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15 Jan 2010

Asian gay men's sex survey reports high levels of sex without condoms

The world’s second-largest sex survey of men who have sex with men, focusing mainly on men in East and Southeast Asia, has found that 46% of those who had anal intercourse reported inconsistent condom use with casual partners, and higher levels of unprotected sex with regular partners.

The (Fridae.com 2009 MSM Sex) survey has produced findings across a wide range of indicators that are remarkably similar to the world’s largest survey of gay men's sexual behaviour, the UK's annual Gay Men’s Sex Survey (GMSS) conducted by Sigma Research.

Take The Survey >> 

The success of the English-language survey, hosted by the gay Asian website www.fridae.com, has led to a larger 2010 survey in nine languages ranging from Hindi to Japanese – see below.

The 2009 survey was answered by nearly 8000 gay men. Twenty per cent of respondents were from the three non-Asian countries of the USA, Australia and the UK, and this may have influenced some results such as the HIV testing figures.

A quarter were from Singapore, where Fridae is based, 13% from Malaysia, 8% from Hong Kong and 6% from mainland China, six per cent from Thailand and about 3% each from Indonesia, the Philippines and Taiwan. There were also significant proportions from Japan, South Korea and Vietnam.

Findings that significantly differed from those of the UK GMSS included:

• A higher proportion of men had ever taken an HIV test than in the UK (74%, versus 65% in the GMSS), though slightly fewer had tested in the last twelve months (51% versus 54%);

• Five per cent who had tested and 3.7% of the whole group knew they had HIV, compared with 11.6% of testers and 9.8% of the whole group in the UK survey;

• A lower proportion had high numbers of partners than in the UK (13% had had more than ten partners in the last year, compared with 19.5% with more than twelve partners in the last GMSS);

• A higher proportion met partners on the internet and fewer in bars and clubs than in the UK, though the proportion meeting partners in saunas was identical.

Apart from these findings, the findings of the Asian and the UK surveys are remarkably similar.

To view or download the 2009 MSM Sex Survey report (in PDF), click onto www.msmsexsurvey.com. 

The report on the survey – see www.msmsexsurvey.com – notes that 31% of men having sex with a regular partner and 21% having casual sex in the last year did not always use a condom. However this includes the 13% of men who had not had sex with a man at all in the last year plus 12% who did not have anal sex with regular partners and 17% who did not anal sex with casual partners.

This therefore understates the proportion of anal sex that was unprotected. In the full findings:

• Fifty-eight per cent of men had had a regular partner and 62% had had casual sex;

• Seventy-nine per cent of those with regular partners and 72% of those with casual partners had had anal sex;

• Fifty-three per cent of those who had regular partners and 33% of those with casual partners had not consistently used condoms;

• Sixty-seven per cent of those who had anal sex with regular partners, and 46% of those who had anal sex with casual partners, had not consistently used condoms.

For comparison, in the last GMSS, 53% of those who had had receptive anal sex and 52% who had had insertive anal sex had not always used a condom in the last year.

The age profile of the respondents was very similar to the GMSS, with a median age of 33 (34 in GMSS). This was an educated and well-travelled group, with two-thirds having had university education (61% in GMSS) and 64% of them having travelled out of their country of residence in the last year.

Eighty-two per cent identified as gay (86% in GMSS) and 15% as bisexual (8.5% in GMSS), with 7% reporting sex with a woman in the last year, the same proportion as in GMSS. Five point five per cent were married to a woman (in the GMSS 4.3% were married or in a primary relationship with a woman). Three quarters said they were comfortable with their sexuality, and about a third appeared socially isolated, saying they had “few or no” gay friends.

As noted above, the proportion having a large number of partners (over 10) was lower and the proportion who had been sexually abstinent was higher than in the GMSS (13% having had no sex with men versus 7% in GMSS).

Forty-five per cent of men were in a committed relationship (48% in GMSS) and 42% only had sex with their regular partner.

The internet was the most common way for men to meet each other: 72% had met someone through the internet in the last year (62% in the last GMSS, whose data was collected in 2007), 38% at saunas (the same as GMSS) and 28% in a club (52% in the GMSS at a “bar, pub or club”).

As indicated above, 5% of those tested for HIV tested positive. Of these 62% were taking antiretroviral medication and 51% had an undetectable viral load. HIV status made no difference to relationship status, with the same proportion reporting a regular partner; 70% of partners were not HIV positive themselves.

Although two-thirds agreed that “the best time to talk about HIV is before sex” only 20% had actually discussed HIV status before sex: this compares with 40% ‘sometimes’ and 10-20% ‘always’ doing so in the GMSS.

