Gay and bisexual men talk about their sexual lives and sexual health needs Report authors: Colin Morrison and Gregory Baker NAVIGATION Use the Bookmark Panel on the left to go to each Chapter. Click on Chapter headings to take you to that page. Each individual chapter content page is hyperlinked. You can also use the “Find” function in the Adobe toolbar to search for specific information. GAY AND BISEXUAL MEN TALK ABOUT THEIR SEXUAL LIVES AND SEXUAL HEALTH NEEDS ABOUT FAQ FAQ Scotland is part of a larger project that wants to prevent HIV infections in Scotland among gay and bisexual men. The larger project is called an HIV Needs Assessment, which is being undertaken by NHS Greater Glasgow and Clyde (GGC) and NHS Lothian. The two health boards launched the HIV Needs Assessment because numbers of men becoming HIV positive are on the rise. Each year around 100 men in Scotland become HIV positive and men who have sex with men is the population group most at risk. A Needs Assessment is a way for the NHS to take a close look at a health issue that affects a population and think about what needs to happen to tackle a problem (like HIV), including how services like sexual health clinics are doing and should do their job. The FAQ Scotland project is the community engagement part of the HIV Needs Assessment. FAQ wanted to make contact with gay and bisexual men and hear from them about their sex and relationships and sexual health. A company called TASC (Scotland) designed and delivered FAQ for the health boards. From August 2012 to August 2013, Colin Morrison and Gregory Baker kept in touch with men to learn about their views and experiences. Designer Bobby Grierson at d4Digital specialises in accessible web and print design and worked with the TASC team to create FAQ branding and FAQ online. ABOUT FAQ 1 GAY AND BISEXUAL MEN TALK ABOUT THEIR SEXUAL LIVES AND SEXUAL HEALTH NEEDS MEN HAD TWO WAYS TO TAKE PART IN FAQ: Telephone interviews To make contact with men and to invite them to be interviewed, FAQ placed adverts on a number of apps and sites that men use to meet other men (this is how most men who took part got in touch). We also asked sexual health clinics and voluntary sector agencies to get information to men about FAQ. The purpose of the FAQ interviews was to learn more about men’s sexual lives, knowledge and attitudes towards HIV, and their experience of engaging with services about their sexual health. FAQ gave men a £20 voucher as a thank you each time they were interviewed. 154 men took part in telephone interviews over three phases of recruitment: 118 men were recruited in the first phase, a further 18 in phase 2 and again a further 18 in phase 3. In all, FAQ undertook 243 detailed semi-structured interviews over the phone (23 men took part in three interviews, 43 men took part in two interviews and 88 men in one interview). Interviews lasted between 20 minutes to over one hour, on average 40 to 45 minutes. FAQ Online Two phases of online work took place. • The Diary Room was a broad based survey completed by 427 men in October and November 2012. • The second phase was a number of thematic surveys that we called Quickies. There were 24 quickie surveys and these attracted a total of 2,423 responses. The surveys were available for men to complete from mid-June to mid-July 2013. The most popular quickie surveys (numbers of men responding in brackets) were: • Bareback (261); • Anal Sex (239) • Poppers (214) • Feeling Down (192) • Oral Sex (174) • Saunas (152) • Bisexual (143). ABOUT FAQ 2 GAY AND BISEXUAL MEN TALK ABOUT THEIR SEXUAL LIVES AND SEXUAL HEALTH NEEDS MORE ABOUT THE MEN WHO TOOK PART IN FAQ The graphics below give some information about who took part in FAQ interviews. There is more about our FAQ interviewees in the FAQ chapters that report on FAQ findings. Age - number of men asked 154 Sexual orientation - number of men asked 154 ABOUT FAQ 3 GAY AND BISEXUAL MEN TALK ABOUT THEIR SEXUAL LIVES AND SEXUAL HEALTH NEEDS HIV status - number of men asked 154 Last HIV Test - number of men asked 136. Number of men responding 125 ABOUT FAQ 4 GAY AND BISEXUAL MEN TALK ABOUT THEIR SEXUAL LIVES AND SEXUAL HEALTH NEEDS Work status - number of men asked 154 Highest educational qualification - number of men asked 154 ABOUT FAQ 5 GAY AND BISEXUAL MEN TALK ABOUT THEIR SEXUAL LIVES AND SEXUAL HEALTH NEEDS We can also report on key characteristics of men who responded to FAQ online surveys, both the Dairy Room and the thematic ‘quickie’ surveys. Phase 1: the Diary