McDaid and Hart BMC Public Health 2010, 10:798 http://www.biomedcentral.com/1471-2458/10/798 been argued that community-level prevention efforts have been difficult to maintain over the course of the epidemic as the threat of HIV has diminished, question- ing the likelihood and potential of a renewed commu- nity response [8]. While further research is required to explore the meaning of ‘gay community’ to MSM in the UK, there is also a need to examine what contact MSM currently have with HIV prevention activities and to assess the extent to which these could be utilised in new prevention efforts. Since 1996, we have surveyed the HIV-related sexual behaviour of MSM in Scotland [9-17]. This paper exam- ines the extent to which MSM engage with existing HIV prevention activities, the factors associated with this, and discusses the opportunities presented for further intervention efforts. Methods The 2008 MRC Gay Men’s Survey collected anonymous, self-complete questionnaires and (Orasure™) oral fluid specimens. Representative samples were recruited from commercial gay venues (12 bars and 2 saunas) in Glas- gow and Edinburgh, Scotland’s two largest cities, using time and location sampling [15]. 1514 men participated in the survey (70.8% response rate [RR]); 1508 com- pleted questionnaires (70.5% RR) and 1277 provided oral fluid samples (59.7% RR). Of the 1508 men who completed questionnaires, 54 (3.6%) heterosexual men reported no sexual contact with men in the previous 12 months and are excluded from the sample. 1318 men provided data on the current HIV preven- tion variables and 136 men with missing data on any of these are excluded from the analyses in this paper. When compared in multivariate analysis, men who pro- vided data on the HIV prevention variables had lower odds of being surveyed in Glasgow (AOR = 0.52, 95% CI 0.33-0.81), being surveyed in a sauna (AOR = 0.43, 95% CI 0.22-0.85), and of having had an STI in the past 12 months (AOR = 0.46, 95% CI 0.25-0.79) than men with missing data on these variables. Questionnaires included demographics, HIV testing history and sexual risk behaviour in the past 12 months [Additional file 1]. Participants were asked if they had, in the past 12 months, picked up sexual health leaflets in bars, clubs or saunas; looked for safer sex/sexual health information on the Internet; obtained free con- doms from bars, clubs, saunas or the Internet; talked to an outreach worker in a bar, club or sauna; or partici- pated in one to one or group counselling sessions on sexual health or HIV prevention. Oral fluid specimens were analysed at the West of Scotland Specialist Virology Centre (screened for anti- HIV using an enzyme immunoassay; positives re- screened, and repeat reactives confirmed using Western Page 2 of 10 Blot). Data were analysed with SPSS 15.0. Logistic regression was used to estimate odds ratios and 95% confidence intervals (CI). Ethical approval was granted by University of Glasgow, Faculty of Medicine Ethics Committee. Results Sample Characteristics Sample characteristics are shown in Table 1. The major- ity were surveyed in bars and identified as gay. The majority were aged over 26 years; 76.8% lived in the Glasgow or Edinburgh areas. Only 3.3% reported being from minority ethnic groups. Just less than half reported degree or post-graduate education and the majority were employed. Many respondents (46.8%) visited the gay scene at least once a week. Just under half had been tested for HIV or other sexually transmitted infections (STIs) in the past 12 months; 3.5% had a HIV-positive oral fluid sample. Most men (96.2%) reported some sex- ual contact in the past 12 months, 12.4% reported UAI with 2+ partners, 20.5% reported UAI with casual part- ners, 24.9% reported UAI with partners of unknown/dis- cordant HIV status, and 8.3% had had an STI in the past 12 months (Table 1). Contact with HIV prevention activities Overall, 1135 men (82.5%) reported some contact with HIV prevention activities in the past 12 months (Table 2). Having obtained free condoms from a gay venue or the Internet was the most frequently reported HIV prevention activity (73.1%), but over a third of men also reported picking up sexual health leaflets in gay venues or using the Internet to look for safer sex or sex- ual health information. Overall, 674 men (51.1%) reported accessing sexual health information (from either leaflets in bars, clubs or saunas, or via the Inter- net). Only 13.5% reported talking to an outreach worker and only 8.0% reported participating in one to one or group counselling on sexual health or HIV prevention. Only 47 men (3.6%) reported use of all four HIV pre- vention activities. Factors associated with contact with HIV prevention activities Table 3 shows the factors associated with contact with HIV prevention activities. The likelihood of engaging with all of the listed HIV prevention activities was higher among men who were more frequent scene users, men who had had an HIV, or other STI, test in the past 12 months, men who reported 10 or more sex- ual partners in the past 12 months, and men who reported having had an STI in the past 12 months (it should be noted that some STIs can be transmitted dur- ing lower risk sexual practices so are not necessarily