Fear Less Live More campaign
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Fear Less Live More is a national campaign addressing HIV-related stigma among gay men. This presentation describes the campaign as well as some of the research that was undertaken as part of the development of the campaign. This presentation was given by Dean Murphy (HIV Educator, AFAO) at the AFAO Positive Services Forum 2012.
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Fear Less Live More campaign
- 1. Development of a national education campaign for gay men on HIV-related stigma and discrimination Dean A Murphy
- 2. Background A two-phased approach to the development of a multi-year program of activities The first phase being one of research; the second being the development and execution of a range of interventions. Research: A series of discussion groups with HIV-negative and HIV-positive gay and bisexual men, about stigma and discrimination within gay communities and settings (GfK Blue Moon) The HIV Stigma Barometer Survey Commissioning a national round of consultations with the NAPWA membership and associated networks
- 3. Qualitative research Qualitative research undertaken by GfK Blue Moon 11 discussion groups and 4 in-depth interviews with gay men and other MSM (in NSW, Qld, Vic, SA) 2nd round of research specifically targeting <35 year old HIV- positive men face-to-face or telephone interviews and mini group discussions (incl. WA)
- 4. Qualitative research HIV-negative men: 1 would never have sex with someone they believed had HIV 2 would not knowingly have sex with someone they knew to be HIV positive, but readily engage in casual, one-off, sexual encounters in certain situations 3 were comfortable having sex with HIV positive men. (Had personal experience of a serodiscordant relationship.) High expectations of disclosure Varying knowledge of HIV Felt that HIV-related stigma was not great
- 5. Qualitative research HIV-positive men: 1 Very few selected causal partners based on HIV status 2 Some specifically targeted other HIV positive men online (or in venues, etc.) to minimise the impact of rejection. Protected sex in a serodiscordant relationship would be a particular difficulty Felt that they were unfairly burdened with responsibility for disclosure
- 6. Qualitative research Recommendations: To assist overcoming fear of HIV-positive partners by making HIV a topic of discussion in general, again, rather than something that is not discussed (except by prevention campaigns) To encourage social interaction between HIV-positive and HIV- negative men To create awareness that that serodiscordant relationships can and do exist
- 7. HIV Stigma Barometer Survey To explore the extent to which HIV-positive gay men experience HIV-related stigma To explore the extent to which non-HIV-positive gay men with express HIV stigma To develop a stigma assessment tool that captures key dimensions of experienced and expressed stigma To explore the personal and social factors that contribute to HIV-related stigma
- 8. HIV Stigma Barometer Survey Disclosure of HIV status (HIV-positive respondents only) HIV-related stigma – Attributions of responsibility – Negative emotional reactions – Social distancing – Sexual exclusion Gay and PLHIV community engagement Perceived risk of HIV transmission Serostatus identity Reliance on disclosure
- 9. Participant characteristics N=1,260 gay and other men who have sex with men Mean age 37.9 NSW 42.6%; Vic 20.8%; QLD 19.6%; SA 5.4%; ACT 2.9%; Tas 2.6%; WA 2.5%; NT 1.5% Gay 88.9%; bisexual 8.9%; queer 1.4%; other 1.4% HIV status HIV positive: n=214 (17.0%) HIV negative: n=915 (72.6%) Untested/status unknown: n=131 (10.4%)
- 10. Disclosure
- 11. Disclosure
- 12. Experienced and expressed stigma
- 13. HIV-positive men Among HIV-positive men, moderate levels of sexual exclusion (M=2.8) – Older men and men who had any HIV-negative sex partners were less likely to experience stigma – Men who engaged more with PLHIV community and placed more importance on serostatus identity were more likely to experience stigma – No associations between stigma and disclosure to sex partners, health care workers, or disclosure in social settings
- 14. Non-HIV-positive men Among HIV negative and unknown status men, moderate levels of sexual exclusion (M=2.9) – Men who were older, had any HIV-positive sex partners, or were more engaged with PLHIV community, expressed less stigma – Men who had HIV-negative or unknown status sex partners, had stronger serostatus identity, or perceived more risk of HIV transmission from sex with an HIV-positive partner, expressed more stigma
- 15. Disclosure expectations, practices, and serostatus preferences (HIV-negative men) Item Agree (%) Mean (SD) ‘I'd expect an HIV-positive man to tell me he was HIV 75.2% 4.09 (1.31) positive before we had sex’ ‘I'd expect an HIV-negative man to tell me he was HIV 42.9% 3.17 (1.48) negative before we had sex’ ‘I'd expect an untested man to tell me he was untested 45.1% 3.30 (1.46) before we had sex’ I always tell my sex partner what my HIV status is 44.1% 3.18 (1.53) before we have sex’ ‘I always know the HIV status of my sex partner before 29.4% 2.69 (1.39) we have sex’ ‘I only have sex with someone whose HIV status I know’ 27.7% 2.60 (1.43) ‘I only have sex with someone whose HIV status is 37.9% 2.90 (1.52) similar to mine’
