European Men-Who-Have-Sex-With-Men Internet Survey (EMIS-2017): Design and Methods

Abstract

Men-who-have-sex-with-men (MSM) carry a disproportionate burden of sexually transmitted infections across Europe. Health planners require sexual health needs assessment data to respond appropriately. In addition, surveillance of risk and precaution behaviours in this population enables evaluative judgements of policy responses. The European MSM Internet Survey (EMIS-2017) aimed to repeat the pan-European online survey on male homosexual behaviour conducted in 2010, both to update information required to plan and monitor health promotion interventions and consolidate harmonisation of existing behavioural surveillance approaches. Our study team collaborated with more than 200 partners from academia, public health and civil society across 50 countries. Starting from our previous EMIS-2010 questionnaire, partners engaged in three rounds of iterative survey development and piloting until the final content was agreed. Transfer to an online survey application was followed by further pretesting before translation into 32 additional languages, final testing and sign-off. The survey was available to complete online in 33 languages simultaneously from 18 October 2017 to 31 January 2018. Ten international MSM dating mobile apps were paid to send short promotional messages, and national partners promoted the survey via at least another 272 websites and social media accounts. Real-time monitoring of responses facilitated targeted advertising by country and recruitment source. Ultimately 144,305 cases were submitted of which 137,358 (95.2%) were eligible for inclusion. EMIS-2017 demonstrated the feasibility of multi-country online MSM surveying with public funding. Meaningful involvement of a large number of collaborators in the survey design and its execution ensured successful recruitment. Careful design, piloting and presentation ensured the survey was acceptable and had authority and perceived community benefit. Partners in 38 countries have already been supplied with a national database of 100 or more respondents for national analysis, while the study team has focussed on international comparisons among 137,358 respondents in 50 countries.

Canadian results from the European Men-who-have-sex-with-men Internet survey (EMIS-2017)

“…While EMIS uses the term "men who have sex with men (MSM)", the authors use the term "gbMSM" to describe the same population as the latter is commonly used in Canada. A more detailed description of the methods can be found elsewhere (11).…”

Sexual practices and the risk of Hepatitis A in men who have sex with men in Spain

“…In 2016, 1,296 cases were diagnosed in Spain and, in 2017, this figure increased to 4,567 cases (Instituto de Salud Carlos III, 2018, 2019), but this may have been an underestimation according to the European Centre for Disease Prevention and Control (ECDC, 2018). Studies published to date have focused on determining the prevalence of high‐risk behaviour within the framework of HIV surveillance and prevention (Paquette & De Wit, 2010) and identifying factors with which they are associated (Weatherburn et al., 2019). Among other studies, research areas include the use of the Internet to find sexual partners (Anzani et al., 2018), the use of psychoactive substances (Carey et al., 2009; Pialoux et al., 2017), the use of pre‐exposure prophylaxis (PrEP) (Pialoux et al., 2017) and participation in ‘chemsex’ (Pialoux et al., 2017; Sida Studi, 2016).…”

Sexual and Mental Health Inequalities across Gender Identity and Sex-Assigned-at-Birth among Men-Who-Have-Sex-with-Men in Europe: Findings from EMIS-2017

“…Fieldwork occurred 9th October 2017 to 31st January 2018. The methods are described in detail elsewhere [ 23 ]. The research design received a favorable opinion from the Observational & Interventions Research Ethics Committee of the London School of Hygiene & Tropical Medicine (14 September 2017; LSHTM ethics ref: 14421).…”

“…We used validated measures of anxiety and depression, potential alcohol dependence, internalized homonegativity and social support. The majority of other measures had been used previously in EMIS-2010, and the face validity of all measures was ensured through testing during development (see [ 23 ]).…”