Places and people: the perceptions of men who have sex with men concerning STI testing: a qualitative study

Datta, Jessica; Reid, David; Hughes, Gwenda; Mercer, Catherine H; Wayal, Sonali; Weatherburn, Peter

doi:10.1136/sextrans-2016-052983

Cited by 26 publications

(32 citation statements)

References 28 publications

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“…In doing this, we aimed to inform the development of a survey instrument to gather comprehensive quantitative data on knowledge of and attitudes towards STIs and BBVs among MSM attending sexual health clinics. 15,16…”

Section: Introductionmentioning

confidence: 99%

Awareness of and attitudes to sexually transmissible infections among gay men and other men who have sex with men in England: a qualitative study

et al. 2019

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Background Rates of sexually transmissible infections (STIs) have increased over recent years among gay men and other men who have sex with men (MSM) in England and Wales. HIV diagnoses remain high in this group and men with diagnosed HIV are disproportionally affected by STIs. MSM are therefore a priority for health promotion efforts to reduce STIs. Understanding awareness of and attitudes towards STIs is essential in developing health promotion interventions to reduce prevalence. Methods: Eight focus group discussions (FGDs) with a total of 61 MSM in four English cities included a ranking exercise to gauge how ‘scary’ participants thought 11 STIs are. The exercise sought insights into participants’ awareness of, knowledge about and attitudes towards STIs and blood-borne viruses (BBVs). FGDs were audio-recorded, transcribed and data analysed thematically. Results: All groups ranked HIV and Hepatitis C virus (HCV) as the scariest infections, and the majority ranked syphilis and herpes as highly scary. Scabies was ranked as the least scary by most groups. Rankings were dependent on how well informed participants felt about an infection, its transmission mechanisms, health affect and the availability of vaccines and treatment. Personal experience or that of friends influenced perceptions of particular infections, as did their prevalence, treatment options, visibility of symptoms and whether an STI could be cleared from the body. Conclusions: The study findings suggest that, although some MSM are well informed, there is widespread lack of knowledge about the prevalence, modes of transmission, health implications and treatment regimens of particular STIs.

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Section: Introductionmentioning

confidence: 99%

Awareness of and attitudes to sexually transmissible infections among gay men and other men who have sex with men in England: a qualitative study

et al. 2019

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“…Design the physical layout, and look and feel, of health care settings to minimize stigma. Yet while other studies have noted the importance of the physical layout and its ability to create or reinforce stigma with other populations [ 77 , 78 ], efforts to modify such settings to reduce stigma are scant. Intervention approaches such as Community-Based Participatory Research [ 79 ] hold promise in the effort to address public health problems such as these.…”

Section: Discussionmentioning

confidence: 99%

Doing battle with “the monster”: How high-risk heterosexuals experience and successfully manage HIV stigma as a barrier to HIV testing

Gwadz

Leonard

Honig

et al. 2018

Int J Equity Health

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BackgroundAnnual HIV testing is recommended for populations at-risk for HIV in the United States, including heterosexuals geographically connected to urban high-risk areas (HRA) with elevated rates of HIV prevalence and poverty, who are primarily African American/Black or Hispanic. Yet this subpopulation of “individuals residing in HRA” (IR-HRA) evidence low rates of regular HIV testing. HIV stigma is a recognized primary barrier to testing, in part due to its interaction with other stigmatized social identities. Guided by social-cognitive and intersectionality theories, this qualitative descriptive study explored stigma as a barrier to HIV testing and identified ways IR-HRA manage stigma.MethodsIn 2012-2014, we conducted in-depth qualitative interviews with 31 adult IR-HRA (74% male, 84% African American/Black) with unknown or negative HIV status, purposively sampled from a larger study for maximum variation on HIV testing experiences. Interviews were audio-recorded and professionally transcribed verbatim. Data were analyzed using a systematic content analysis approach that was both theory-driven and inductive.ResultsStigma was a primary barrier to HIV testing among IR-HRA. In the context of an under-resourced community, HIV stigma was experienced as emerging from, and being perpetuated by, health care organizations and educational institutions, as well as community members. Participants noted it was “better not to know” one’s HIV status, to avoid experiencing HIV-related stigma, which could interact with other stigmatized social identities and threaten vital social relationships, life chances, and resources. Yet most had tested for HIV previously. Factors facilitating testing included health education to boost knowledge of effective treatments for HIV; understanding HIV does not necessitate ending social relationships; and tapping into altruism.ConclusionsIn the context of economic and social inequality, HIV stigma operates on multiple, intersecting layers. IR-HRA struggle with an aversion to HIV testing, because adopting another stigmatized status is dangerous. They also find ways to manage stigma to engage in testing, even if not at recommended levels. Findings highlight strategies to reduce HIV stigma at the levels of communities, institutions, and individuals to improve rates of annual HIV testing necessary to eliminate HIV transmission and reduce HIV-related racial and ethnic health disparities among IR-HRA.

