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NEWS
Study Finds Many Ignore Warnings on Sex Practices
August 9, 2003

By RICHARD PÉREZ-PEÑA

Most New Yorkers with multiple sexual partners do not know whether they are infected with H.I.V., and more than 40 percent did not use condoms the last time they had sex, according to what city officials say is the most comprehensive survey ever conducted of the city's sexual habits.
People with multiple partners were more likely than others to use condoms and to have had a recent H.I.V. test, but not much more, according to the survey, by the city's Department of Health and Mental Hygiene. In all, the results call into question the continuing effectiveness of nearly two decades of messages about protected sex since the onset of the AIDS epidemic.
Last year, the department conducted a telephone poll of a random sampling of 10,000 adult New Yorkers about a wide range of health issues, providing a rich source of data on subjects like diabetes and obesity. The department has not yet formally released its findings on sexual practices, but they were posted last week on its Web site, www.nyc.gov/health.
"I think there is a degree of complacency, of H.I.V. precaution burnout," said the city's health commissioner, Dr. Thomas R. Frieden. "Sex in the city needs to get safer, and H.I.V. testing needs to be a routine part of medical care. Anyone who's ever had sex, anyone who's ever used IV drugs, needs to know their H.I.V. status." People need to talk to their sexual partners about H.I.V. status and condom use, he said, adding that the department's new motto is "Do ask, do tell."
Among city residents who had three or more sex partners in the previous year, 58 percent said they used a condom the last time they had sex. City health officials said the figure would have been much lower if respondents in this group, who made up one-seventh of the population polled, had been asked whether they used a condom every time they had sex in the last year. In that same group, 34 percent said they had been tested for H.I.V., the virus that causes AIDS, in the previous 18 months.
Among all the New Yorkers surveyed, the poll found that 36 percent used a condom the last time they had sex, and that 26 percent had been tested for H.I.V. in the preceding 18 months. Men who had sex with men were more likely than others to use condoms. But again, as with those who had three or more sex partners, high-risk behavior was not accompanied by a dramatically higher rate of condom use. Of men who had sex with men, 45 percent said they used a condom the last time they had sex, compared with 38 percent of other men.

"That's the really disturbing thing, that the population that is at highest risk really is not taking the steps to protect themselves and others," said Dr. Farzad Mostashari, an assistant health commissioner.
The survey found that middle-aged people were less than half as likely to use condoms as younger adults. Among people aged 45 to 64, 24 percent said they used a condom the last time they had sex. Among those 18 to 24, the figure was 61 percent, and rose to 73 percent for those who had three or more partners. The findings suggest that messages about protected sex have taken root most firmly among people who grew up with them.
Department officials said there was no such generational divide among gay men, probably because those in middle age now were the original targets of pro-condom campaigns when AIDS first burst on the scene in the 1980's, and they are the ones most likely to have been scarred by seeing their friends and partners die of the disease.
The department's report did not break down many of its findings, including H.I.V. testing, by sexual orientation or race. It is also impossible to chart any trends or to compare the city figures with practices across the country, experts say, because no comparable surveys have been done before, locally or nationally.
AIDS deaths in New York City have dropped sharply from a mid-1990's peak of 8,000 people each year, thanks in part to new classes of antiviral drugs. But contrary to perception, the disease has continued to kill people in large numbers, including 1,774 in the city in 2001. Among illnesses, only cardiovascular diseases, cancers and pneumonia and influenza caused more deaths.
And as long-term survival with H.I.V. becomes the norm, the number of infected people continues to climb steadily. About 80,000 people in New York City have tested positive for H.I.V., and an unknown number have the virus but do not know it, according to city health officials.