A new decline in preventive behaviours among homosexual men : the role of highly active antiretroviral therapy?

The articles published in this issue of Eurosurveillance on recent trends of preventive behaviours in homosexual men in Spain, Switzerland, and the Netherlands, all conclude that the practice of safer sex is declining. They emphasise increases in anal penetration (regardless of the nature of the relationship), non-protected anal intercourse, and ejaculation in the mouth, in particular among casual partners. The increase of diagnoses of acute sexually transmitted diseases (such as gonorrhoea and syphilis) in different European countries – illustrated in this issue by the data from the Netherlands – is the first tangible consequence of this decline.