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“…Due to dearth of data on contextual drivers of STI among MSM and BC populations [ 12 , 13 ], informed by 2014 GUMCAD data, we decided to implement the BBEST in SHCs that had a high proportion of BC attendees (n=13) and MSM attendees (n=3), referred to henceforth as “BC only study sites” and “MSM only study sites,” respectively. Additional 3 SHCs with high proportions of both BC and MSM attendees were selected and are referred to henceforth as “combined study sites.”…”

Section: Methodsmentioning

confidence: 99%

“…From June 2014 to August 2015, face-to-face or telephone interviews were conducted with 20 staff members recruited from all study sites to assess the acceptability of the proposed BBEST model. A total of 61 MSM were recruited to 1 of the 8 focus group discussions (FGDs) with the help of lesbian, gay, bisexual and trans/sexual health community-based organizations (CBOs) via newsletters and Facebook pages and an MSM geospatial sociosexual networking application [ 12 ]. Moreover, 65 BC participants (n=32 men), aged 15-70 years, recruited from SHCs, colleges, and CBOs, participated in 5 FGDs and 31 interviews.…”

Section: Methodsmentioning

confidence: 99%

The Acceptability and Feasibility of Implementing a Bio-Behavioral Enhanced Surveillance Tool for Sexually Transmitted Infections in England: Mixed-Methods Study

Wayal¹,

Reid²,

Blomquist³

et al. 2018

JMIR Public Health Surveill

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BackgroundSexually transmitted infection (STI) surveillance is vital for tracking the scale and pattern of epidemics; however, it often lacks data on the underlying drivers of STIs.ObjectiveThis study aimed to assess the acceptability and feasibility of implementing a bio-behavioral enhanced surveillance tool, comprising a self-administered Web-based survey among sexual health clinic attendees, as well as linking this to their electronic health records (EHR) held in England’s national STI surveillance system.MethodsStaff from 19 purposively selected sexual health clinics across England and men who have sex with men and black Caribbeans, because of high STI burden among these groups, were interviewed to assess the acceptability of the proposed bio-behavioral enhanced surveillance tool. Subsequently, sexual health clinic staff invited all attendees to complete a Web-based survey on drivers of STI risk using a study tablet or participants’ own digital device. They recorded the number of attendees invited and participants’ clinic numbers, which were used to link survey data to the EHR. Participants’ online consent was obtained, separately for survey participation and linkage. In postimplementation phase, sexual health clinic staff were reinterviewed to assess the feasibility of implementing the bio-behavioral enhanced surveillance tool. Acceptability and feasibility of implementing the bio-behavioral enhanced surveillance tool were assessed by analyzing these qualitative and quantitative data.ResultsPrior to implementation of the bio-behavioral enhanced surveillance tool, sexual health clinic staff and attendees emphasized the importance of free internet/Wi-Fi access, confidentiality, and anonymity for increasing the acceptability of the bio-behavioral enhanced surveillance tool among attendees. Implementation of the bio-behavioral enhanced surveillance tool across sexual health clinics varied considerably and was influenced by sexual health clinics’ culture of prioritization of research and innovation and availability of resources for implementing the surveys. Of the 7367 attendees invited, 85.28% (6283) agreed to participate. Of these, 72.97% (4585/6283) consented to participate in the survey, and 70.62% (4437/6283) were eligible and completed it. Of these, 91.19% (4046/4437) consented to EHR linkage, which did not differ by age or gender but was higher among gay/bisexual men than heterosexual men (95.50%, 722/756 vs 88.31%, 1073/1215; P<.003) and lower among black Caribbeans than white participants (87.25%, 568/651 vs 93.89%, 2181/2323; P<.002). Linkage was achieved for 88.88% (3596/4046) of consenting participants.ConclusionsImplementing a bio-behavioral enhanced surveillance tool in sexual health clinics was feasible and acceptable to staff and groups at STI risk; however, ensuring participants’ confidentiality and anonymity and availability of resources is vital. Bio-behavioral enhanced surveillance tools could enable timely collection of detailed behavioral data for effective commissioning of sexual health ser...

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Places and people: the perceptions of men who have sex with men concerning STI testing: a qualitative study

Cited by 26 publications

References 28 publications

Awareness of and attitudes to sexually transmissible infections among gay men and other men who have sex with men in England: a qualitative study

Awareness of and attitudes to sexually transmissible infections among gay men and other men who have sex with men in England: a qualitative study

Doing battle with “the monster”: How high-risk heterosexuals experience and successfully manage HIV stigma as a barrier to HIV testing

The Acceptability and Feasibility of Implementing a Bio-Behavioral Enhanced Surveillance Tool for Sexually Transmitted Infections in England: Mixed-Methods Study

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