In 2016 we interviewed 31 men who have sex with men (MSM) who lived, worked, or socialized in Toronto. .
The participants were asked about what they considered to be “risky” sex and about their knowledge of, and attitudes toward, sexually transmitted infections (STIs), especially syphilis. We also asked them about what they thought of the potential ways to treat STIs.
What we found:
- We learned that many guys thought of HIV prevention first and applied those strategies in the sex they had.
- No one used condoms for oral sex, nor did they intend to.
- PrEP ie. Pre-exposure prophylaxis was seen as both threatening and liberating
- Folks also thought emotional risk when they were talking about risky sex.
- Conversations with partners about STI testing were easier than STI status.
- Stigma made it harder to access sexual health care and this was also true for those who did not “come out” to their healthcare providers.
- None of the participants recommended sexual behavior or sexual health interventions. Instead, recommendations centered on social changes to reduce or eliminate shame, embarrassment, stigma, and discrimination around both STIs and sexual orientation.
Our Main Takeaways:
Participants were thinking about sexual risk and using a variety of ways to prevent STI transmission, although most relied on HIV prevention strategies. This maybe because they might not know as much about other STIs, and other STIs were perceived as curable, especially syphilis.
Interventions that promote having conversations about STI testing may be promising and will also reduce stigma as testing becomes normalized. Social and clinic interventions focused on creating psychologically safe spaces to disclose sexual identity and providing sexual orientation affirming health care may reduce STIs and improve sexual health for Gay, Bi, Trans and Men who have sex with Men (MSM).