McDaid and Hart BMC Public Health 2010, 10:798 http://www.biomedcentral.com/1471-2458/10/798 Table 2 Contact with HIV prevention activities in the past 12 months (N = 1318) Contact with HIV prevention activities in last 12 months Any Obtained free condoms from a bar/club/sauna or the Internet Picked up sexual health leaflet in a bar/club/sauna Looked for safer sex/sexual health information on the Internet Talked to an outreach worker in a bar/club/sauna Participated in one to one or group counselling on sexual health or HIV prevention Contact in past 12 months n 1082 964 508 459 178 105 Yes % 82.1 73.1 38.6 34.8 13.5 8.0 n 236 354 810 859 1140 1213 Page 4 of 10 No % 17.9 26.9 61.5 65.2 86.5 92.0 discordant HIV status, which was not associated with any HIV prevention activities. Factors significant at the bivariate level were entered into a multivariate model for each of the HIV preven- tion activities (Table 4). The factors that remained sig- nificantly associated with obtaining free condoms were: age, frequency of gay scene use, STI testing in the past 12 months, and having 10 or more sexual partners in the past 12 months. The factors associated with acces- sing sexual health information were ethnicity and fre- quency of gay scene use, while odds remained lower among men who did not provide oral fluid specimens. Factors associated with talking to an outreach worker were frequency of gay scene use, and HIV and STI test- ing. Factors associated with participating in counselling were frequency of gay scene use, HIV treatment opti- mism, HIV testing, HIV-positive status and having had an STI in the past 12 months. Discussion In a study of the economic implications of HIV infec- tion in the UK, it has been estimated that the lifetime HIV-related costs for diagnosed HIV-positive individuals is between £280,000 and £360,000 and preventing the HIV infections acquired and diagnosed in the UK in 2008 would save £1.1 billion in future HIV-related costs [1]. MSM, who accounted for over a third of diagnoses in 2008, most of which were probably acquired in the UK [1], are therefore a high priority for HIV prevention interventions. This is the first UK paper to report engagement with HIV prevention strategies in MSM since the advent of antiretroviral treatment in 1996. The majority of the MSM in our community-based surveys reported having contact with HIV prevention activities in the past 12 months. Obtaining free condoms was reported by almost three quarters of the sample. Half also reported picking up sexual health leaflets in a bar, club or sauna or looking for safer sex or sexual health information on the Internet. Talking to outreach workers in gay venues or participating in one to one or group counselling on sexual health or HIV prevention was less common, reported by just one in ten respec- tively. Comparable data are not available elsewhere in the UK, but our findings are similar to those of the US National HIV Behavioural Surveillance survey of MSM, which found 80% had received free condoms, but few had participated in individual or group HIV prevention interventions in the past 12 months (15% and 8%, respectively) [18]. In multivariate analysis, each of the HIV prevention activities remained associated with frequency of gay scene use, but not with sexual risk behaviours (with the exception of having ten or more sexual partners, which itself only remained associated with obtaining free con- doms). Frequency of gay scene use could be taken as a proxy for risk behaviour and the two were correlated, but there were no significant interactions between the two in any of the multivariate HIV prevention models and when separate models were fitted for each of the correlated variables and compared with the final models to check for the effects of collinearity, no substantively important differences were observed (data not shown). It is also of particular note that contact with HIV pre- vention activities (with the exception of accessing sexual health information) remained associated with either HIV or other STI testing in the past 12 months, with utilising counselling also more likely among men who reported having had an STI in the past 12 months and HIV-posi- tive men. There are some limitations to note when considering these results. Only men who visited the venues surveyed had the opportunity to participate and caution should be taken when generalising to a wider population of gay men. The data are cross-sectional and participants were only asked if they had contact with a pre-determined list of HIV prevention activities, not the extent of this contact, the quality, intensity, or frequency of exposure to these activities, or what, if any, impact it had on them. Other activities could have been available to, and utilised by, the men who participated in this survey. It is recognised that these factors should be assessed in the future to accurately assess the potential of prevention