The last section of the survey asked about HIV stigma. Nearly 40% of respondents knew someone with HIV and 14% had had sex with someone they knew had HIV. Three-quarters of respondents said they would befriend someone with HIV but only 60% would share food with them and 30% would have sex with them (these results included the HIV positive respondents).

Fridae’s founder, Dr Stuart Koe, commented: “Our survey started in 2004 mostly as an adjunct to the local study done in Singapore. By 2006, we were collecting not only far more results than the pen and paper studies, but were more cost-effective to market, and had more candid answers about sensitive topics.” 

This article was first published by NAM/Aidsmap.com and is republished with permission.

The 2010 Asia Internet MSM Sex Survey is currently online at www.2010aimss.com and will run until 28 February.

To view or download the 2009 MSM Sex Survey report (in PDF), click onto www.msmsexsurvey.com. 

Reader's Comments

1. 2010-01-15 18:21  
I believe education is the key component to the understanding of sex as a whole. I am speaking of a growing number of young adults who are unaware of the implication of their actions. I remember growing up during the 80's in Malaysia there were huge campaigns towards the awareness of HIV/AIDS, which I feel it hit the spot of knowledge and protecting yourself.

We must further address that there are rampant substance abuse which are available anywhere, and the eagerness of trying it for the first time. This usually leads to the unprotected sex chapter.
2. 2010-01-15 20:38  
Education aside, responsibility for oneself is equally important.
3. 2010-01-15 21:31  
I found on my visits to Taiwan ( 3), Hong Kong (1) Shanghai (4 times ), Beijing (1) that maybe 20-30% of the guys that fucked me insisted on a condom, the rest preferred bareback. For us it worked. I am still neg and we all had a pleasurable time.
Risky - yes, but communication is helpful in limiting the risk
4. 2010-01-15 21:56  
#3, you talked to the HIV virus and asked nicely for it not to infect you? That's something I never though about!

... I would not say that it worked, just that so far you have been lucky. But is there really a point to have this conversation again?
5. 2010-01-15 22:35  
Yes, post #3 pretty much explains the "think" behind much of the risky behavior going on...imagine that tidbit of advice coming from a 41 year old man who lives in one of the hardest HIV-struck cities in the USA who then travels to Asia and repeatedly practices unsafe sex. It's not difficult to imagine then, young, uneducated men in Asia thinking that it's safe to put a loaded gun to their head and pull the trigger. ...because they "communicated well"....or their neighborhood fortune teller told them they would have long, happy lives.
6. 2010-01-15 22:39  
Thanks for hosting the survey, through the results, it turned out to be that there are too many innocent people in their ways of practicing.
7. 2010-01-15 22:39  
Posts3-5:

Kuman long ago had an op to swap over his mouth and anus. This has enabled him to have lower risk sex and talk crap at the same time.
8. 2010-01-15 23:07  
What, no use of condoms, don't get me wrong, sex feels good without a condom, but doing it with a long term partner in a relationship is fine when you're not being promiscuous and sleeping around!

With strangers, why don't people use them, is it because people have this thought that they will never get caught out and that they will be protected from diseases because the people they encounter will be clean?

That's so stupid, think about it!

Some people will never learn, what's the point of people trying to find cures for these diseases if people can't even protect themselves?
I think that it's pure negligence, I don't feel that it's arrogance or ignorance but more likely to be naive about it due to lack of knowledge of it from school or peers.

I'm astonished that there are so many people who think you can't catch STDs from oral sex!!
9. 2010-01-15 23:30  
When I was doing this survey, I thought some of the qns were flawed.
10. 2010-01-16 01:30  
I honestly believe to each his own. There's no point preaching condoms when people just go online and download porn.

However, I think Jan should do a follow up article based on the results, since he's the expert. :P

Personally, knowing some couples who do bareback and have been monogamous for as long as 15 years and above with not a single houserocking gossip of a scandal, I'll keep my thoughts to myself about the condom issue.

However, that doesn't mean PT should stop giving out condoms at clubs across KL here in Malaysia.
11. 2010-01-16 06:08  
RE post 5 - wow -- Quite an assumption that men in Asia are only young and uneducated. Most of the men I met were men, not boys and a subtantial number of the men I have engaged in sex with are college graduates and working professionals bankers, teachers, doctors, lawyers, merchants) . Such a bigoted attitude you have assumed about men in Asia.

