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Biomedical subjects

A P Coxon

Publications and source records attributed to A P Coxon.

16 recordsLinked to original sources
PubMed1999

Parallel accounts? Discrepancies between self-report (diary) and recall (questionnaire) measures of the same sexual behaviour.

Questionnaires and diaries have complementary biases and advantages for obtaining information on sexual behaviour but self-completed sexual diaries have the advantage of reducing retrospective bias. In a validation study of homosexual behaviour, sexual diary counts and subsequent questionnaire estimates (together with ratings of the certainty of the estimates) referring to the same month are compared and the discrepancies analyzed. Main findings include: questionnaire data yield consistently higher average estimates than diary counts, but have the same ordinal profile; individual difference (diary-questionnaire) scores show that 55% of questionnaire estimates of acts are higher than diary counts, 20% are identical and 25% are under-estimates; discrepancies are differentially located in different sexual acts. Masturbation and fellatio are systematically over-estimated in questionnaires and anal intercourse without a condom is the major source of inaccuracies, but in different directions: active partners under-estimate and passive partners over-estimate the amount of highest-risk sex. A strategy of joint use is discussed.

Homosexuality, Male↗
PubMed1994

Gay men as victims of nonconsensual sex.

Incidents of nonconsensual sexual activity among 930 homosexually active men living in England and Wales are analyzed. Of these men, 27.6% said they had been sexually assaulted or had sex against their will at some point in their lives; one third had been forced into sexual activity (usually anal intercourse) by men with whom they had previously had, or were currently having, consensual sexual activity. The contention that male rape is usually committed by heterosexually identified men, primarily as an expression of power and control, is not supported. Recognition that gay men rape other gay men is needed, both by the gay community and support services for victims.

Adolescent↗
PubMed1993

Changes in condom use by gay men.

Cross sectional and longitudinal data on condom use among homosexually active men is presented. Data pertain to two waves of interviewing (1987/8 and 1991) from Project SIGMA, a large longitudinal study of male homosexual behaviour in the light of HIV. Aggregate changes across the time-period indicate an increase in condom use for both insertive and receptive anal intercourse, particularly with casual partners. Condom use is still much more prevalent with casual rather than regular partners. Longitudinal analysis show considerable changes at the individual level, with almost a third of men changing their practices. Half of those decreased their risk behaviours, whilst the other half increased them. Less than 1% used condoms for fellatio in the year preceding the 1991 interview, but 8.3% had used other barriers during sex, primarily for hygiene and fun reasons, rather than as disease prophylaxis. Some implications are drawn for condom promotion and HIV prevention.

Adolescent↗
PubMed1993

No connection between alcohol use and unsafe sex among gay and bisexual men.

OBJECTIVE: To investigate the relationship between alcohol use and unsafe sexual behaviour. METHODS: The paper discusses data collected from 461 gay and bisexual men interviewed in England and Wales by Project SIGMA during 1991-1992. These data were collected during face-to-face interviews using retrospective weekly diary techniques and include details of all sexual sessions and alcohol use. The 819 reported sexual sessions with other men are divided into those that involved alcohol use (30.6%) and those that did not. RESULTS: Differences in the incidence of HIV risk behaviours between sexual sessions that involved alcohol use and those that did not are small, and none are statistically significant. Furthermore, for those men who engaged in sexual behaviour whilst under the influence of alcohol, the quantity of alcohol consumed had no effect on sexual behaviour. CONCLUSIONS: Among gay and bisexual men, sex under the influence of alcohol is no more likely to be unsafe than sex among men who have not consumed alcohol.

Alcohol Drinking↗
PubMed1993

Sex role separation in sexual diaries of homosexual men.

OBJECTIVE: To measure types of sex role prevalence in common and risk-related behaviours among gay men for modelling HIV transmission. DESIGN: Cohort study of 385 homosexually active men recording sexual diaries over 1-month periods. METHODS: Measures of incidence of behavioural sex roles for masturbation, fellatio, anal intercourse and anilingus by relationship type, derived from 1-month sexual diary data. RESULTS: Low behavioural role rigidity for masturbation and fellatio, but higher rigidity for anal intercourse and anilingus. Participants with no regular partner showed a relatively low frequency of anal intercourse, whereas those in closed relationships showed a high frequency. CONCLUSION: Although anal intercourse shows a certain degree of behavioural role rigidity, this rigidity is not large enough to conclude that gay men exclusively engage in either an active or a passive role. Typical rates for exclusive active and passive roles for anal intercourse during the month the diaries were recorded were in the range of 12-15%; the dual role was significantly higher.

Adolescent↗
PubMed1993

The testing of saliva samples for HIV-1 antibodies: reliability in a non-clinic setting.

