Sexual health determinants in black men-who-have-sex-with-men living in Toronto, Canada

Abstract

Purpose – The purpose of this paper is to develop a profile of the sexual behavioural characteristics of black men who have sex with men (MSM) in the Greater Toronto Area (GTA), Canada who constitute a unique mixture in terms of background, race, ethnicity, and culture. Having a profile of the sexual health and risk taking behaviours of these men is important since it provides information on these black Canadian men in comparison other black MSM. Design/methodology/approach – Data were collected as part of a cross-sectional study of black MSM in GTA. Survey participants completed a questionnaire requesting information on socio-demographic characteristics, sexual behaviour, general and mental health, and awareness of social marketing strategies for gay men. The study was conducted in 2007-2008, through convenience sampling. Based on the data collected, the authors characterized the profile of black MSM with respect to sexual risk behaviours. Findings – The authors collected data on 168 black MSM. These men perceived their general health to be good. However, a large proportion of them practiced inconsistent condom use but this varied according to the ethnicity of the partner. Inconsistent condom use also varied by place of birth with Canadian-born men and Caribbean-born men less likely to consistently use condoms than African-born men. In multiple regression analysis, being born in Africa favoured condom use. Men were also more likely to practice inconsistent condoms use when the sexual partner was non-black. Further, when sex with other black men was examined, those who were older (30 years) and had not disclosed their sexuality were more likely to stop using condoms. Other variables which were expected to have associations with inconsistent condom use, based on studies in other jurisdictions – such as previous sexually transmitted infections, sex with women, sex while travelling, and drug use were not related to inconsistent condom use. Research limitations/implications – While the survey data were based on a relatively small sample size and may not be representative of the entire black MSM population in the GTA, it provides a basis for ongoing and targeted support for black MSM particularly those born in Canada. Older men who are not open with their sexuality may be at a risk of acquiring or transmitting HIV. Future research should focus on these men. Originality/value – This report provides a perspective on the sexual health and risk taking behaviours of black MSM in Canada. This is particularly important since their social history and health determinants are different from those of US African Americans. The results will stimulate further research targeting this group, and support HIV programmes and services for these men.