I really do not know much about the HIV rates in NYC, as I actually lived in the greater NYC area, not in the city itself, but rather a suburban residential community of 10,000 people. I think the highest rates of HIV involve groups such as drug users and certain neighborhoods in the city, which were not really on my radar.

Candidly after almost 10 years in NYC I think I only know 3, maybe 4 guys that are HIV positive and now that I am back upstate, far from the city, I do not know anyone in my circles.

I understand that there is still a risk of course and that the choices we made were made mutually based on a reasonable understanding of our sexual backgrounds.

You might note that upon discussion, their preference was for no condom use and I agreed to it as the bottom.

I do not seek to justify my actions or seek approval from others. Each person makes his own decision in life and must live with the consequences. For me, fortunately thus far, I have not been wrong in the decision to trust a partner, casual or long term. I do not necessarily advocate my actions to others. My remarks were to confirm the general tone of the survey results.

12. 2010-01-16 07:26  
I'm interested in knowing the age range of the respondent(s) in the survey
Comment edited on 2010-01-16 07:30:07
13. 2010-01-16 07:45  
Re Kuman's posts (#5 and 11). He does not seem to get the msg, does he? The moment he has unprotected sex with anyone, no matter in NY State, NY City, or Asia, he puts himself and all subsequent partners at risk. He obviously doesn't care about himself but he surely must think about his subsequent partners.

Frequent testing is not the answer for him as there is a time span following the sexual act before a result can be relied upon. During that time he could be infecting many others.

But I think Kuman is something of a fraud. Anybody who lives in "NYC" (New York City), lives in one of the 5 Boroughs of the City. If one is outside those 5 Boroughs, one is not in NYC: one is in New York State. There's no such thing as a "suburban residential community" outside NYC, nor is there such a thing as the "greater NYC area".

Finally, just take a walk arounf Chelsea or Greenwhich Village at more or less any time of day and you will note many people who are obviously in fairly advanced stages of AIDS. Statistically, there will be many more than that number who are HIV+.

Kuman has his mind and his eyes firmly closed. He should close another part of his anatomy.
14. 2010-01-16 09:02  

"4 Sep 2009
Condoms: In defence of our unliked friends
by Jan Wijngaarden"

Remember this article ? (and others by Jan)

For those who think condom is 'a burden', make four copies of the above article so your wont forget: one in your bedroom, one in the bathroom, and one you keep your your wallet...and one to accompany you in the coffin.

Yes, dear Aput, I read you however "We few, we happy few, we band of brothers" are diminishing at a fast rate. Education among the novices and ignorant is an ever must, and above all, self-control

JPS
15. 2010-01-16 10:46  
As I recall Kuman is also a huge defender of the conservative - dare I say fascist thoughts of Sarah Palin and the Republican party based upon his previous statements opposed to gay marriage legislation here in the US.

16. 2010-01-16 10:51  
Come on, if you are responsible to each other, you must use condom when have anal sex.

If you don't when you get HIV+, what you should to your partner?
Blame him? angry with him? even break up with him?

that is an idiot!!
17. 2010-01-16 12:25  
yes I agree some of the questions were flawed cus they wouldn't just fit me in that part but neverthless , it I still prefer to have full time protected sex ...
18. 2010-01-16 12:47  
Guys, can we talk about the issues, rather than abusing each other?
19. 2010-01-16 12:56  
Let's face it - when it comes to passion and situation, added to by various chemicals - well, sense flies out the bedroom window, and a standing prick takes over very often. However, condoms don't cure AIDS and HIV, they provide limited protection only. A responsible approach to our sexual acitivity will limit the virus spread, but then again, I dont have a hard-on right now!
20. 2010-01-16 13:45  
the comment above re age is good. a lot of the behaviour is no doubt linked/associated with age or generation, as every social survey is, an urban/rural split would also be good since urban and rural people behave differently, usually.

One gets a sense in the world now, the gay world and I think younger gay world, that HIV AIDS is a treatable disease, like a fever. IT IS NOT. HIV/AIDS is probably as treatable as CANCER, maybe.

and who wants CANCER or HIV/AIDS and HIV can be prevented.
21. 2010-01-16 13:50  
second thought, there is a birth date question so maybe the results will be tabulated or cross reference by age?
22. 2010-01-16 18:30  
This is a disturbing result. I had no idea there were so many of us 'MSM' who didnt use condoms consistently with casual partners when engaging in anal sex.. .

I thought condom use was just common-place except for a few.

Am I naive ?

Comment edited on 2010-01-17 06:33:15
23. 2010-01-16 21:22  
I disapprove of Kuman10127's sexual practice, but I strongly condemn those who take the liberty to offend him publicly just because they -- like myself -- disapprove of his choices.

