This study examines patterns of agreement, knowledge and practice which can prevent or facilitate HIV transmission among men who are in regular ('primary') male-to-male relationships. Data are from a national volunteer phone-in survey of homosexually-active men in Australia. A sub-sample of 1070 men from a larger sample (n=3039) were found to have one or more regular partners for longer than 6 months. Self-reported HIV serostatus of survey participant and his regular partner, type of agreement regarding anal intercourse both within and outside the regular relationship, and engaging in unprotected anal intercourse with regular and with casual partners were examined. Risk practice was defined as unprotected anal intercourse with a regular partner of different or unknown serostatus and/or unprotected anal intercourse with a casual partner. Agreements were classified as: negotiated safety (28.8%); no unprotected anal intercourse (33.6%); unsafe (10.6%) and no agreement (17.0%). Risk practice was reported by 17.8% of the men. Type of agreement was found to be the strongest predictor of risk practice. Negotiated safety agreements were common, and were kept on the whole. Men with unsafe agreements, although only a small proportion of men in relationships, had high levels of risk practice.

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Exploring the social dimension of sexuality is crucial to prevention strategies for AIDS. New developments in social theories of sexuality can inform empirical research. A survey of 535 gay and bisexual men in New South Wales and the Australian Capital Territory was designed in the light of practice-based analyses of gender and sexuality. Anal intercourse without condoms ranks high in physical and emotional significance though it is known to be relatively unsafe with regard to transmission of the human immunodeficiency virus. This practice shows few statistical connections to variables describing social structure, but is linked to variables describing gay social milieu attachment, patterns of sexuality, and awareness of the situation created by the AIDS crisis. Potentially dangerous anal practice is more common within established relationships and especially common with men who describe themselves as 'monogamous'. This creates dilemmas for prevention strategy. Connections between social variables and the frequency of unprotected anal intercourse point to the importance of informed social support for safer sex. Prevention strategy needs to emphasise collective action, not just personal change.

The aim of this study was to examine gay and homosexually active men's knowledge of hepatitis C, drug use, injecting practices and testing for hepatitis C. The data were from 3039 men who participated in the Male Call 96 national telephone survey of Australian gay and homosexually active men. Altogether, 9.9% of the men had ever injected and 4.4% had injected in the 6 months prior to data collection. Injecting drug use was more common among gay identified men and gay community attached men. Among the injecting drug users, 73.4% had injected before 25 years of age. There was a fair amount of uncertainty about hepatitis C although 41.3% of the men reported having been tested (higher at 64.2% among those who had ever injected). Sixty‐five men self‐reported a hepatitis C diagnosis, 17 with HIV co‐infection. In a multivariate model, self‐report of hepatitis C diagnosis was associated with being in the 30‐39 or 40‐49 years of age brackets, better knowledge of hepatitis C, HIV positivity and injecting drug use. Needs identified include education and support for both younger and older gay and homosexually active men within a health promotion framework of partnership, harm minimisation and community development.