- 16. Disclosure expectations, practices, and serostatus preferences (HIV-negative men) Item Agree (%) Mean (SD) ‘I'd expect an HIV-positive man to tell me he was HIV 75.2% 4.09 (1.31) positive before we had sex’ ‘I'd expect an HIV-negative man to tell me he was HIV 42.9% 3.17 (1.48) negative before we had sex’ ‘I'd expect an untested man to tell me he was untested 45.1% 3.30 (1.46) before we had sex’ I always tell my sex partner what my HIV status is 44.1% 3.18 (1.53) before we have sex’ ‘I always know the HIV status of my sex partner before 29.4% 2.69 (1.39) we have sex’ ‘I only have sex with someone whose HIV status I know’ 27.7% 2.60 (1.43) ‘I only have sex with someone whose HIV status is 37.9% 2.90 (1.52) similar to mine’
- 17. Disclosure expectations, practices, and serostatus preferences (HIV-negative men) Item Agree (%) Mean (SD) ‘I'd expect an HIV-positive man to tell me he was HIV 75.2% 4.09 (1.31) positive before we had sex’ ‘I'd expect an HIV-negative man to tell me he was HIV 42.9% 3.17 (1.48) negative before we had sex’ ‘I'd expect an untested man to tell me he was untested 45.1% 3.30 (1.46) before we had sex’ I always tell my sex partner what my HIV status is 44.1% 3.18 (1.53) before we have sex’ ‘I always know the HIV status of my sex partner before 29.4% 2.69 (1.39) we have sex’ ‘I only have sex with someone whose HIV status I know’ 27.7% 2.60 (1.43) ‘I only have sex with someone whose HIV status is 37.9% 2.90 (1.52) similar to mine’
- 18. Disclosure expectations, practices, and serostatus preferences (HIV-negative men) Item Agree (%) Mean (SD) ‘I'd expect an HIV-positive man to tell me he was HIV 75.2% 4.09 (1.31) positive before we had sex’ ‘I'd expect an HIV-negative man to tell me he was HIV 42.9% 3.17 (1.48) negative before we had sex’ ‘I'd expect an untested man to tell me he was untested 45.1% 3.30 (1.46) before we had sex’ I always tell my sex partner what my HIV status is 44.1% 3.18 (1.53) before we have sex’ ‘I always know the HIV status of my sex partner before 29.4% 2.69 (1.39) we have sex’ ‘I only have sex with someone whose HIV status I know’ 27.7% 2.60 (1.43) ‘I only have sex with someone whose HIV status is 37.9% 2.90 (1.52) similar to mine’
- 19. Campaign: FearLessLiveMore Focus – disclosure – sexual exclusion – factors associated with stigma: » Fear of HIV transmission » Importance on serostatus identity » Social and sexual engagement with PLHIV (for non-HIV-positive men) Aims – Encourage non-stigmatising attitudes and behaviours – Promote resilience
- 27. Solutions – ‘trust what you know’; Achievable – ‘easy’; ‘simply’; ‘don’t worry’; ‘rising above’; ‘fear less, live more’; Care – ‘protects’; ‘unnecessarily hurtful’; ‘why build barriers?’; Benefits – ‘have fun’; ‘great sex’; ‘let your love life take off’; don’t worry’, ‘fear less, live more’
- 28. Acknowledgements Campaign development group Colin Batrouney; Sam Bowden; Kim Brooklyn; Shane Dinnison; Simon Donohoe; Jenny Duggan; James Gray; Mark Halton; Rob Lake; Cipri Martinez; David Menadue; Simon O'Connor; Phillip Keen; Daniel Reeders; Sean Slavin; Kathy Triffit; Ian Walker; Russell Westacott; Ben Wilcock; Sonny Williams Also John de Wit; Philippe Adam
Notas del editor
- We also examined responses to the seven individual items that comprised the ‘reliance on disclosure’ scale. Overall, 75.2% of participants expected an HIV-positive man to disclose his serostatus before having sex (mean score 4.1). However, only 42.9% expected an HIV-negative man to disclose before having sex (mean= 3.2) and 45.1% expected an untested man to disclose (mean= 3.3). These differences were statistically significant. Almost half of the men (44.1%) reported that they always tell sex partners their HIV status before having sex (mean=3.2), and 29.4% reported that they always know the serostatus of their sex partners (mean=2.7). The difference between these responses was significant, indicating that men were more likely to report that they tell partners their own serostatus than they were to know the serostatus of their partners. In terms of serostatus preferences, 27.7% reported that they only have sex with someone whose serostatus they know (mean=2.6); and 37.9% reported that they only have sex with someone whose serostatus is similar to their own (mean=2.9). The difference between these responses was significant. There were also differences between these subgroups of questions. First, expectations of disclosure were higher (regardless of serostatus of partners) than their reported knowledge of their partners’ serostatus. Second, men had higher expectations of disclosure from HIV-positive and untested men than their own reported disclosure their HIV-negative serostatus to sexual partners. However, there was no difference between self-reported disclosure of serostatus to sexual partners and their expectations of disclosure by other HIV-negative men. Finally, men were more likely to report that they only had sex with partners who were the same status as them than they were to say they only have sex with partners whose serostatus they know.
