Mens Beliefs and Intents Towards Treatment as Prevention

April 16/2013

In efforts to stem the rising tide of HIV infection among Canada’s most affected group – men who have sex with men – University of Toronto researchers have completed one of the most innovative, ambitious and comprehensive studies ever of this demographic.

Results from this groundbreaking national telephone survey provide a clear – and sometimes surprising – snapshot of a group on which very little reliable data exists, and for whom HIV is a critical health issue. Study results were presented at the Canadian Association of HIV Research (CAHR) Conference in Vancouver on April 11.

“Men who have sex with men are the most vulnerable to HIV, and yet – until now – a clear sense of the attitudes, opinions, and behaviours of many in this group have been missing,” says Dan Allman, Assistant Professor at U of T’s Dalla Lana School of Public Health. “With responses from both rural and urban areas, in all regions of the country, our survey provides new directions for health policies and programs that can serve this group, prevent further HIV infection and improve overall health and well-being.”

The Male Call Canada telephone survey captured mens’ attitudes, opinions and behaviours on topics such as sexual identity, homophobia, general and mental health, condom use, HIV testing and disclosure, the criminalization of HIV and transactional sex. By employing a method in which respondents chose when and where to anonymously call into a toll-free telephone line, researchers were able to collect responses from men aged 16 to 89, and from an impressive 40 per cent of Canadian postal codes.

One key finding was that men from rural communities are living the HIV epidemic the same way that men in cities are, but because they live in areas where same sex sexual behaviour is stigmatized, they are less likely to be ‘out,’ and less likely to access HIV prevention and other health services.

Other interesting insights, outlined in a series of graphic-novel inspired fact sheets that the researchers hope will provide a “touch-point” between men and their health care practitioners, included:

• 26.2 per cent did not know their HIV status, including 50.6 per cent of bisexual men;
• 62.1 per cent felt criminal prosecution increases the stigma and discrimination of people living with HIV;
• 21.7 per cent moved away from family or friends because of homophobia;
• 4.1 per cent self-identified as heterosexual, 35.6 per cent bisexual, 54.6 per cent gay and 5.7 per cent identified otherwise;
• 19.2 per cent were married or partnered to a woman;
• 32.2 per cent lived in rural areas where access to health care and programs was limited

“For many men, these topics aren’t easy to discuss with a doctor wearing a white coat. These fact sheets may help cut through the discomfort and act as a starting point for discussion,” says Professor Ted Myers in the Dalla Lana School of Public Health. “HIV treatment is changing – in many cases it’s now a manageable chronic disease, and our study provides insight into men’s attitudes on this phenomenon that can help inform policy and improve services for this vulnerable population.”