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Objective: Sexual orientation change efforts (SOCE), or “conversion therapy,” are pseudoscientific practices intended to suppress or deny sexual attraction to members of the same gender/sex. There are currently no data available to inform estimates of the prevalence of SOCE exposure in Canada. The objective of this study is therefore to describe the prevalence, social–demographic correlates, and health consequences of SOCE among Canadian sexual minority men. Methods: Sex Now 2011 to 2012 was a cross-sectional nonprobability survey of Canadian sexual minority men. Respondents were asked about lifetime SOCE exposure. We estimated prevalence of SOCE exposure by sociodemographic characteristics and examined psychosocial health outcomes among those exposed to SOCE. Results: Of N = 8,388 respondents, 3.5% (95% confidence interval, 3.2% to 4.1%) reported having ever been exposed to SOCE. Exposure to SOCE was higher among gay men (as compared with bisexual men), transgender respondents (as compared with cisgender respondents), those who were “out” about their sexuality (as compared with those who were not “out”), Indigenous men (as compared with White men), other racial minorities (as compared with White men), and those earning a personal income <$30,000 (as compared with those earning ≥$60,000 CAD). Exposure to SOCE was positively associated with loneliness, regular illicit drug use, suicidal ideation, and suicide attempt. Conclusions: SOCE exposure remains prevalent and associated with substantial psychosocial morbidity among sexual minority men in Canada. All levels of government in Canada should consider action to ban SOCE. SOCE survivors likely require intervention and support from the Canadian health-care system.

Background Researchers and activists have long called for changes to blood donation policies to end what is frequently framed as unjustified bans or deferral periods for men who have sex with men (MSM). Since 2016, in Canada, a man had to be abstinent from all sexual contact (anal or oral sex) with other men for at least 12 months in order to be an eligible blood donor. As of June 3, 2019, this deferral period was reduced to 3 months. Methods To better understand the acceptance of existing deferral policies and possible future policy, we conducted 47 in-depth interviews with a demographically diverse sample of gay, bisexual, queer, and other men who have sex with men (GBM) in Canada’s three largest cities: Vancouver, ( n = 17), Toronto ( n = 15), and Montreal ( n = 15). Interviews were coded in NVivo 11 following an inductive thematic analysis. We focus on men’s preferred policy directions and their opinions about a policy change proposed by Canada’s blood operators: a 3-month deferral for all sexual activity between men. We interviewed GBM approximately one-year before this new deferral policy was approved by Health Canada. Results Most participants were opposed to any deferral period in relation to MSM-specific sexual activity. A fair and safe policy was one that was the “same for everyone” and included screening for several risk factors during the blood donation process with no categorical exclusion of all sexually active MSM. Participants believed that multiple “gender blind” and HIV testing-related strategies could be integrated into the blood donation process. These preferences for a move away from MSM-specific exclusions aligned with their opinions concerning the possible change to a 3-month MSM deferral, for which participants shared three overarching perspectives: (1) step in the right direction ; (2) ambivalence and uncertainty ; and (3) not an improvement. Conclusion A predominant assertion was that a change from a 12-month to a 3-month deferral period would not resolve the fundamental issues of fairness and equity affecting blood screening practices for GBM in Canada. Many participants believed that blood donation policy should be based on more up-to-date scientific evidence concerning risk factor assessment and HIV testing. Electronic supplementary material The online version of this article (10.1186/s12889-019-7123-4) contains supplementary material, which is available to authorized users.

Blood donation policies governing men who have sex with men have shifted significantly over time in Canada—from an initial lifetime ban in the wake of the AIDS crisis to successive phases of time-based deferment requiring periods of sexual abstinence (5 years to 1 year to 3 months). We interviewed 39 HIV-negative gay, bisexual, queer, and other sexual minority men (GBM) in Vancouver, Toronto, and Montreal to understand their willingness to donate blood if eligible. Transcripts were coded following inductive thematic analysis. We found interrelated and competing expressions of biological and sexual citizenship. Most participants said they were “safe”/“low risk” and “willing” donors and would gain satisfaction and civic pride from donation. Conversely, a smaller group neither prioritized the collectivizing biological citizenship goals associated with expanding blood donation access nor saw this as part of sexual citizenship priorities. Considerable repair work is required by Canada’s blood operators to build trust with diverse GBM communities.

Sexual script research (Simon & Gagnon 1969 , 1986 ) bourgeoned following Simon and Gagnon's groundbreaking work. Empirical measurement of sexual script adherence has been limited, however, as no measures exist that have undergone rigorous development and validation. We conducted three studies to examine current dominant sexual scripts of heterosexual adults and to develop a measure of endorsement of these scripts. In Study 1, we conducted three focus groups of men ( n = 19) and four of women ( n = 20) to discuss the current scripts governing sexual behavior. Results supported scripts for sex drive, physical and emotional sex, sexual performance, initiation and gatekeeping, and evaluation of sexual others. In Study 2, we used these qualitative findings to develop a measure of script endorsement, the Sexual Script Scale. Factor analysis of data from 721 participants revealed six interrelated factors demonstrating initial construct validity. In Study 3, confirmatory factor analysis of a separate sample of 289 participants supported the model from Study 2, and evidence of factorial invariance and test-retest reliability was obtained. This article presents the results of these studies, documenting the process of scale development from formative research through to confirmatory testing, and suggests future directions for the continued development of sexual scripting theory.

