Categories
EMIS 2010 Journal Articles 2010

Predictors of never testing for HIV among a national online sample of men who have sex with men in Norway

Scandinavian Journal of Public Health. 2013;41(4):398-404. doi:10.1177/1403494813483216

Authors: Rigmor C. Berg

Abstract

Background: HIV testing among persons at risk of infection has become a cornerstone in prevention and control of the HIV/AIDS epidemic. Understanding factors related to HIV testing is thus fundamental for informing prevention and testing initiatives. Aims: This study aims to identify prevalence of, and factors that are associated with, HIV testing. 

Methods: This study analysed data from 2011 HIV-negative and untested MSM collected in a national, online survey. Results: More than a third (35.3%) of MSM had never received an HIV test result. Multivariate logistic regression results showed that compared with men ever tested, untested men were younger (odds ratio, OR 0.95), closeted about same sex attractions (OR 3.84), had low educational level (OR 0.47), low HIV transmission and testing knowledge (OR 0.98), did not believe that HIV testing is free (OR 0.27), had never taken a test for sexually transmitted infection (OR 0.08), and had not engaged in sex abroad in the past year (OR 0.69).

Conclusions: These results underscore the urgency in efforts to reduce testing delay among especially young MSM and point to the need for additional public health resources and prevention marketing efforts to be directed towards increasing awareness of HIV testing.

Available online

Categories
EMIS 2010 Journal Articles 2010

Structural and environmental factors are associated with internalised homonegativity in men who have sex with men: Findings from the European MSM Internet Survey (EMIS) in 38 countries

Social Science & Medicine, February 2013, Pages 61-69, doi.org/10.1016/j.socscimed.2012.11.033

Authors: Rigmor C. Berg, Michael W. Ross, Peter Weatherburn, Axel J. Schmidt

Abstract

Internalised homonegativity refers to a gay person’s negative feelings about homosexuality and is believed to stem from negative societal stereotypes and attitudes towards homosexuality. Surprisingly, little research has centred on this link. In this research, we aimed to examine the associations between internalised homonegativity and structural forces, cultural influence, and access to sexual health promotion measures among a sample of 144,177 men who have sex with men (MSM) in 38 European countries. Participants were recruited as part of the European MSM Internet Survey (EMIS) during 2010. It was a self-completion, multilingual Internet-based survey for men living in Europe who have sex with men and/or feel attracted to men. Assumed causal relations were tested through multiple regression models. Variables at the structure of rule-systems (macro-level) that were significantly and negatively associated with internalised homonegativity were the presence of laws recognising same-sex relationships and same-sex adoption. In the meso-level model, greater proportions of the population expressing that they would not like to have homosexuals as neighbours predicted higher internalised homonegativity. In the last model, five variables were significantly and negatively associated with internalised homonegativity: being exposed to HIV/STI information for MSM, access to HIV testing, access to STI testing, access to condoms, and experience of gay-related hostility. In turn, men who had tested for HIV in the past year evidenced lower internalised homonegativity. This is the largest and certainly most geographically diverse study to date to examine structural and environmental predictors of internalised homonegativity among MSM. Our results show that one insidious consequence of society’s stigma towards homosexuals is the internalisation of that stigma by gay and bisexual men themselves, thus, drawing attention to the importance of promoting social equity for self-acceptance around gay identity in building a positive sense of self.

Highlights

This is the largest study to date to examine structural and environmental predictors of internalised homonegativity among MSM. The presence of laws recognising same-sex relationships and same-sex adoption was associated with lower levels of internalised homonegativity. This 38-country study demonstrates the importance of promoting social equity for self-acceptance around gay identity.

Available online

Categories
EMIS 2010 Journal Articles 2010

Internalised homonegativity predicts HIV-associated risk behavior in European men who have sex with men in a 38-country cross-sectional study: some public health implications of homophobia

BMJ Open 2013;3:e001928. doi: 10.1136/bmjopen-2012-001928

Authors: Michael W. Ross, Rigmor C. Berg, Axel J. Schmidt, Harm J. Hospers, Michele Breveglieri, Martina Furegato, Peter Weatherburn, The EMIS Network

Abstract

Objectives Internalised homonegativity (IH) is hypothesised to be associated with HIV risk behaviour and HIV testing in men who have sex with men (MSM). We sought to determine the social and individual variables associated with IH and the associations between IH and HIV-related behaviours.

