Desde que el ChemSex (el uso intencionado de drogas con fines sexuales entre hombres gais y bisexuales) se diera a conocer a nivel mediático, especial atención ha cobrado de parte muchos sectores. ...Recientemente se ha comenzado a mencionar, desde fuera de este colectivo, la ocurrencia de “violencia sexual” en los contextos donde se lo práctica, pero muchos hombres no entienden como tal los “actos sexuales sin consentimiento (expreso)” que pudieran darse. Este ensayo busca entender, desde una perspectiva cultural, por qué muchos hombres no se reconocen como “víctimas” o “agresores” de “violencia sexual” en contextos de ChemSex. Como el ChemSex ocurre dentro de la cultura sexual gay, la cual tiene sus propios códigos, normas, valores, lenguaje, etc. que son diferentes a los de la cultura dominante (heterosexual), los significados y entendimientos en torno al contacto físico y al sexo son diferentes. Además, partiendo que la intención es tener sexo y por las formas de contacto (p.e. virtual) y encuentro (p.e. locales de sexo), entienden que los consentimientos pueden darse de manera diferente a la verbal o que están dados de manera tácita dentro de las propias dinámicas de relacionamiento socio-sexual, por eso no se reconocen como “víctimas” ni como “agresores”.
Gay, bisexual, and other men who have sex with men (MSM) might be particularly likely to migrate to experience freedoms unavailable in their home countries. Structural stigma (eg, laws and policies ...promoting the unequal treatment of oppressed populations) in MSM migrants' sending and receiving countries represent potential barriers to HIV prevention among this intersectional population. This study represents the first investigation of structural determinants of HIV risk in a large, geographically diverse sample of MSM migrants.
The 2010 European MSM Internet Survey (n = 23,371 migrants) was administered across 38 European countries.
Structural stigma was assessed using (1) national laws and policies promoting unequal treatment of sexual minorities across 181 countries worldwide and (2) national attitudes against immigrants in the 38 receiving countries. We also assessed linguistic status, time since migrating, and 5 HIV-prevention outcomes.
Structural stigma toward sexual minorities (in sending and receiving countries) and toward immigrants (in receiving countries) was associated with a lack of HIV-prevention knowledge, service coverage, and precautionary behaviors among MSM migrants. Linguistic status and time since migrating moderated some associations between structural stigma and lack of HIV prevention.
Structural stigma toward MSM and immigrants represents a modifiable structural determinant of the global HIV epidemic.
Background: High rates of sexual risk behaviours are being reported among HIV-positive MSM which raises the question about the ideas of sexual responsibility that exist in this population to prevent ...the transmission and/or re-infection of HIV and other STIs. This study sought to understand the discourses on sexual care and responsibility in men living with HIV who have sex with men. Methods: A qualitative study was carried out with 78 men (aged 27-65): 35 individual interviews and 43 in five discussion groups, in the cities of Barcelona, Madrid and Palma de Mallorca, between 2007 and 2008. The selection criterion was that eighteen months had passed after a HIV diagnosis was established. The grounded theory approach was used to analyze the data. Results: Three distinct discourses about sexual responsibility were observed: (1) sole responsibility: it is the HIV-positive man who should protect himself in order to protect others. This discourse is based on an ethical position (altruistic), in which the duty and obligation to protect others is a priority; (2) shared responsibility: both parties agree and/or consent to high risk sexual practices although those who tend to use this discourse, in practice, ultimately assume full responsibility, and (3) individual responsibility: each person is responsible for himself, although the type of emotional bond with others may affect the decision to protect only oneself (there is some commitment to protect a sexual partner when something is felt for that person). Conclusions: The sexual care behaviour among HIV-positive MSM was determined by three discourses. Those discourses were influenced by various factors: moral conscience, sexual context, type of sexual partner and disclosure of HIV status.
Fundamentos: Entre los hombres VIH-positivos que tienen sexo con hombres (HSH VIH-positivos) se vienen reportando elevadas tasas de prácticas sexuales de riesgo, lo que lleva a preguntarnos sobre las ideas del cuidado sexual que existen en este colectivo para evitar la transmisión y/o reinfección del VIH y otras ITS. Este estudio buscó comprender los discursos que sobre la responsabilidad sexual tienen estos hombres. Método: Se realizó un estudio cualitativo. Participaron 78 hombres (27-65 años), 35 en entrevistas individuales y 43 en cinco grupos de discusión, en las ciudades de Barcelona, Madrid y Palma de Mallorca, entre 2007 y 2008. Se estableció como criterio de selección que hubieran transcurrido 18 meses desde el diagnóstico del VIH. El enfoque utilizado para analizar los datos fue la Teoría Fundamentada. Resultados: Entre los participantes se diferenciaron tres tipos de discurso respecto a la responsabilidad sexual: (1) Responsabilidad única: el sujeto seropositivo es el que debe cuidarse para cuidar a otros. Se fundamenta en un posicionamiento ético (altruista) en el que el deber y la obligación por proteger a los otros está por encima de todo. (2) Responsabilidad compartida: ambas partes deciden y/o consienten tener una relación sexual de riesgo aunque los que esgrimen este discurso en la práctica terminen asumiendo toda la carga de la responsabilidad. Y (3) Responsabilidad individual: cada uno vela por el cuidado de sí mismo, aunque el tipo de vínculo emocional con otras personas podría afectar la decisión de cuidarse o no (existe algún tipo de compromiso de proteger a alguien cuando se siente algo por esa persona). Conclusiones: La conducta de cuidado sexual de los HSH VIH-positivos estuvo orientaba en base a los tres discursos sobre la responsabilidad. Estos discursos estuvieron influenciados por diversos factores: conciencia moral, el contexto sexual, el tipo de pareja sexual y el revelamiento del seroestatus.
