Research Team: Jan Yorke (nominated principal applicant), Terry Trussler (co-principal investigator), Nathan Lachowsky (co-principal investigator), Jillian Fenik, Mark Hammann, Phillip Banks, Marlene Hamm, Matt Craggs, George Tesseris, Winston Husbands
What is this research about?
The Gilbert Centre (formerly the AIDS Committee of Simcoe County) launched the first HIV prevention program in Simcoe County and the Muskoka District for men who have sex with men in 2012. To gather a better understanding of the needs of men in the area, they have coordinated a team of community and academic researchers to undertake research to inform programs to reduce HIV transmission and promote sexual health in the region.
Simcoe County is spread over a wide geographic area, with few gay-specific services. Some men have settled here from other regions, while others have been born and lived their entire lives in the region, and may have very different identities and experiences than men with connections to an urban gay context. None-the-less the community’s proximity to the greater Toronto area means that a proportion of men seek both social and sexual contacts and health services in the city.
The research includes an online survey of men in the region as well as more detailed interviews with community members and local service providers. It examines an array of individual factors: testing practices, HIV risk behaviours, experiences of stigma, impact of HIV status and viral load on decision making as well as mental health issues and relationships with care providers. The study also looks at more systemic issues including social determinants of health and the systemic barriers to care in the region.
Outcomes:
Online questionnaires were collected from over 200 men who have sex with men in Muskoka & Simcoe County, just over 60% identified as gay. While many respondents wanted more open activities for LGBT people in the area, such as sports teams, others were not open about their sexuality in many areas of their lives. Over half of men were not out to their healthcare provider, 40% had left the region to access primary health care in the Greater Toronto Area, and 30% had never been tested for HIV. Men with a female partner were least likely to have tested for HIV.
Fear, stigma and time remain barriers to accessing health care services, however establishing rapport with healthcare providers facilitates ongoing contact and may lead to improved diagnosis, treatment and prevention. Health care providers identified the need to promote an environment of acceptance, trust, and open communication with clients in a safe and confidential environment – and both men and caregivers observed that the short time period of medical appointments was often a barrier.
OHTN Support:
This project is supported by a OHTN project grant of $30,493 awarded in 2014.