Design and setting We examined IH and its predictors as part of a larger Internet-delivered, cross-sectional study on HIV and health in MSM in 38 European countries.

Participants 181 495 MSM, IH data analysis subsample 144 177. All participants were male, over the age of consent for homosexual activity in their country of domicile, and have had at least one homosexual contact in the past 6 months.

Methodology An anonymous Internet-based questionnaire was disseminated in 25 languages through MSM social media, websites and organisations and responses saved to a UK-based server. IH was measured using a standardised, cross-culturally appropriate scale.

Results Three clusters of European countries based on the level of experienced discrimination emerged. IH was predicted by country LGB (lesbian, gay and bisexual) legal climate, Gini coefficient and size of place of settlement. Lower IH was associated with degree the respondent was ‘out’ as gay to others and older age. ‘Outness’ was associated with ever having an HIV test and age, education and number of gay friends, while IH (controlling for the number of non-steady unprotected sex partners and perceived lack of control over safe sex) was associated with condom use for anal intercourse.

Conclusions IH is associated with LGB legal climate, economic development indices and urbanisation. It is also associated with ‘outness’ and with HIV risk and preventive behaviours including HIV testing, perceived control over sexual risk and condom use. Homonegative climate is associated with IH and higher levels of HIV-associated risk in MSM. Reducing IH through attention to LGB human rights may be appropriate HIV reduction intervention for MSM.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

Available online

Categories
EMIS 2010 Journal Articles 2010

High rates of unprotected sex and serosorting among men who have sex with men: A national online study in Norway

Scandinavian Journal of Public Health. 2012;40(8):738-745. doi:10.1177/1403494812465032

Authors: Rigmor C. Berg 

Abstract

Unprotected sexual contact between men remains the predominant means of HIV transmission in men. 
Aim: To ascertain predictors of unprotected anal intercourse between non-primary partners among a sample of 2096 men who have sex with men in Norway and to characterise the sociosexual profile of men who have sex with men who engage in this behaviour. 
Methods: A cross-sectional survey, using an anonymous self-administered questionnaire, was conducted in 2010. 
Results: Multivariate logistic regression showed that the likelihood of engaging in unprotected anal intercourse with non-primary partners was lower for men over 30 years (OR = 0.60), those with higher education (OR = 0.58), and higher HIV-related knowledge (OR = 0.98). The likelihood of engaging in unprotected anal intercourse with non-primary partners was higher among men who have sex with men reporting that condoms had not been available (OR = 1.58), who had a higher number of non-primary anal intercourse partners (OR = 1.20), and who reported use of party drugs (OR = 2.34). These men were not more likely to test for HIV/sexually transmitted infections, but they were more likely to have been diagnosed with sexually transmitted infections, engage in serosorting, and various other sexual behaviours. 
Conclusions: As we enter the fourth decade of the HIV epidemic, the results for Norwegian men who have sex with men underscore the need for a scaling-up of prevention campaigns, highlighting messages and behavioural strategies that encourage safer sex strategies.

Available online

Categories
EMIS 2010 Journal Articles 2010

Prevalence of HIV among MSM in Europe: comparison of self-reported diagnoses from a large scale internet survey and existing national estimates

BMC Public Health 2012, 12:978 http://www.biomedcentral.com/1471-2458/12/978

Authors: Ulrich Marcus, Ford Hickson, Peter Weatherburn, Axel J. Schmidt, The EMIS Network

Abstract

Background: Country level comparisons of HIV prevalence among men having sex with men (MSM) is challenging for a variety of reasons, including differences in the definition and measurement of the denominator group, recruitment strategies and the HIV detection methods. To assess their comparability, self-reported data on HIV
diagnoses in a 2010 pan-European MSM internet survey (EMIS) were compared with pre-existing estimates of HIV prevalence in MSM from a variety of European countries.
Methods: The first pan-European survey of MSM recruited more than 180,000 men from 38 countries across Europe and included questions on the year and result of last HIV test. HIV prevalence as measured in EMIS was compared with national estimates of HIV prevalence based on studies using biological measurements or modelling approaches to explore the degree of agreement between different methods. Existing estimates were taken from Dublin Declaration Monitoring Reports or UNAIDS country fact sheets, and were verified by contacting the nominated contact points for HIV surveillance in EU/EEA countries.
Results: The EMIS self-reported measurements of HIV prevalence were strongly correlated with existing estimates based on biological measurement and modelling studies using surveillance data (R2
=0.70 resp. 0.72). In most countries HIV positive MSM appeared disproportionately likely to participate in EMIS, and prevalences as measured in EMIS are approximately twice the estimates based on existing estimates.
Conclusions: Comparison of diagnosed HIV prevalence as measured in EMIS with pre-existing estimates based on biological measurements using varied sampling frames (e.g. Respondent Driven Sampling, Time and Location Sampling) demonstrates a high correlation and suggests similar selection biases from both types of studies. For comparison with modelled estimates the self-selection bias of the Internet survey with increased participation of men diagnosed with HIV has to be taken into account. For most countries self-reported EMIS prevalence is higher than measured prevalence, which is likely due to a combination of different time points of measurement, measurement errors for small sample sizes, different sampling methods, and an indicator-inherent overestimate of
prevalence among the untested fraction of MSM.