Abstract Background Among men who have sex with men (MSM), the association between searching for sexual partners’ on the Internet and increased risk of sexually transmitted infections (STIs)/HIV ...infection, together with current low levels of partner notification (PN), justifies a study to explore the intention to use new communication technologies for PN in Spain. Methods Two cross-sectional surveys were performed: the first was administered online to visitors to web pages where the survey was advertised; the second was administered on paper to patients attending an STI Unit and centres similar to Community-Based Voluntary Counselling and Testing centres. Results The study population comprised 1578 Spanish residents (median age, 34 years range: 18 to 74); 84% lived in urban areas, and 69% reported searching for sexual partners on the Internet. Thirty-seven per cent would be willing to use a website for PN, 26% did not know if they would use one, and 37% would not want to use one. The main reasons for not intending to notify STI/HIV were “shame or fear” (stable partner) and “not knowing how to contact them” (casual partner). The preferred method of notification was face to face (73%) for both stable and casual partners, although using new technologies (Short Messaging System, e-mail, web page, phone applications) was widely accepted for notifying casual partners. Conclusions Fighting stigma and promoting alternative methods of PN among MSM and health professionals through new technologies could increase the frequency of PN. This approach will improve early detection and reduce transmission in Spain.
To describe the pattern of drug use among men who have sex with men (MSM) living in Spain and its association with sexual risk practices.
The European MSM Internet Survey was implemented in 2010 in ...38 European countries on websites for MSM and collected data on sociodemographics, sexual behavior, and other sexual health variables. The association between unprotected anal intercourse (UAI) with casual partners and drug consumption was evaluated using multivariate logistic regression models.
Among the 13,111 participants, most consumed drugs were cannabis (30.1%), popper (28.4%) and cocaine (18.7%). The risk of UAI with casual partners was 1.5 among those who had used drugs in relation to the other participants. The proportion of MSM who had injected drugs at least once in life was 2.5%, and 1.4% in the last 12 months. The prevalence of UAI with casual partners (53.4%), human immunodeficiency virus (HIV) (23%), hepatitis C (8.2%) and sexually transmitted infections (STI) (15.8%) was higher in MSM injectors related to those who had not used injected drugs (P<.05).
The results of this study confirm a high prevalence of drug use in MSM and their relationship to sexual risk behavior. Although the use of injected drugs in MSM is a minority, this group reported a higher level of sexual risk behaviors, self-reported HIV, hepatitis C and other STI.
This study examines understandings of sexual and reproductive health and healthcare, and perceptions of health services among women who regularly or occasionally sell or transact sex in Escuintla, ...Guatemala. Using an approach informed by grounded theory, 35 individual interviews were analysed. Results suggest that sex workers face multiple forms of vulnerability due to their level of education, economic situation and unequal gender relations. Many feel dissatisfied with the quality of health services received, specifically with the lack of medicines, poor personal treatment by health workers and scanty information. Condoms were widely acknowledged as the means of preventing STI/HIV; however, many of the women do not use them with regular clients and regular partners. An effective STI/HIV-prevention strategy that addresses sex workers' circumstances and needs, requires a comprehensive approach, which includes a combination of individual and community-based interventions. These interventions must involve clients, sex establishment owners and health personnel.