NO ONE is responsible for protesting your OWN life -- unless you are unconscious/in a coma. It is your OWN responsibility to practice safe sex, not jump off the bridge, take your diabetes/heart pills etc.

So if Kuman10127's sexual partners choose to engage in risky sexual behaviour with him, it is their OWN choice, not his doing.
24. 2010-01-17 01:50  
I am older than some people here. And the history of the gay civil rights struggle worldwide, worldwide in different ways,

ONE BIG LESSON LEARNED OR NOT LEARNED

WE GAY PEOPLE HAVE TO TAKE RESPONSIBILITY FOR OUR COMMUNITY AND COMMUNITY BEHAVIOUR AND "POLICE OURSELVES" THAT IS CONTROL AND MANAGE OUR OWN COMMUNITY

BECAUSE

AS WE SEE IN BEIJING TODAY, THE REAL POLICE WILL POLICE US AND THEN WE ALL SUFFER.

SORRY BUT GAY GUYS RUNNING AROUND ALL OVER BAREBACKING AND NOT USING CONDOMS WITH MANY PARTNERS PUTS EVERYBODY AT RISK, IT IS NOT JUST A PERSONAL DECISION.

IF YOU WHACK OFF IN YOUR OWN BEDROOM ALONG, THAT IS PERSONAL BUT WHEN YOU INVOLVE OTHER PEOPLE IN A LIFE THREATENING BEHAVIOUR, SUCH AS ANAL SEX WITHOUT CONDOMS, YOU ARE PULLING A TRIGGER ON A GUN, MAYBE THE GUN MISSED THIS TIME (BAREBACKING) BUT AT SOME POINT - YOU WILL BE DEAD OR WOUNDED.

PASSING ON A DEADLY CONTAGIOUS DISEASE TO OTHER PEOPLE, OFTEN UNKNOWN, IS LIKE JUMPING OFF THE BRIDGE AND YOU HIT OTHER PEOPLE AT THE BRIDGE BOTTOM, MAYBE KILLING THEM TOO.

DO GAY PEOPLE AROUND THE WORLD REALLY HAVE TO DIE AGAIN, MILLIONS FROM AIDS, JUST TO SHOW OUR ARROGANCE?

WE SHOULD BE TALKING MORE ABOUT LOVE AND NOT JUST SEX.
25. 2010-01-17 02:08  
Once again, the aimss misses the mark substantially. As in previous years, no question has related to those who are in a long-term intercontinental relationship. In this day and age, it is imperative that we understand that long-distance relationships not only do exist but are working. Further, it is negligent on the part of the aimss sponsors to not acknowledge these relationships exist and work.

I've been in a long-term, sero-discordant relationship with a Thai national for the past five years. I'm positive while my partner is negative. We at best have sex once or twice a year and remain monogamous but what of those who have open relationships?

PLEASE aimss, I implore you to begin tracking these types of relationships as necessary data within this study! At least a few questions need to reflect current intercontinental relationships or some data will be flawed or at least inaccurate.
Comment #26 was deleted by its author on 2010-01-17 02:29
27. 2010-01-17 02:37  
RE: lpark, steveuk, TroyBoy4u, et al...

While I certainly understand and commend your passion on the matter, shaming another for a lapse in judgment is not the answer.

Attacking someone on their sexual proclivities does a disservice to the community at large by further driving these types of sexual activities underground. When you seek to humiliate someone you inevitably make them turn a deaf ear to your argument. A study recently confirmed this.

Note however Kuman10127, that this does not in anyway absolve you from the responsibility to protect yourself and your partners every time. Especially if you engage in sex with multiple partners. I'm not crazy about the use of condoms myself but because I care very much for my partner I wouldn't dream of having unsafe sex at this stage of my five year relationship and neither would he. It only takes one time and two wrongs do not make a right!

28. 2010-01-17 02:56  
I agree about lapses in judgement, i have done that too.

but barebacking as a constant practice, with no thought to the consequences for others, such as death? and long suffering, is more than a lapse in judgement, it is killing us slowly.
29. 2010-01-17 21:13  
sounds like a great market for Durex and other condom companies, they should pay for this free data

gosh, all the internet hook ups surprise me, Fridae must be making a huge fortune
30. 2010-01-17 21:33  
anymore news on that lipo suction death (Franklin Heng) by those plastic surgeons in Singapore? although not an exclusive gay issue, its something more and more people are doing, can't Fridae assign an investigative reporter and find out what really happened?




31. 2010-01-21 13:40  
Just to add on to what had been said..

