Does bar-based, peer-led sexual health promotion have a community-level effect amongst gay men in Scotland?

Abstract

This paper evaluates the effectiveness of a bar-based, peer-led community-level intervention to promote sexual health amongst gay men. The intervention consisted of peer education within bars, gay specific genitourinary medicine (GUM) services and a free-phone hotline. Data were collected at baseline (1996) and at follow-up (1999) in gay bars in Glasgow (intervention city) and Edinburgh (control city). During the intervention peer educators interacted with 1484 men and new clients increased at the gay specific GUM service. However, the hotline was under-utilized and abused. The outcome measures were: reported hepatitis B vaccination; HIV testing; unprotected anal intercourse (UAI) with casual partners; negotiated safety; and amongst men reporting UAI with a regular partner, the proportion who knew their own and their partner's HIV status. Significant differences in sexual health behaviours were observed across locations and across time, but the only significant intervention effects were amongst men who had direct contact with the intervention, with higher uptake of hepatitis B vaccination and HIV testing. The intervention did not produce community-wide changes in sexual health behaviours. These results question the replication and transferability of peer-led, community-level sexual health promotion for gay men outwith the USA and across time.

Peer-led HIV prevention among gay men in London: Process evaluation

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Why some MSM present late for HIV testing: a qualitative analysis

“…MSM gave a sense that they would have tested had they been further encouraged, an important missed opportunity. Missed opportunities in HIV testing, in both primary and secondary care, are widely recognised (Stekler & Golden, 2009 (Kelly et al, 1997;Elford et al, 2002;Flowers et al, 2002;).…”

Public Sexual Cultures: A Systematic Review of Qualitative Research Investigating Men's Sexual Behaviors with Men in Public Spaces

“…Unfortunately, extant research does not explore the social function of PSEs other than to document that it exists; we know little about those cruisers who exploit PSEs' social functions, nor why they choose these locations over other gay spaces. Capitalizing on these structures, health promoters could explore peer education amongst cruisers, similar to the community mobilization models which successfully improved sexual health behaviors amongst gay men who use U.S. and U.K. commercial gay venues (Kegeles, Hays, Pollack, & Coates, 1999;Kelly et al, 1997;Elford, Bolding, & Sherr, 2001a;Flowers, Hart, Williamson, Frankis, & Der, 2002). Moreover, PSEs are likely to provide health promoters' with access to men who do not use commercial gay venues, such as socially disadvantaged men without the fiscal means to access commercial venues, or other MSM whose identity and anonymity may be challenged by the use of the gay scene .…”