Available online

Categories
EMIS 2010 Journal Articles 2010

Aids. New challenges for social and medical prevention

Bundesgesundheitsbl 2012 · 55:535–542 DOI 10.1007/s00103-012-1451-1

Authors: Rolf Rosenbrock, Axel J. Schmidt

Abstract

Anti-retroviral therapy (ART) produces spectacular improvements in life expectancy and quality of life for people infected with HIV, and contributes to primary prevention in the wider population by reducing the viral load. Many people infected with HIV begin therapy later than indicated, while, despite ongoing prevention efforts, the number of new HIV diagnoses is increasing, along with the incidence of other STIs and, in identifiable subgroups, of hepatitis C, above all among men who have sex with men (MSM). The prevention consequences of this complex situation are discussed in the context of the alternative between control and containment (Suchstrategie) and inclusion and cooperation (Lernstrategie), arguing for HIV prevention to be integrated in the broader paradigm of sexual health and sub-group-specific efforts to increase the willingness to undergo testing both through community-based campaigns and in the health care context on the basis of informed consent and counseling. Above all ethical considerations mitigate against an undifferentiated test-and-treat approach. The contribution identifies research gaps and institutional obstacles that stand in the way of achievable advances and productive linkage of social and medical prevention.

Aids. New challenges for social and medical prevention

Categories
EMIS 2010 Journal Articles 2010

Ideas of the best sex life among Slovene MSM.

Etnolog, 21: 77-100.
Authors: Ales Lamut

ABSTRACT

The article describes the Internet survey, conducted for public health purposes, on the sexual behaviour of men who have sex with men (MSM). It describes the usefulness of qualitative surveys for research into the sexual behaviour of MSM in the context of the HIV/aids pandemic. The article expands the description of the social situation of MSM with a discussion of the importance the Internet has for their communication and for the research into sexual behaviour. It presents the results of the author’s analysis of an openend question on respondents’ ideas of the best sex life and discusses the implications for public health efforts.

Ideas of the best sex life among Slovene MSM. [in Slovenian]

Categories
EMIS 2010

EMIS-2010 Conferences

Conferences

This section provides links to talks and posters presented at scientific conferences.

Marcus U: Rational strategies for HIV-testing. 5th German-Austrian AIDS Conf.(DÖAK) Hannover 2011. MedReport 15:2 (German)

Schmidt AJ: STI test site performance across Europe. 5th German-Austrian AIDS Conf.(DÖAK) Hannover 2011. MedReport 15:7 (German)

Fernández-Dávila P et al.: Knowledge, Testing & Access to HIV/STI Services Among MSM, Spain. Tallin 2011 (English)

Diez M et al.: Late HIV Diagnosis in Spain. Tallin 2011 (English)

Fernández-Dávila P et al.: Circuncisión en HSH en España. XIV Congr Nat sobre el SIDA, Zargoza 2011 (Spanish)

Diez M et al.: Infección por el VIH y conductas de riesgo en HSH en España. Zaragoza 2011 (Spanish)

Breveglieri M et al.: Indicators on HIV Testing & Prevention among MSM in Italy. ICAR, Florence 2011 (English)

Schmidt AJ et al.: Harmonizing surveillance & prevention research: The EMIS. XVIII IAS, Vienna 2011 (English)

Fernández-Dávila P et al.: High prevalence of risk behaviour among HIV-positive MSM in Spain. SEE‐SESPAS, Madrid 2011 (Spanish)

Naseva E et al.: Bulgarian MSM – sexual behaviour. FEMP, Stockholm 2011

Naseva E et al.: Bulgarian MSM – HIV testing, knowledge, coverage with prevention activities. FEMP, Stockholm 2011

