Fifteenth International Conference on Interdisciplinary Social Sciences

Abstract

Among gay and bisexual men (GBM), the measure of gay social engagement (GSE) has been used to represent involvement in gay subcultures. GSE has contradictorily been associated with both risk behaviours and harm minimisation strategies over time in Australia. We reviewed the role of GSE over time, and reassessed its meaning and implications in current contexts. GSE was initially associated with awareness of ‘safe sex’, condom use and other forms of HIV risk-reduction. In the late 1990s, GSE was associated with condomless sex with casual partners, and yet remained associated with knowledge of other risk reduction strategies like serosorting and strategic positioning. Engagement in sexually adventurous gay subcultures was a key factor in HIV infection and men who engaged in these subcultures were also very socially connected to gay community. GSE is also associated with sexual sensation seeking, greater partner number, sex partying, and use of drugs for sex. GSE has been associated with recent and more frequent HIV testing and with treatment uptake following HIV diagnosis, and more recently, with initiation of HIV pre-exposure prophylaxis (PrEP), as well as subsequent declines in condom use following PrEP. When examining risk reduction knowledge or practice, GSE indicates greater access to detailed knowledge about risk reduction strategies. When examining risk behaviour, GSE indicates greater risk. However, what appears to be contradictory may be two sides of the same coin: GSE may have always been indicative of a complex tension between pleasure-seeking and risk-reduction among GBM.