AIMS: To assess the reliability of saliva samples as a means of testing for HIV-antibodies outside clinic settings. METHODS: Men taking part in a non-clinic longitudinal study of homosexually active men provided samples of saliva and blood. Sera were screened using a competitive ELISA (Wellcozyme) and positive sera were confirmed by an indirect ELISA (Abbott). Saliva samples were screened either using an IgG captive radioimmunoassay or an amplified ELISA. RESULTS: A total of 534 paired saliva and blood samples were tested. Overall sensitivity was 96.2% and specificity was 100%. None of the saliva tests were falsely positive for HIV-1 antibodies. CONCLUSIONS: HIV-1 saliva tests can reliably be used in a non-clinic or field setting. However, if results are to be given to respondents, it is necessary to offer adequate counselling and consider the mechanisms for referral and follow-up for those that are found to be HIV-1 antibody positive.

HIV Antibodies↗
PubMed1992

The sexual behaviour of young gay men in England and Wales.

Much research has concluded that young gay men are at disproportionately higher risk of HIV infection through unsafe sexual behaviour. This paper is the first report on this particular group in the UK. As part of a larger cohort study, 111 young (less than 21) gay and bisexual men were interviewed about their sexual behaviour, knowledge of AIDS and HIV, particularly safer sexual practices and other factors. Three per cent had not had sex and 13% had not had anal intercourse with a man at the time of interview. Forty-five per cent had sexual experience with a woman and 34% had engaged in vaginal intercourse. The average age at first homosexual experience was just under 15 years and this is higher than other age groups in the cohort. Median number of male partners in the year before interview was 5, with 1 of whom anal intercourse occurred. Sexual repertoire was relatively restricted compared to older men. Condom use was slightly more consistent and levels of knowledge not significantly different. From these findings, the contention that young gay men are at higher risk of HIV infection through risky sexual behaviour is not supported.

Adolescent↗
PubMed1992

Maintenance of open gay relationships: some strategies for protection against HIV.

The role of sexual exclusivity (monogamy) in relation to HIV, and the use of rule making in non-exclusive (open) relationships, are discussed. Data from interviews with 387 homosexually active men are presented. The most common sexual/relational configuration amongst these men is that of open relationships. Sexual non-exclusivity was found to be associated with longer relationships, and a greater age difference between partners. The strategies some of these men are using to maintain sexually non-exclusive relationships are outlined. These rules pertain both to interpersonal dynamics and HIV prevention. Differing epidemiological significance of the rules and some implications for health education are discussed.

Adolescent↗
PubMed1991

Condom use in a large cohort of homosexually active men in England and Wales.

As part of a prospective study of the seroprevalence of HIV, a cohort of 930 men were interviewed regarding their condom use. Of the 270 respondents that engaged in insertive anal intercourse in the month preceding interview 38.9% always used a condom, 49.6% never used one, and 11.5% sometimes used one. Of the 254 respondents that engaged in receptive anal intercourse in the same time period 42.5% always used a condom, 45.7% never used one, and 11.8% sometimes used one. Compared to other research the proportion of respondents who always use a condom for anal intercourse is relatively high, though use is by no means universal. Condom use is more widespread and consistent with casual rather than regular sexual partners, and it is significantly more common within open rather than monogamous relationships. Out of a wide range of other factors only geographical location (London against outside), marital status, perceived HIV status, number of sexual partners, and how seriously respondents take safer sex are correlated with condom use.

Adult↗
PubMed1991

Sexual partners, penetrative sexual partners and HIV risk.

This paper argues that the notion of sexual partners per se is insufficient for estimating levels of HIV risk behaviour or changes in HIV risk over time, even though it is a crucial element of most epidemiological models of HIV. The concept of a penetrative sexual partner (PSP) is introduced as a considerably more accurate measure of HIV risk. Using data from a longitudinal study of 930 homosexually active men in England and Wales, this paper demonstrates that variation in numbers of PSPs (and thus HIV risk) is not related to variation in the gross numbers of sexual partners.

Adolescent↗
PubMed1990

Heterosexual behaviour in a large cohort of homosexually active men in England and Wales.

This paper seeks to outline the range and type of heterosexual behaviour in a large non-clinic cohort of homosexually active males. A cohort of 930 homosexually active men were interviewed as part of a prospective study of the seroprevalence of HIV. The paper indicates that over 60% of these men have had at least one sexual experience with a female and that about 90% of these males have engaged in vaginal intercourse with a female. Twelve per cent of the cohort had sexual contact with females in the last year, and 5% had sex with females, in the month preceding interview. Amongst these behaviourally bisexual males the number of female partners is significantly lower than the number of male partners. However, the proportion of female partners with whom penetration occurs is very much higher than for male partners.

Adult↗
PubMed1990

Seroprevalence of HIV-1 infection in a cohort of homosexually active men.

A non-clinic cohort of 525 homosexually active men from London and South Wales were recruited in 1988 for a study by interview of sexual behaviour. A sample of blood was tested for HIV-1 antibodies. Seropositivity in London was 9.2% compared with 3.4% in South Wales. Men who were not regular STD clinic attenders had a lower rate of seropositivity than did those who were regular attenders. Men who were seropositive reported more sexual partners with whom they had anal intercourse and also reported more episodes of syphilis. Overall, rates of seropositivity were lower than those reported by studies from STD clinics.

Adolescent↗