Fernández-Dávila P et al.: Migrant MSM: an exploration of sexual risk in Europe. FEMP, Stockholm 2011

Soriano R: Sexual behaviour and risk among Latino MSM in Spain. FEMP, Stockholm 2011

Hickson F: Towards better sex with less harm for gay and bisexual men in Europe. Keynot speech at FEMP, Stockholm 2011

Lamut A et al.: Best sex life idea among Slovenian MSM. FEMP, Stockholm 2011

Mozalevskis A et al.: Factors Associated With Higher Risk Sexual Behaviour among MSM in Latvia. FEMP, Stockholm 2011

Roos E et al: EMIS and Schorer Monitor 2010: Similar surveys with different results: how to interpret? FEMP, Stockholm 2011

Fuertes R et al: Substance use among Portuguese MSM. FEMP, Stockholm 2011

Carvalho C et al: Description of Portuguese EMIS participants. FEMP, Stockholm 2011

Bourne A: What constitutes the best sex life for gay and bisexual men? 15th CHAPS Conference, Bristol 2012 (English)

Lociciro S et al.: Influence du ‘Swiss Statement’ sur les comportements préventifs. 6ème Conférence Francophone VIH, Genève 2012

Carvalho et al.: HIV-testing among MSM in Portugal, Copenhagen (English) 2012

Marcus U et al.: Differences in association between HIV testing and risk taking among MSM across Europe. IAC Washington 2012

Schmidt AJ et al.: Advancing Methods in Internet-based HIV Prevention Gay Community Research Projects. IAC Washington 2012

Schmidt AJ et al.: Deficits in Targeted STI-Testing For Gay & Bisexual Men in 34 major European cities. IAC Washington 2012

Fernández-Dávila P et al.: Mobile MSM in Europe: Exploration Of Sexual Risk Taking While Traveling Abroad. IAC Washington 2012

Mozalevskis A et al.: Behaviorally bisexual men – an underestimated bridge population in Latvia. IAC Washington 2012

Categories
EMIS 2010 International reports 2010

EMIS-2010 Community Reports

2nd EMIS-2010 Community Report 

Community Reports are designed to provide feedback to EMIS study participants and to gay, bisexual, transgender and other MSM. They are available for download in all the 25 European languages used for EMIS. The 2nd Community Report was prepared by a team of Collaborating Partners led by Mick Quinlan from the Gay Men’s Health Service (GMHS), HSE, Ireland. The EMIS partners involved in producing this report included:

  • Mick Quinlan (GMHS,HSE, Ireland)
  • Susan Donlon & Daniel McCartney (Gay Health Network, Ireland)
  • Antons Mozalevskis (Mozaika, Latvia)
  • Ekaterina Shmykova (PSI, Russia)
  • Marianella Kloka (Positive Voice, Greece)
  • Todd Sekuler (Berlin Social Science Research Center, Germany)
  • Axel J. Schmidt & Ulrich Marcus (Robert Koch Institute, Germany)

The report was designed by: Maurice Farrell, funded by GMHS and GHN (Ireland), and published in July, 2011.

EMIS-2010. Community Report No. 2 English (.eu/.ie/.uk)

EMIS-2010. Community Report No. 2 български език (.bg)

EMIS-2010. Community Report No. 2 Čeština (.cz)

EMIS-2010. Community Report No. 2 Dansk (.dk)

EMIS-2010. Community Report No. 2 Deutsch (.at/.ch/.de/.lu)

EMIS-2010. Community Report No. 2 Eesti (.ee)

EMIS-2010. Community Report No. 2 Español (.es)

EMIS-2010. Community Report No. 2 Français (.be/.ch/.fr/.lu)

EMIS-2010. Community Report No. 2 Ελληνικά (.gr/cy)

EMIS-2010. Community Report No. 2 Italiano (.it)

EMIS-2010. Community Report No. 2 Latviešu valoda (.lv)

EMIS-2010. Community Report No. 2 Lietuvos (.lt)

EMIS-2010. Community Report No. 2 Magyar nyelv (.hu)

EMIS-2010. Community Report No. 2 Nederlands (.nl/.be)

EMIS-2010. Community Report No. 2 Norsk (.no)

EMIS-2010. Community Report No. 2 Polski (.pl)

EMIS-2010. Community Report No. 2 Português (.pt)

EMIS-2010. Community Report No. 2 Română (.md/ro)

