40% of gay Scots men with HIV �undiagnosed�

EXPERTS have called for an urgent renewal of HIV prevention efforts in Scotland after new research revealed that four out of 10 gay men who have the virus are unaware they are infected.

In the first study of its kind north of the Border, a survey was undertaken in bars and saunas in Glasgow and Edinburgh to establish the prevalence of HIV infection using questionnaires and anonymous testing.

The results showed that, while one in 25 gay men had the virus, just in excess of 40% had not been diagnosed as HIV-positive. In addition, more than half of those who were undiagnosed had assumed they were in the clear because they had tested negative for HIV in the recent past.

Author Lisa Williamson, a research scientist at the Medical Research Council Social and Public Health Sciences Unit at Glasgow University, said that the study had shown gay men in Scotland are at "significant risk" of HIV.

"It did appear there were significantly more men than we thought there would be who had undiagnosed HIV and were therefore making incorrect assumptions about their status," she said.

"There is a sense that there is a generation of gay men who have grown up without the awareness of HIV that there was earlier in the epidemic, for instance in the 1980s.

"We would now argue that there is a real need to renew HIV prevention efforts."

Nearly 1800 men took part in the study, which has just been published online in the journal of Epidemiology and Social Science.

In Edinburgh, just more than a third of gay men were unaware they were HIV-positive, compared with nearly 50% who were undiagnosed in Glasgow.

In addition, three-quarters of men aged under 26 were unaware they were infected, compared with just in excess of one-third of men who were 26 years old or over.

Williamson pointed out that the issue was not that men were failing to take HIV tests, but they were not having tests frequently enough.

"We would recommend six-monthly sexual health checks should now be promoted for men, given the fact there was quite a high proportion of men with undiagnosed infection who had been tested in the previous year," she added.

Roy Kilpatrick, chief executive of HIV Scotland, said that efforts had been under way to improve access to HIV testing in recent years. He also pointed to innovative projects, such as making sexual health outreach workers available in online chatrooms to those who want advice, which have been pioneered through the Healthy Gay Scotland health promotion initiative.

"There is a lot of work going on, but there is still a lot that needs to be done," he said. "One of the difficulties is that younger men who have sex with men are probably less likely to test for HIV than heterosexual men.

"We don't know why that is, but it could be because young heterosexual men have been targeted through sexual health campaigns on the TV that don't feel appropriate for men who have sex with men."

Kilpatrick also pointed out that, while some health boards in Scotland were recognising the needs of gay and bisexual men, others areas should be doing more.

"In Scotland we had a lot of good innovative, urgent work done in the 1980s with intravenous drug users and we really need to regain that urgency and sense of innovation that was around then," he said. "The needs of gay and bisexual men need to be much better recognised at local levels in Scotland by health boards."

Susan MacDonald, national director of the Terrence Higgins Trust Scotland, said that action "had to be taken fast" to reduce levels of undiagnosed HIV in gay men in Scotland.

"We need to find ways to encourage men to take up existing testing services and find acceptable, accessible options in alternative venues," she said.

"The majority of HIV transmission is from men who don't know their status, so we also have to get the message across that it's dangerous to make assumptions about yourself or your partners."