Sex in two cities--gay men, risk and HIV in Perth and Sydney.

After massive and sustained reductions in HIV risk behaviour amongst Australian gay men in the 1980's and early 1990's, since 1996 there have been signs of small but significant increases in unprotected analintercourse. Gay communities are responding to a post crisis context. However, is this response constant across different locations? This paper investigates changes in sexual negotiation and behaviour amongst gay men in the relatively small Australian city of Perth between 1998 and 2002 and compares these results to similar studies in Sydney, an Australian HIV epicentre city. A number of important similarities and differences between the Perth and Sydney samples are identified, particularly in casual contexts and disclosure of HIV status, identifying that isolated or smaller cities may experience similar phenomena to larger cities, but these may be due to different reasons. The findings point to the need for complementary qualitative research and cautions health promotion practitioners to test their assumptions when developing responses to prevent HIV transmission.