EMIS-2010. Community Report No. 2 русский (.ru)

EMIS-2010. Community Report No. 2 Slovenščina (.si)

EMIS-2010. Community Report No. 2 Slovenských (.sk)

EMIS-2010. Community Report No. 2 Srpski (.rs/ba/hr/mk)

EMIS-2010. Community Report No. 2 Suomi (.fi)

EMIS-2010. Community Report No. 2 Svenska (.se)

EMIS-2010. Community Report No. 2 Türkçe (.tr/.cy)

1st EMIS-2010 Community Report 

Community Reports were designed to provide feedback to EMIS study participants and to gay, bisexual, transgender and other MSM. They are available for download in several European languages. The 1st Community Report was written by the Associated Partners and published on World AIDS Day 2010.

EMIS-2010. Community Report No. 1 English (.eu /.uk)

EMIS-2010. Community Report No. 1 English (.ie)

EMIS-2010. Community Report No. 1 Bulgarian (.bg)

EMIS-2010. Community Report No. 1 Croatian (.hr)

EMIS-2010. Community Report No. 1 Czech (.cz)

EMIS-2010. Community Report No. 1 Danish (.dk)

EMIS-2010. Community Report No. 1 Dutch (.nl /.be)

EMIS-2010. Community Report No. 1 Estonian (.ee)

EMIS-2010. Community Report No. 1 Finnish (.fi)

EMIS-2010. Community Report No. 1 French (.be/.ch/.fr/.lu)

EMIS-2010. Community Report No. 1 German (.at/.ch/.de)

EMIS-2010. Community Report No. 1 Greek (.gr)

EMIS-2010. Community Report No. 1 Italian (.it)

EMIS-2010. Community Report No. 1 Latvian (.lv)

EMIS-2010. Community Report No. 1 Lithuanian (.lt)

EMIS-2010. Community Report No. 1 Norwegian (.no)

EMIS-2010. Community Report No. 1 Polish (.pl)

EMIS-2010. Community Report No. 1 Portuguese (.pt)

EMIS-2010. Community Report No. 1 Romanian (.ro/.md)

EMIS-2010. Community Report No. 1 Russian (.ru/.ua/.by/.md)

EMIS-2010. Community Report No. 1 Slovak (.sk)

EMIS-2010. Community Report No. 1 Slovenian (.si)

EMIS-2010. Community Report No. 1 Spanish (.es)

EMIS-2010. Community Report No. 1 Swedish (.se)

EMIS-2010. Community Report No. 1 Turkish (.tr)

Categories
EMIS 2010 Questionnaires

EMIS-2010 Questionnaires & Variable Manual

Manual

EMIS-2010 Variable Manual

Questionnaires

EMIS-2010 English language version (PDF of online only questionnaire)

EMIS-2010 Bulgarian language version (PDF of online only questionnaire)

EMIS-2010 Croatian / Serbian language version (PDF of online only questionnaire)

EMIS-2010 Czech language version (PDF of online only questionnaire)

EMIS-2010 Danish language version (PDF of online only questionnaire)

EMIS-2010 Dutch language version (PDF of online only questionnaire)

EMIS-2010 Estonian language version (PDF of online only questionnaire)

EMIS-2010 Finnish language version (PDF of online only questionnaire)

EMIS-2010 French language version (PDF of online only questionnaire)

EMIS-2010 German language version (PDF of online only questionnaire)

EMIS-2010 Greek language version (PDF of online only questionnaire)

EMIS-2010 Hungarian language version (PDF of online only questionnaire)

EMIS-2010 Italian language version (PDF of online only questionnaire)

EMIS-2010 Latvian language version (PDF of online only questionnaire)

EMIS-2010 Lithuanian language version (PDF of online only questionnaire)

EMIS-2010 Norwegian language version (PDF of online only questionnaire)

EMIS-2010 Polish language version (PDF of online only questionnaire)

EMIS-2010 Portuguese language version (PDF of online only questionnaire)

EMIS-2010 Romanian language version (PDF of online only questionnaire)

EMIS-2010 Russian language version (PDF of online only questionnaire)

EMIS-2010 Slovenian language version (PDF of online only questionnaire)

EMIS-2010 Spanish language version (PDF of online only questionnaire)

EMIS-2010 Swedish language version (PDF of online only questionnaire)

EMIS-2010 Turkish language version (PDF of online only questionnaire)

EMIS-2010 Ukrainian language version (PDF of online only questionnaire)