Exploring the State of Sexual Health Literacy among Young Black Men Who Have Sex with Other Men in Toronto

Participants

English speaking, self-identified African, Caribbean or Black gay, bisexual, queer, non-hetero+ cis-and trans men aged 15-29 years who live in Toronto

Purpose

Despite advancements in diagnosis, prevention and treatment of HIV and other STIs,
young straight and gay, bisexual, queer + men (GBQ+) continue to be at heightened risk of
infection in Canada. In 2010, individuals aged 15-24 years made up 62.8% of all positive
chlamydia and 48.7% of gonorrhea reports (Public Health Agency of Canada,
2014). In the same year, young men made up 90.5% of all infectious syphilis cases(PHAC, 2014). HIV infection risk is very high for certain subpopulations of young Canadians. National HIV surveillance data from 2014 found 65% of new youth HIV diagnoses were among GBQ+ while 19% were linked to heterosexual sex
(Challacombe, 2017). Although national HIV rates based on populations’ age, race and sexual
orientation could not be found, Toronto based HIV surveillance data showed positive HIV
diagnoses among Black GBQ+ rose from 11.5% between 2009-2011 to 18.9% in 2012 (p=0.008)
while their White counterparts’ rates fell from 61.4% in 2009-2011 to 52.4% in 2012 (p=0.02)
(Laboratory Enhancement Program, 2013). An international study that reviewed factors linked to
HIV disparities among Black GBQ+ populations in Canada, the U.S. and U.K. found young
Black GBQ+ were five times more likely to be HIV-positive than other young GBQ+. They also
had a 45% higher chance of testing positive for other STIs (Millett, Peterson, et al., 2012).

While the literature shows various social (e.g. racism) and structural (e.g. low income) factors
contribute to the aforesaid risks by impacting sexual healthcare access or prompting sexual
risk practices (e.g. condomless sex) (Maulsby et al., 2014), it also indicates young Black GBQ+
have safe sex. One study showed Black and White men were equally likely to get HIV testing
and see healthcare providers (Maulsby et al., 2014) implying Black men have some
sexual health literacy—people’s ability to understand, make sense of and use sexual health
information in their daily lives. While there is a lot of research on the impact on the earlier mentioned factors on young Black GBQ+ sexual health, there continues to be a gap in research on this perplexing contradiction between these youths’ high STI rates and their sexual health literacy. As STI rates among young GBQ+ keep rising, more research focused on these youths’ sexual health literacy is needed.

The research goals are to: 1) Identify sources of young Black GBQ+ men’s sexual health information; 2) Identify how young Black GBQ+ men evaluate the information they get from these sources; and 3) identify the ways, if any, these young men are applying this information to their everyday lives

Anticipated Outcomes: This study is one step towards identifying:
1) Gaps in current sexual healthcare services and resources;
2) How Black GBQ+ men youth locate, evaluate and use sexual health information; and
3) Ways to enhance youths’ sexual health literacy.

References
Challacombe, L. (2017). The Epidemiology of HIV in Youth. Retrieved from http://www.catie.ca/en/factsheets/epidemiology/epidemiology-hiv-youth#footnote7_2ab1uey

Laboratory Enhancement Program. (2013). Laboratory Enhancement Program HIV Laboratory, Public Health
Ontario Updated analyses: January 2009 to December 2012. Retrieved from http://www.ohemu.utoronto.ca/doc/2013/LEP%20ethnicity_2009-2012.pdf

Maulsby, C., Millett, G., Lindsey, K., Kelley, R., Johnson, K., Montoya, D., & Holtgrave, D. (2014). HIV among
black men who have sex with men (MSM) in the United States: A review of the literature. AIDS and Behavior,
18(1), 10-25

Millett, G. A., Peterson, J. L., Flores, S. A., Hart, T. A., Jeffries, W. L., Wilson, P. A., . . . Fenton, K. A. (2012).
Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: A meta-analysis. The Lancet, 380(9839), 341-348.

Public Health Agency of Canada. (2014). Population-Specific Status Report-HIV/AIDS and other sexually transmitted and blood borne infections among youth in Canada

How will this research help LGBT people and communities?

I believe this research will help the LGBT people and communities as well as the centre’s communities and health care services in three ways: 1. Youth Programs (e.g. SOY & BQY) and school-based sexual health education: The findings may be used to enhance tailored sexual health messages and resources given to young, self-identified Black gay, bisexual, gay + (GBQ) men. Also, it may help program staff and teachers identify the most impactful ways to share sexual health information with these youth. 2. Projects and activities for LGBT+ newcomer youth: The findings may help program staff collaborate with LGBT+ newcomer youth to create and/or enhance interactive, culturally safe sexual health activities (e.g. creating memes, crafts, etc.) in the language of their choice. This may help make youth more engaged in learning about sexual health information with their peers. 3. Primary Healthcare: The findings (e.g. information about young, Black GBQ+’s sexual health knowledge, how youth access and discuss sexual health information) may help clinicians enhance their ability to provide sexual health information in a culturally appropriate way to young, self-identified Black GBQ+ men.

Compensation

Participants will get a $25 honorarium to thank them for their time.

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

Several measures have been put in place to appropriately mitigate any potential distress caused to participants as a result of being part of this study: 1) One-on-One Semi-Structured Interviews: This interview format relies on participants’ responses to direct the interview questions. During the interviews, participants are encouraged to share as much or as little as they want. They also have the right to pause the interview, skip interview questions or quit the project during the survey or interview without any consequences. This flexibility ensures participants can guide the conversation, thereby giving participants power in the interview process and creating a lower sense of risk. 2) Confidentiality and Privacy: Participants will be informed that any self-identifying information they share (e.g. name, workplace name, etc.) during the interviews will be removed from any reports of the research findings shared with the community and healthcare organizations. In order to participate in the study, participants will be required to sign an informed consent document. To enhance privacy, participants will be asked to sign the document with an ‘X’ instead of their names to indicate their consent.3) Resource Guide: Should participants require additional support post-interview, participants will be provided with a list of free, LGBT+ youth-friendly services they can access in Toronto.

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

2018-11-24

Contact

Name: Nakia Lee-Foon

Email: n.lee.foon@utoronto.ca

Website: https://www.facebook.com/realtlkshealth

Investigator

Nakia Lee-Foon

Funded By

Social Sciences and Humanities Research Council Doctoral Fellowship

Deadline

2019-01-31

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