Services For Men Who Have Sex With Men In Western Sydney

Abstract

Introduction

HIV and STIs are associated with significant morbidity and mortality and affect men who have sex with men (MSM). This thesis explores the prevalence of HIV/STIs in MSM attending SOPVs in Australia, focusing on the Western Sydney Local Health District (WSLHD). Sexual risk and health-seeking behaviours are considered to understand testing needs and health service preferences.

Material and methods

This is a mixed methods thesis by publication of 3 main phases and supplementary information. The 1st publication is a systematic review and meta-analysis of the prevalence of STIs and HIV among MSM attending SOPVs in Australia; 2nd is a cross-sectional study comparing STI/HIV prevalence, sexual risk and testing behaviours of MSM attending a sexual health clinic (SHC) and a SOPV in WSLHD; 3rd is a qualitative study of semi-structured interview with MSM attending a SOPV and SHC in WSLHD.

Results

The systems review and meta-analysis confirm MSM tested at SOPVs experience a high rate of STI and HIV compared to non-SOPV community samples of MSM and men who have sex with women. The cross-sectional study finds SOPV MSM differ from SHC MSM, demographically and behaviourally (sex risk and testing). The qualitative publication demonstrates that all MSM experience diverse sexual behaviours and identities However, SOPV MSM differ from SHC MSM regarding HIV/STI knowledge, perception of risk and testing behaviours due to fear, unwillingness to disclose behaviour, privacy concerns, and perceived low risk. Convenience, confidentiality and trust as critical factors for services.

Conclusion

MSM reported diverse sexual identities, behaviours and risk. Fear of disclosure and judgement are key barriers for accessing care. All MSM valued privacy and convenience. A variety of testing options are required, ideally anonymous and free. Health promotion campaigns are required to address sexual health knowledge and testing deficits.

To date, this is the only study of its kind.