- We also examined responses to the seven individual items that comprised the ‘reliance on disclosure’ scale. Overall, 75.2% of participants expected an HIV-positive man to disclose his serostatus before having sex (mean score 4.1). However, only 42.9% expected an HIV-negative man to disclose before having sex (mean= 3.2) and 45.1% expected an untested man to disclose (mean= 3.3). These differences were statistically significant. Almost half of the men (44.1%) reported that they always tell sex partners their HIV status before having sex (mean=3.2), and 29.4% reported that they always know the serostatus of their sex partners (mean=2.7). The difference between these responses was significant, indicating that men were more likely to report that they tell partners their own serostatus than they were to know the serostatus of their partners. In terms of serostatus preferences, 27.7% reported that they only have sex with someone whose serostatus they know (mean=2.6); and 37.9% reported that they only have sex with someone whose serostatus is similar to their own (mean=2.9). The difference between these responses was significant. There were also differences between these subgroups of questions. First, expectations of disclosure were higher (regardless of serostatus of partners) than their reported knowledge of their partners’ serostatus. Second, men had higher expectations of disclosure from HIV-positive and untested men than their own reported disclosure their HIV-negative serostatus to sexual partners. However, there was no difference between self-reported disclosure of serostatus to sexual partners and their expectations of disclosure by other HIV-negative men. Finally, men were more likely to report that they only had sex with partners who were the same status as them than they were to say they only have sex with partners whose serostatus they know.
- We also examined responses to the seven individual items that comprised the ‘reliance on disclosure’ scale. Overall, 75.2% of participants expected an HIV-positive man to disclose his serostatus before having sex (mean score 4.1). However, only 42.9% expected an HIV-negative man to disclose before having sex (mean= 3.2) and 45.1% expected an untested man to disclose (mean= 3.3). These differences were statistically significant. Almost half of the men (44.1%) reported that they always tell sex partners their HIV status before having sex (mean=3.2), and 29.4% reported that they always know the serostatus of their sex partners (mean=2.7). The difference between these responses was significant, indicating that men were more likely to report that they tell partners their own serostatus than they were to know the serostatus of their partners. In terms of serostatus preferences, 27.7% reported that they only have sex with someone whose serostatus they know (mean=2.6); and 37.9% reported that they only have sex with someone whose serostatus is similar to their own (mean=2.9). The difference between these responses was significant. There were also differences between these subgroups of questions. First, expectations of disclosure were higher (regardless of serostatus of partners) than their reported knowledge of their partners’ serostatus. Second, men had higher expectations of disclosure from HIV-positive and untested men than their own reported disclosure their HIV-negative serostatus to sexual partners. However, there was no difference between self-reported disclosure of serostatus to sexual partners and their expectations of disclosure by other HIV-negative men. Finally, men were more likely to report that they only had sex with partners who were the same status as them than they were to say they only have sex with partners whose serostatus they know.
- We also examined responses to the seven individual items that comprised the ‘reliance on disclosure’ scale. Overall, 75.2% of participants expected an HIV-positive man to disclose his serostatus before having sex (mean score 4.1). However, only 42.9% expected an HIV-negative man to disclose before having sex (mean= 3.2) and 45.1% expected an untested man to disclose (mean= 3.3). These differences were statistically significant. Almost half of the men (44.1%) reported that they always tell sex partners their HIV status before having sex (mean=3.2), and 29.4% reported that they always know the serostatus of their sex partners (mean=2.7). The difference between these responses was significant, indicating that men were more likely to report that they tell partners their own serostatus than they were to know the serostatus of their partners. In terms of serostatus preferences, 27.7% reported that they only have sex with someone whose serostatus they know (mean=2.6); and 37.9% reported that they only have sex with someone whose serostatus is similar to their own (mean=2.9). The difference between these responses was significant. There were also differences between these subgroups of questions. First, expectations of disclosure were higher (regardless of serostatus of partners) than their reported knowledge of their partners’ serostatus. Second, men had higher expectations of disclosure from HIV-positive and untested men than their own reported disclosure their HIV-negative serostatus to sexual partners. However, there was no difference between self-reported disclosure of serostatus to sexual partners and their expectations of disclosure by other HIV-negative men. Finally, men were more likely to report that they only had sex with partners who were the same status as them than they were to say they only have sex with partners whose serostatus they know.