse--considered high-risk behavior--and 8% said they stopped having sex with prostitutes.

The surveys, conducted by RAND between October, 1989, and January, 1990, focused on the sexual activities for a month of 300 gay and bisexual men and 1,305 adults, all between 18 and 75.

Within the gay community, the survey reported that seven of eight respondents have made some behavorial changes to reduce their risk of contracting the HIV virus. Almost 80% reduced their number of sex partners.

During the month studied, 22% had no sex partner, 54% had one, and 23% had two or more.

One of the “most dramatic findings,” Kanouse said, is that two-thirds of gay and bisexual men had been tested for the AIDS virus. This is more than a fourfold increase above the 16% who had been tested in 1986, he said.

Of those willing to disclose their test results, 17% said they were HIV positive. However, no details about their sexual practices were provided in the RAND report.

Another surprising finding, Kanouse said, was the “overwhelming public support” for AIDS education in middle schools and high schools. A strong majority supports education at the elementary level as well, according to the survey.

Kanouse, who presented the RAND report to the Los Angeles AIDS Commission on Friday, applauded information campaigns for educating the public about the “major routes of transmission” for the AIDS virus--which include anal intercourse without the protection of a condom.

Kanouse also said that “worrisome gaps of knowledge” remain regarding how the virus is transmitted. He cited findings that 33% of the general population mistakenly believes that there is a “very likely” or “somewhat likely” chance of contracting the virus from being around someone with AIDS who coughs or sneezes.

About 28% incorrectly believe that the virus could be transmitted via a mosquito bite or by eating food prepared by a cook infected with the virus. About 25% expressed discomfort with the idea of working in the same office with someone who is HIV-positive.

Kanouse urged the AIDS commission to conduct an education campaign to assure the public that such contacts pose “no known risk of infection.” Otherwise, he warned that these “misperceptions may have serious attitudinal consequences that may lead to discrimination” against HIV-infected people.

Continuing educational efforts are needed within the gay community as well, Kanouse said. “There is still a lot of risky sexual behavior and it would be premature, unfair and tragic to write off this population,” he said.

Instead of practicing “safe sex” by using a condom, many gays are engaging in “safer sex,” he said. For example, they have unprotected anal intercourse and withdraw before ejaculation, or they engage in oral-genital intercourse without a condom.

These two practices are “commonly relied on to reduce the risk of HIV transmission,” the study found. “Neither practice is risk-free and both could eventually prove to be much more risky than many now suppose.”

The survey of gay and bisexual men found 52% had engaged in oral-genital sex without a condom, 18% had anal sex without a condom, and 28% never used a condom.

The RAND surveys break new ground in several ways.

No other study has involved such a large and random sample of gay and bisexual men in Los Angeles County, said RAND researcher Michael Gorman. “Heretofore, most information about the behavior of gay men came out of San Francisco or New York,” he said.

The study showed Los Angeles’ gay population has some distinguishing characteristics, Gorman said. Even though the number of gay men tested here for AIDS has increased dramatically, the number is still lower than elsewhere, he said. More of the men are bisexual, more are monogamous in their relationships, and more engage in oral sex. He added that the Los Angeles study shows that behavioral changes here in response to AIDS are comparable to San Francisco and New York.

However, a San Francisco study last year warned that some homosexual men in that city appeared to be “relapsing” into unsafe sexual activities. Researchers reported that while 48% of the study’s participants were low risk throughout the survey period, 19% relapsed by engaging in one or more acts of unprotected intercourse.

Sex Survey

A survey of 300 gay or bisexual men in Los Angeles County and of 1,305 adults from the county’s population at large shows that the AIDS epidemic has caused both groups to modify their sexual practices. Here are some of the findings of the survey conducted by RAND between October, 1989, and January, 1990: HETEROSEXUAL RESPONDENTS

Total % Because of who changed AIDS Any change 29% 29% Became celibate 3 48 Reduced number of sex partners 21 44 More selective in choosing 24 52 partners Reduced number of casual 21 53 partners Used condoms more often 16 56 Stopped anal intercourse 9 52 Stopped sex with prostitutes 8 60 Lowered alcohol/drug use 13 11

Because of AIDS and other reasons Any change -- Became celibate 38 Reduced number of sex partners 46 More selective in choosing 37 partners Reduced number of casual 34 partners Used condoms more often 24 Stopped anal intercourse 37 Stopped sex with prostitutes 28 Lowered alcohol/drug use 15

GAY AND BISEXUAL RESPONDENTS

Total % Because of who changed AIDS Any change 87 87 Became celibate 11 70 Reduced number of sex partners 79 49 More selective in choosing 70 49 partners Reduced number of casual 57 58 partners Used condoms more often 58 87 Stopped anal intercourse 36 68 Stopped sex with prostitutes 19 64 Lowered alcohol/drug use 45 15

Because of AIDS and other reasons Any change -- Became celibate 21 Reduced number of sex partners 46 More selective in choosing 45 partners Reduced number of casual 35 partners Used condoms more often 12 Stopped anal intercourse 19 Stopped sex with prostitutes 22 Lowered alcohol/drug use 30

SOURCE: RAND