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The research, published in the journal 'Sexually Transmitted Infections' includes a survey of men at gay bars, clubs and saunas in London, Manchester and Brighton between 2003 and 2004. It found that more than one in three HIV-positive gay men, and almost one in five HIV-negative gay men, said they have unprotected sex.

The surveys involved participants filling in questionnaires on sexual behaviour. Out of almost 3600 questionnaires handed out across 90 venues, 2640 were completed. Saliva samples were also requested to find out about HIV prevalence, and 2311 men agreed to provide these.

Results of the saliva tests found the rate of HIV infection to be highest in Brighton, at almost 14 per cent, and lowest in Manchester, at 8.6 per cent. However, the rate of infections that were undiagnosed was high in all three cities, ranging from one in three in Brighton to more than four out of ten (44 per cent) in London.

Across the entire sample, one in three men who was HIV positive did not know they had the infection. This was despite the fact that over two thirds of these men said they had been to a sexual health clinic within the past year.

Almost one in five (18 per cent) of HIV-negative men and over a third (37 per cent) of HIV-positive men said they had had unprotected sex with more than one partner in the past year. Over the same time period, one in five HIV-negative men and four out of ten HIV-positive men said that they had had a sexually transmitted infection.

The study's authors, Dr Danielle Mercey and Julie Dodds of the UCL Centre for Sexual Health & HIV Research, concluded that despite the availability of treatment and a national policy to promote HIV testing, a significant proportion of infection remains undiagnosed.

They call for renewed efforts to be made to boost diagnosis and curb risk behaviours that encourage onward transmission of HIV and other sexually transmitted infections.

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