Currently there is a growing trend toward high-risk sexual practices with casual partners in the group of men who have sex with men (MSM) in many industrialized countries. This study offers some ...understanding of why a group of men had unprotected anal intercourse (UAI). A grounded approach was used to analyze 20 interviews with MSM from Barcelona between 18 and 40 years of age who had at least one episode of UAI in the past three months. The results reveal that many respondents had UAI practices with casual sexual partners because they were in search of experiences that were not directly tied to sexual relations: reaffirmation of a sense of personal worth and of their own physical attractiveness, offset shortcomings and feelings of emotional loneliness, the search for connection and intimacy, being in love, conversion of the risk into pleasure for the forbidden and a desire to rebel against established rules. In these cases, concerns about sexual and health care seemed to overwhelm and were not taken into account when having UAI. It is important that HIV prevention programs include in their messages the power of these motivations that lead to practices of UAI. URN: urn:nbn:de:0114-fqs0902219
Abstract Objectives To compare sexual practices and risk behaviours between MSM who were first diagnosed with hepatitis C (HCV) in the previous 12 months and those who were never diagnosed; and, to ...identify factors associated with a diagnosis of HCV. Methods The European-MSM-Internet-Survey (EMIS) was implemented for 3 months during 2010, mainly on websites for MSM. Data on socio-demographic characteristics, sexual behaviour, drug use, STI history, and other sexual health variables were collected. The Chi-square test and logistic regression analysis were used to analyse the data. Results Data from 13,111 respondents were analysed. The proportion of MSM who had ever been diagnosed with HCV infection was 1.9% ( n = 250), and of those currently infected with the virus was 0.6% ( n = 78). The percentage of those first diagnosed in the last 12 months was 0.4% ( n = 46), of whom 70% were HIV-negative and 22% had HIV coinfection. Having a first diagnosis of HCV in the last 12 months was more common among HIV-positive than among HIV-negative MSM (0.9% vs 0.4%) and among MSM born abroad than among Spanish-born (0.7% vs 0.3%). MSM diagnosed with HCV in the last 12 months were more likely to have had: more than 10 sexual partners, sex abroad, receptive anal intercourse, insertive/receptive fisting, and unprotected anal intercourse with non-steady partners of unknown or discordant HIV-status. Likewise, they reported more frequent visits to sex-focused venues, higher drug use, as well as a higher proportion of STI diagnosis. In the multivariate model, visiting a public sex-focused venue, practicing receptive fisting, using erection enhancing medication and having a diagnosis of syphilis were independently associated with a first diagnosis of HCV in the last 12 months. Conclusions HCV infection does not seem to be restricted to HIV-infected MSM. Certain sexual behaviour (fisting, visiting sex-focused venues), drug use, and ulcerative STI seem to be associated with a diagnosis of HCV.
High rates of sexual risk behaviours are being reported among HIV-positive MSM which raises the question about the ideas of sexual responsibility that exist in this population to prevent the ...transmission and/or re-infection of HIV and other STIs. This study sought to understand the discourses on sexual care and responsibility in men living with HIV who have sex with men.
A qualitative study was carried out with 78 men (aged 27-65): 35 individual interviews and 43 in five discussion groups, in the cities of Barcelona, Madrid and Palma de Mallorca, between 2007 and 2008. The selection criterion was that eighteen months had passed after a HIV diagnosis was established. The grounded theory approach was used to analyze the data.
Three distinct discourses about sexual responsibility were observed: (1) sole responsibility: it is the HIV-positive man who should protect himself in order to protect others. This discourse is based on an ethical position (altruistic), in which the duty and obligation to protect others is a priority; (2) shared responsibility: both parties agree and/or consent to high risk sexual practices although those who tend to use this discourse, in practice, ultimately assume full responsibility, and (3) individual responsibility: each person is responsible for himself, although the type of emotional bond with others may affect the decision to protect only oneself (there is some commitment to protect a sexual partner when something is felt for that person).
The sexual care behaviour among HIV-positive MSM was determined by three discourses. Those discourses were influenced by various factors: moral conscience, sexual context, type of sexual partner and disclosure of HIV status.
To identify factors associated with high risk sexual practices among men who have sex with men (MSM) in Spain.
An online survey was conducted in 2010, which included, among others, questions on ...HIV/STI sexual behaviours and prevention needs. Unprotected anal intercourse (UAI) with a partner of unknown or discordant HIV status in the past year was defined as a high risk sexual behaviour.
Of the 13,111 participants, 49.4% had had sex with steady partners (SP) and 73.4% with non-steady partners (NSP) in the last 12months; and the prevalence of high risk UAI was 25.4% and 29.4%, respectively. Factors associated with high risk UAI with SP were: living in a city of less than 500,000 inhabitants (OR=1.42 <100,000 inhabitants), being out to no-one or only a few people (OR=1.42), and being HIV-positive with undetectable viral load among those with a high level of HIV/STI knowledge (OR=3.18). Factors associated with high risk UAI with NSP were mainly: having a higher number of sexual partners (OR=4.31 >50 partners), having used drugs for sex (OR=1.33), and at parties (OR=1.19), having a medium (OR=1.82) or low (OR=1.33) level of HIV/STI knowledge, and being HIV-positive (OR=1.56).
Among MSM, the prevalence of high risk sexual practices is high with both SP and NSP. Factors associated with high risk UAI vary by type of sexual partner (e.g., having HIV with an undetectable viral load). These must be taken into account when planning strategies for primary and secondary prevention.
PDF
