In the summer of 2016, we interviewed 31 men who have sex with men about their sexual lives.  We learned there may be 7 geosexual archetypes that make up the architecture of the sexual network:

Hosters – Are a centralizing force.  Prefer not to travel very far for sex, find most of your partners online, and have their partners come to them.

House-callers – Are a dispersing force. They either can’t or don’t want to host sex at their place but want to keep things intimate and private so they’re willing to travel to their partner’s place for sex, even if they have to travel a little further than their local neighbourhood.

Rovers – Are local boys and their sexual universe is within about 5km of their homebase.  They prefer to meet their partners in person and prefer to have sex in a public place away from their home and their partner’s.

Privates – Are a highly localizing force and very private, keeping sex local (on average less than 1km), except on rare occasion when they may travel to the suburbs. They are willing to meet their partners in a variety of ways; however, they want to have sex in private à your place or theirs.

Travellers – Often bridge people and places. Geography does not limit them – they will travel for sex, locally and out of town.  They prefer to find their partners online and have sex away from home, at a partner’s house, the park, the club, anywhere really, as long as it’s not their place.

Sirens –  Are an exceedingly rare type. They prefer not to travel to someone else’s home for sex but they gladly have their partners come to them, or connect at the bathhouse, the club or the gym.

Geoflexibles – Are a free spirit with a lot of love to share (or sex at least).  They find partners both online and in person and they’ll have sex in a variety of environments – their place, their partner’s place, the park, the club, the airport…They often bridge people and places.

We also learned…

Partner Seeking:

  • Most MSM had one or two strategies for finding sexual partners (i.e. Craigslist, Grindr, or cruising) and only changed strategies out of necessity if challenges arose (i.e. time constraints).
    • On-line apps were the predominant strategy used to find sexual partners
  • Men travelled the shortest distance possible for sex
    • Distances MSM would travel were defined by their modes of transportation (subway, walking, biking, etc.).
    • Relative notions of distance were strongly correlated with the surrounding density of MSM
      • e.g. 4 blocks away in the Village is perceived as way further away than 4 blocks in Scarborough

Sex:

  • Guys were more comfortable asking partners when they were last tested for STIs instead of asking about their STI status (this is a great approach)
  • Guys protected themselves from STIs using multiple strategies:
    • Condoms
    • STI testing
    • Creating rules around sex
    • Assessing the risk of the situation (e.g. anonymous sex)
    • Risk reduction strategies (e.g. sober sex, sero-positioning)
    • Talking with partners about STI testing and status
  • Many men recognized the risk of oral transmission of syphilis (or any other STI)
    • However, very few men used condoms for oral sex
  • Negotiating safe sex was easier and more direct on-line than in-person
    • In-person strategies relied on intuition and non-verbal communication
    • Trust was undefinable yet central to negotiating sex and minimizing risk
  • There was a complex intersection between power, intimacy, trust and sex

What Guys Knew About Syphilis and STIs:

  • HIV predominated all conversations about STIs
    • Knowledge of HIV prevention was good
    • The seriousness of HIV made other STIs seem trivial
    • Syphilis and other bacterial STIs (chlamydia, gonorrhea) were dismissed because they are curable
    • Concern that increasing PrEP use for HIV prevention may increase transmission of other STIs
  • Most guys had difficulty knowing the difference between Syphilis, Gonorrhea and Chlamydia
    • Most knew very little about modes of transmission, symptoms, testing or treatment for these STIs
  • Knowledge surrounding syphilis was very low
    • Most men were unable to name any symptoms
    • Most men did not know there is an ongoing epidemic

What Can Be Done?

The men we talked with described three interventions worth exploring:

  1. Increase the availability of, and access to, “gay-friendly” sexual health services – this can be extended to meaning providing sexual health services that are welcoming, supportive, and affirming of all sexual and gender identities. Sexual health services are especially needed in non-urban areas.
  2. Eliminate the embarrassment, shame, and stigma associated with STI testing so people don’t wait so long to get tested and treated.
  3. Eliminate the stigma and discrimination associated with being a sexual or gender minority, which contributes to concealment of identity, including from health care providers, and thus compromises proper health care provision. Again, this is especially needed in non-urban areas.