Background We developed estimates of community viral load (VL) and risk factors for unsuppressed VL from a cross-sectional study of men who have sex with men (MSM) in Vancouver, Canada. Methods MSM were recruited from February 25, 2012 – February 28, 2014 using Respondent-Driven Sampling (RDS). Participants completed a computer assisted self-interview questionnaire and a nurse-administered point-of-care HIV test. For HIV positive participants, we conducted VL and CD4 cell counts. We used RDS-weighted analysis to obtain population estimates of key variables and multivariable logistic regression to examine factors associated with having a VL ≥200 copies/mL among HIV-positive participants. Results We recruited 719 participants, of whom 119 (16.6%) were seeds. Our estimate of the population HIV prevalence was 23.4% (95% CI 15.8 – 31.0%) after RDS-adjustments. We estimated that 18.6% (95% confidence interval [CI] 8.8 – 30.4%) of HIV-positive MSM in Vancouver had a VL ≥200 copies/mL. Having an unsuppressed VL was associated with non-Caucasian ethnicity (adjusted odds ratio [AOR]= 4.34; 95% CI 1.67 – 11.1); an annual income of <$15,000 CAD (AOR=6.43; 95%CI 2.08–19.9); using GHB in the previous six months (AOR=4.85; 95%CI 1.79–13.2); unprotected anal intercourse with a known HIV negative or unknown serostatus partner (AOR=3.13; 95%CI 1.10–8.90); and disclosing one’s HIV serostatus ≥50% of the time (AOR=7.04; 95%CI 1.01–49.1). Conclusion Despite a high prevalence of HIV, we estimated that a small proportion of HIV positive MSM have undiagnosed HIV and unsuppressed VL. Our results highlight the importance of continued work to address health inequities using a social determinants of health framework.

IntroductionAwareness and knowledge of treatment as prevention (TasP) was assessed among HIV-positive and HIV-negative gay, bisexual and other men who have sex with men (GBMSM) in Vancouver, Canada.MethodsBaseline cross-sectional survey data were analyzed for GBMSM enrolled, via respondent-driven sampling (RDS), in the Momentum Health Study. TasP awareness was defined as ever versus never heard of the term “TasP.” Multivariable logistic regression identified covariates of TasP awareness. Among those aware of TasP, men's level of knowledge of TasP was explored through an examination of self-perceived knowledge levels, risk perceptions and short-answer definitions of TasP which were coded as “complete” if three TasP-related components were identified (i.e. HIV treatment, viral suppression and prevention of transmission). Information source was also assessed. Analyses were stratified by HIV status and RDS adjusted.ResultsOf 719 participants, 23% were HIV-positive, 68% Caucasian and median age was 33 (Interquartile range (IQR) 26,47). Overall, 46% heard of TasP with differences by HIV status [69% HIV-positive vs. 41% HIV-negative GBMSM (p<0.0001)]. In adjusted models: HIV-positive GBMSM were more likely to have heard of TasP if they were Canadian born, unemployed, not using party drugs and had higher CD4 counts; HIV-negative GBMSM were more likely to have heard of TasP if they were Caucasian (vs. Aboriginal), students, had higher education, a regular partner and multiple sexual partners. Among those aware of TasP 91% of HIV-positive and 69% of HIV-negative GBMSM (p<0.0001) felt they knew “a lot” or “a bit in general” about TasP; 64 and 41% (p=0.002) felt HIV treatment made the risk of transmission “a lot lower”; and 21 and 13% (p<0.0001) demonstrated “complete” TasP definitions. The leading information source was doctors (44%) for HIV-positive GBMSM and community agencies (38%) for HIV-negative GBMSM, followed by gay media for both populations (34%).ConclusionsNearly half of GBMSM in this study reported having heard of TasP, yet only 14% demonstrated complete understanding of the concept. Variations in TasP awareness and knowledge by HIV status, and key socio-demographic, behavioural and clinical factors, highlight a need for health communication strategies relevant to diverse communities of GBMSM in order to advance overall TasP health literacy.

Background Men who have sex with men (MSM) are not eligible to donate blood or plasma in Canada if they have had sex with another man in the last 3 months. This time-based deferment has reduced since 2013; from an initial lifetime ban, to five-years, one-year, and now three-months. Our previous research revealed that gay, bisexual, queer, and other MSM (GBM) supported making blood donation policies gender-neutral and behaviour-based. In this analysis, we explored the willingness of Canadian GBM to donate plasma, even if they were not eligible to donate blood. Methods We conducted in-depth interviews with 39 HIV-negative GBM in Vancouver (n = 15), Toronto (n = 13), and Montreal (n = 11), recruited from a large respondent-driven sampling study called Engage. Men received some basic information on plasma donation prior to answering questions. Transcripts were coded in NVivo following inductive thematic analysis. Results Many GBM expressed a general willingness to donate plasma if they became eligible; like with whole blood donation, GBM conveyed a strong desire to help others in need. However, this willingness was complicated by the fact that most participants had limited knowledge of plasma donation and were unsure of its medical importance. Participants’ perspectives on a policy that enabled MSM to donate plasma varied, with some viewing this change as a “stepping stone” to a reformed blood donation policy and others regarding it as insufficient and constructing GBM as “second-class” donors. When discussing plasma, many men reflected on the legacy of blood donor policy-related discrimination. Our data reveal a significant plasma policy disjuncture—a gulf between the critical importance of plasma donation from the perspective of Canada’s blood operators and patients and the feelings of many GBM who understood this form of donation as less important. Conclusions Plasma donor policies must be considered in relation to MSM blood donation policies to understand how donor eligibility practices are made meaningful by GBM in the context of historical disenfranchisement. Successful establishment of a MSM plasma donor policy will require extensive education, explicit communication of how this new policy contributes to continued/stepwise reform of blood donor policies, and considerable reconciliation with diverse GBM communities.