I have, just for the fun of it, profile myself as a +ve guy.
Go on SG chat room looking for sex..

Connected with some guys also claim to be +ve..
They are still actively looking for sex although knowing that they are +ve.

Furthermore, they do RAW !!
Regularly !! no ConDom !! didnt tell that they are +ve.

So guys.. we just need ONE, n only one guy like this to get us all into trouble.

Thinks about it.. this is not in US.. it is in SG.
Report these guys to the authority ?!
32. 2010-01-21 20:03  
Some guys (both givers and takers) deliberately prefer bareback though they know the risks. Should be another survey on using condom in oral sex.
33. 2010-01-22 11:10  
HIV is only part of the picture in unprotected sex. Its also Hep B, chlamydia, gonorrhea and syphilis. Anyone whom you do not know or trust, always assume they are positive and use condoms. Be safe.

However, agree that communication is important in having unprotected sex only with a partner you trust and monogamous but once any party strays (as we are only human), back to condoms until further testing...
34. 2010-01-22 11:18  
If I may add my 2 cents worth.

It's all very well to talk about "taking responsibility for yourself". I believe the real issue behind many risky behaviors is a lack of personal value of one's life.

Most MSM communities around the world are marginalised and there are many individuals within those communities who do not have a healthy self esteem and struggle with a clear value and perspective of their life today and for their future.
In many cases these individuals crave love and acceptance and in many of those cases they look to their sexual partners to provide it; albeit in the short term.

Previous studies, have identified the heightened sense of intimacy in unprotected sex: and if it is intimacy and love that someone is craving then unprotected sex is more likely to occur.

If we can find ways to improve sense of self worth of those individuals at greatest risk, then we maybe able to achieve a comparative reduction in the number of sero-conversions.

PS
Maybe a good place to start would be to stop denigrating those individuals with differing opinions on this forum. The input is very a valuable insight into a fellow community members.
35. 2010-01-22 11:58  
i m not too sure about the title "Asian gay men's sex survey reports high levels of sex without condoms" for the article, but to me it seems a bit of in-sensitive regard to certain group of ethnicity people, plus reading the comments here also leading to the assumption that Asian gays are not well-educated and taking non or less responsibility to the society and the community.

i m absolutely support this survey and any kind of responsible activity. but it would be better if the people who involved in such reports and comments knowing what they r actually saying and have proper background knowledge, apart from trying to making themselves standing out because aim to certain group of ethnicity.

TO BE RESPONSIBLE IS EVERY ONE'S DUTY IN THE COMMUNITY, WITHOUT TARGET ON ANYONE.

i d like to provide my thoughts to anyone who think is useful:
Education/promotion (promote unstable, unprotected sexual activities lead to great danger)
Funding/supply (provide free condoms and water based lubricants in the place where gays gathering)
Guiding (promote Monogamous Relationship, and family value in the gay way)

i use to work for New Zealand Aids Foundation, http://www.nzaf.org.nz/, NZAF is doing great job to keep it healthy.
36. 2010-01-24 09:56  
Unless I missed it, I didn't see mention of the impact of drug and alcohol use on unsafe sex practices in this survey. As someone who used to drink and drug, I know that my self-esteem used to take a back seat to sex. Sad, but true! This is not an excuse. Just a statement of fact. Now I insist on safe sex practices for the safety of myself and my sex partner and I am encouraged when my partner broaches the subject before I do. Many opinions have been posted regarding this survey. I would just like to echo those who have stated that we must be responsible for ourselves. And I disagree with #19. Condoms do not provide limited protection. They provide significant protection. In lieu of condoms, there are safe sex acts that can be really hot and passionate. Let's take care of ourselves and our partners, eh?
37. 2010-02-26 02:25  
#3, communication is not helpful - under any circumstance, no matter what your partner says - in reducing any risk in contracting HIV. Like others have already pointed out, you were lucky - and it had nothing to do with your communication.

In fact, I would go so far as to say that asking someone's HIV status is essentially unnecessary. What if he says he's negative - will condom use be disregarded? Only for those unaware of how HIV testing actually works. As long as you are sexually active - no matter how self you are - you don't know what your HIV status is. Period.

Furthermore, while many gay people do suffer from low self esteem, we can no longer blame the great heterosexual population and the wider culture for our problems. The rise in HIV must be attributed to the government covering the cost of anti-retrovirals - in both developed and developing nations. While I wouldn't advocate the government pulling out, it would significantly stem the rise of HIV for those folks who engage in unsafe sex knowing that their pockets would pay the price should they contract the virus.

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