Safe sex campaigns 'may backfire'

HIV awareness campaigns may fail to change behaviour

Campaigns to encourage gay men to practise safe sex may backfire.

Researchers found that it is wrong to assume that every strategy aiming at encouraging less risky sexual behaviour among gay men is necessarily beneficial.

Instead, they warn that each initiative should be evaluated individually.

We have to look at the possibility that they don't have an effect or that they may potentially do harm

Dr John Imrie

Researchers at a London sexual health clinic recruited 343 gay men with an acute sexually transmitted infection, or who said they had had unprotected anal sex in the past year.

All the men were given a 20 minute one-to-one counselling session and 175 of the men were invited to a one day workshop.

New infections

The number of new infections diagnosed at the clinic were then recorded.

Each participant was also asked to keep a record of their sexual behaviour over the next 12 months.

The researchers found that the advice seemed to have very little effect.

In fact, the proportion of men who contracted a new STD during the 12 month follow-up period was larger in the group who had been given advice (31%) than in a comparable group who were not (21%).

The report authors said the results were "unexpected" and clearly a cause for concern.

They concluded that even carefully designed interventions should not be assumed to bring benefit and the potential for such interventions to do more harm than good needed to be taken seriously.

Assumptions

Study author, Dr John Imrie, of the Royal Free and University College Medical School, London, said: "We shouldn't just assume that health promotion and in particular HIV preventions are going to be beneficial.

"We have to look at the possibility that they don't have an effect or that they may potentially do harm.

"Although we have seen a large degree of behaviour change since the mid-80s, we are now seeing that some of those messages are not reaching people and don't have the same kind of impact they had in the past.

"So we need to redouble our efforts around prevention and to make sure that things we are doing are going to be effective."

Dr Imrie said it was possible that safe sex campaigns encouraged people to indulge in other forms of sex that might also spread STDs.

A spokesperson for the National Aids Trust told BBC News Online: "There needs to be different ways of providing information and education about safe sex - some will work for some people, and some for others.

"Sometimes information is more effective when it is given in a social context.

"Some of the more traditional ways of giving information, for instance in a clinic setting, have been shown to have limited success."

A spokesperson for the Public Health Laboratory Service said: "It is disturbing that following interventions such as one to one counselling the participants in the study returned with new infections, meaning that safe sex messages are not being heeded."

The research is published in the British Medical Journal.