Room - 427 responses Sexuality Sexual Health Clinic Visits HIV Status ABOUT FAQ 6 GAY AND BISEXUAL MEN TALK ABOUT THEIR SEXUAL LIVES AND SEXUAL HEALTH NEEDS Phase 2: Thematic Quickie surveys - 2,423 responses across 24 surveys Looking across the surveys we can report on some average numbers regarding key characteristics of respondents. Sexuality Sexual Health Clinic Visits HIV Status ABOUT FAQ 7 GAY AND BISEXUAL MEN TALK ABOUT THEIR SEXUAL LIVES AND SEXUAL HEALTH NEEDS HOW WE WORKED WITH THE DATA WE GATHERED During the telephone interviews with men, the FAQ interviewers, Gregory and Colin, took detailed notes. Immediately after each interview they reviewed and clarified, or when necessary, extended the notes. Gregory and Colin shared and read all interviews, and through a process of reflection, discussion, distilling and checking, they organised the men’s stories into themes. By working manually from the notes FAQ interviewers were able to remain faithful to the variety, richness and individual character of each man’s contribution. Gregory and Colin were joined by Information Analyst Paul Drosinis to make the most of the information collected through FAQ online. To collect and store the data, FAQ online used a provider called Survey Gizmo. All of the survey returns reside on the Survey Gizmo’s highly secure servers. All survey entries received as part of the project will be securely deleted from the servers upon completion of the project. The following issues were considered as we used the online survey data. The data from the surveys was downloaded from the website and then loaded in SPSS version 20. FAQ focused on men who live, work, or party in NHS Lothian or NHS Greater Glasgow and Clyde (NHS GGC) areas. FAQ launched the Diary Room, the first phase of online survey work by advertising on the apps and websites men use to arrange meets. Unfortunately some online advertisers targeted men beyond the geographic locations we wanted to reach, however because the survey asked men if they had a connection with one of targeted areas in our analysis we were able to include only the men who reported living, working, or partying in NHS GGC/NHS Lothian. With better targeting, the second phase of FAQ online, the themed quickie surveys, aimed to reach only men who lived in one of the key areas. Before analysing the data every survey was checked and all the missing data coded out. Due to the online nature of the surveys it was necessary to examine each participant’s response to ensure there were no discordant answers or ambiguities. For example, if a respondent said they had not attended a clinic in one response, but indicated later in the survey that they had, then they were not included. We analysed all of the survey to look for associations between clinic attendance, age, and sexual orientation with the relevant thematic variable that the particular survey focused on. We can provide more detail about our approach on request. Having described our FAQ approach the detail of what men told FAQ is represented in the chapters published at www.faqscotland.co.uk More about TASC from More about d4digital from Colin Morrison Bobby Grierson T: 0131 555 3527 T: 0798 474 0663 [email protected] [email protected] www.tascagency.co.uk www.d4digital.com ABOUT FAQ 8 ALCOHOL GAY AND BISEXUAL MEN TALK ABOUT THEIR SEXUAL LIVES AND SEXUAL HEALTH NEEDS ALCOHOL This FAQ chapter presents the views and experiences of men in relation to alcohol. We begin with quotes from men below, and continue to represent what we have been told in the pages that follow. Most people my age/gender use alcohol to initiate sexual encounters. Is my experience typical of gay men my age? (Online respondent) I drink like a fish and don’t care about the consequences, makes me sad when I’m hung-over. (Online respondent) I live alone, I wouldn’t say lonely but you go out more. This means drinking alcohol, so the next day or two, I feel down, a bit anxious. So I’m trying not to drink so much. It’s with circumstances, I can feel anxious. And with alcohol, it’s the old cliché, seems like a good idea at the time and the next day you think ‘Oh my god did I do that?’ (Gay, 26-35, HIV negative) I was in a relationship with a man for a year. We broke up just about a year ago. He was drinking and would get violent… He had been violent before with me and with other people. Alcohol was the main trigger but he just wasn’t right I don’t think. It was only one or two times before this but not serious but it was getting worse and worse.