An Examination of Resilience Against HIV/AIDS Among Middle-aged and Older Men Who Have Sex With Men: Resources, Strengths, and Protective Factors

Participants

In order to participate in this study, one must be at least 40 years old, aware of their HIV status, and willing to confidentially disclose their HIV status for the study. More specifically, one must be willing to share their lived experiences and personal views on how HIV acquisition and transmission is or can be prevented in the MSM community, as well as their perspectives on how MSM can thrive in our society that may not be ready to address the health care and service needs of aging MSM. They must live within the Greater Toronto Area, the Southwestern, Golden Horseshoe and Ottawa Regions of Ontario, and participate in an interview personally.

Purpose

Background and Rationale: There is considerable resilience among middle-aged and older, cis and trans, gay, bisexual, and other men who have sex with men (MSM) against HIV/AIDS. Despite being part of a population at increased risk for acquiring HIV, many MSM aged 40 years and older (40+) have remained HIV-negative (HIV-) since the start of the epidemic. Among HIV-positive (HIV+) MSM aged 40 years and older, many have exhibited resilience against HIV/AIDS not only by surviving its adverse impacts, but also by living active and full lives; fiercely advocating for their rights, and health care and service needs; and staunchly supporting and promoting prevention and intervention programs dedicated to ending HIV/AIDS. Since the beginning of the HIV/AIDS epidemic in the early 1980s, MSM have remained the population most affected by HIV/AIDS in Canada. Although the proportion of HIV cases among MSM 30 to 39 years old has been decreasing since 1994, the proportion of new HIV infections among 40+ MSM has been increasing since the beginning of the epidemic. The Public Health Agency of Canada reports that most research available on HIV/AIDS among MSM focuses on their vulnerability and that research on resilience of MSM against HIV/AIDS is wanting. It also reports that although there are studies on young MSM and resilience, there is a lack of research undertaken with older MSM. This suggests that resilience of older MSM against HIV/AIDS represents a serious research gap. Scientific literature and historical accounts provide evidence of resilience among MSM, and some research shows the challenges and coping strategies of HIV+ older MSM. However, to date, there has been no research conducted to examine the resilience of both HIV+ and HIV- 40+ cis and trans MSM against HIV/AIDS. Aim: The aim of our project is to examine the resources, strengths, and protective factors HIV+/- 40+ MSM possess that prevent HIV acquisition and transmission in the community and allow them to thrive in a society that may not be ready to meet the growing needs of a burgeoning number of older MSM and HIV long-term survivors in the decades to come. Project Design: Staying true to the tenets of Community-Based Research (CBR), we plan to recruit and include in our project several HIV+ and HIV- 40+ MSM as members of our Community Advisory Board and as peer researchers (PRs) so that they can provide input and feedback on all aspects and during all stages of the research process as full partners. We will provide training for our PRs so that they can interview thirty HIV+ and thirty HIV- 40+ cis/trans MSM from across Ontario to explore their resilience against HIV/AIDS. Our PRs will use an interview guide – informed, developed, and created with the input of our relevant stakeholders – to conduct confidential, semi-structured, digitally audio-recorded interviews with study participants. We will be employing a constructivist grounded theory approach to our research project, including multiple perspectives and interpretations into the iterative process of generating information and theory from the critical thematic analysis of interview data at different phases of the project.

How will this research help LGBT people and communities?

Significance and Impact: This project will generate new knowledge to inform and enhance current, efficacious HIV transmission prevention programs, as well as other programs relevant to HIV+/- 40+ cis/trans MSM and their access to inclusive and appropriate health care and services in the future. With our Collaborators and other partners, we will develop innovative and accessible Knowledge Translation and Exchange products and platforms to share our findings and lessons. This project will build CBR capacity by meaningfully engaging affected communities and trainees alongside academic researchers and networks of community Collaborators. It will also be an opportunity for older HIV+/- cis/trans MSM to experience greater and meaningful participation and crucial decision-making in a study aiming to reduce HIV transmission, as well as inform programs dedicated to improve health care and social services for older MSM in the future.

Compensation

For their involvement in this study, participants will receive a $25 as an honorarium. The honorarium will be given at the completion of their scheduled interview.

What mitigation measures are in place to reduce potential distress caused to participants as a result of being part of the research study?

There are no foreseeable physical risks to participating in this study. During the interview, there are no major risks to participants

When do you anticipate that this study's findings will be available?

2020-12-15

Contact

Name: Rainier Liboro

Email: rainier.liboro@camh.ca

Website: N/A

Investigator

Paul Shuper/Lori Ross/Rainier Liboro

Funded By

Canadian Institutes of Health Research

Deadline

2020-06-30

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