Surveys are not only interesting for the responses provided by their respondents but also for the unanswered questions raised by unasked questions. The 2007 UK Gay Men’s Sex Survey is no exception and the latest report published in advance of the December release contains a few pearls of wisdom. The oddness of some of the responses could not been spotted without putting together data from different tables into the same table. All the data described here are for the London area.

For instance let’s compare the number of respondents who engaged in unprotected anal intercourse (UAI) in the previous year with sexual partner whose HIV status was unknown or discordant with the willingness of respondents to risk HIV infection rather than to use a condom.

Notwithstanding that the first question did not include people who knew that their sexual partner was being HIV positive (15.8 % of the respondents of the London area reported being HIV positive), there is a gap of 14% between those who said they would engage in UAI and those who actually engaged in UAI. Despite 7.5% of the respondents being unsure about engaging or not in unsafe sex, some people are obviously not straightforward in their answer. It is also quite worrying that some MSM do engage in unsafe sex not knowing the HIV status of their sexual partners.

Let’s look at the perceived risk of HIV transmission amongst all men for the same period, i.e. did men perceived that they were engaging in an unsafe sexual activity?

Interestingly there is a 8.6% difference between those who engage in unsafe sex and those who perceived engaging in safe sex. There is some uncertainty about the veracity of the latest figure. If indeed the figure of 36.1% reflects a reality, i.e. these respondents engage in unsafe sex, we are even much further away from the figure of 13.5% of respondents who say they would risk HIV infection rather than use a condom.

One reason to explain why men engage in unsafe sex is that they may find it difficult to have safe sex, to negotiate safe sex or to stick to safe to safe sex with their partners. Let’s look at the answers to these questions:

The first and very much against the flow observation is that it is overall easy for men to have safe sex and to stick to it. The second is that the second question does not specify which kind of sex is being negotiated, safe or unsafe, and the third and striking observation is that if negotiating and keeping up with safe sex is not that difficult, why so many gay men engage still engage in unsafe sex?

These surveys capture much more than a simple look at the answers would reveal. Behind simple answers hide responses that sum up the complexity of real life experience.

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