A regional survey of men who have sex with men has found that those who are “out” (open about their sexuality) have a more positive self-perception but are more vulnerable to homophobic abuse or assault than those in the closet.
According to the findings of the Caribbean Men’s Internet Survey (CARIMIS), which is the region’s largest study of gay, bisexual and other men who have sex with men, just over half—52%—of the 3,567 respondents were out to “few or none” of their family members, friends, work or school colleagues.
The CARIMIS report says, “Those out to most of their friends, family and work colleagues had roughly half the levels of internalized homonegativity… than those out to less than most…. This significantly higher score among those who have not come out to as many people may reflect the difficulty that some respondents have in accepting and communicating their attraction to other men, which has a negative impact on how they consider homosexuality more broadly.”
It adds, “Outness was associated with a higher vulnerability to homophobic abuse, but it was also linked with lower degrees of internalized homonegativity and an increased likelihood of being tested for HIV.”
Although the report says most of the respondents in the survey (76%) were happy with their sex lives, it notes those who are not out to many of their friends, family and colleagues were most likely to be unhappy with their sex lives.
Also among the findings in the report is that homophobic abuse is a common experience for many men who have sex with men. The report says many respondents experience “intimidation, verbal abuse and violence” because of their sexuality. It notes that within the past month, 33% of respondents had been “stared at or intimidated,” while 23% experienced “verbal insults or name-calling” because people knew or presumed they were attracted to men. It was also reported that about one in ten (11%) reported being physically assaulted in the past five years.
Younger men and those who were out to most of their friends, family and work or school colleagues, the report adds, were more vulnerable to intimidation and verbal abuse. Many of these men who have sex with men have negative feelings about their sexuality. “Men who have sex with men with internalized homonegativity accept negative social attitudes about same-sex attraction. This is linked with stress, worse sexual health outcomes and higher rates of behaviour associated with HIV risk,” the report points out, while mentioning that based on a similar survey in the UK, Caribbean men are more likely to have negative feelings about themselves.
As a result, it recommends anti-discrimination advocacy and engagement surrounding tolerance and non-violence being coupled with practical interventions to improve safety. “Further, efforts to eliminate prejudice towards men who have sex with men and people living with HIV should be coupled with psychosocial support and interventions regarding self-perception,” it adds.
‘Dissonance’
According to a statement from UNAIDS Caribbean, the research was done by the Joint United Nations Programme on HIV and AIDS (UNAIDS) Caribbean Regional Support Team in collaboration with Sigma Research of the London School of Hygiene and Tropical Medicine, with the partial support of the United States Agency for International Development (USAID).
Data was collected over the period November, 2011 to June, 2012, through an online survey of respondents who were 18 or older, lived in the Caribbean and were either attracted to men, had sex with men, or thought they might do so in the future. The respondents comprised 3,567 men living in 33 Dutch-, English-, French- and Spanish-speaking Caribbean countries and territories.
Because of the challenges associated with gathering reliable information on men who have sex with men, CARIMIS utilised an “internet-based, multi-language survey method” and is the region’s first online survey of this group.
The report notes that 58% of respondents described themselves as gay or homosexual, 24% said they were bisexual and 2% said they were straight. Another 15% indicated that they do not usually use a term to describe their sexual identity.
The majority (91%) of respondents had had sex with a man in the past year, and 23% had sex with both men and women during that time, while a minority (2%) reported having had sex only with women. In addition, 9% said they were attracted to transgender people, and 3% said that they had sex with a transgender person in the past year.
According to the report, although how a man describes his sexual identity is strongly related to the sex of his sexual partners, there was sometimes “dissonance.” “For example, 6% of those describing themselves as gay had sex with a woman in the previous 12 months, and 24% of those describing themselves as heterosexual had sex with men only over the same period,” it points out.
Sexually-transmitted infections, according to the report, are an issue as more than one quarter of the respondents (28%) had been diagnosed with a sexually transmitted infection other than HIV, including 10% who had been diagnosed within the previous 12 months of the survey.
The survey also found that almost half of the respondents (47%) were university graduates, while 50% attained secondary or post-secondary education. The report recognises that men who have sex with men with low education are more vulnerable.
“Although this survey did not have many respondents with primary-level or no formal education, it consistently found higher degrees of vulnerability among survey respondents from this group,” the report says, while noting that these vulnerabilities include increased susceptibility to homophobic abuse and assault, higher levels of dissatisfaction with knowledge of HIV and sexually transmitted infections and more behaviour that could lead to condom failure.
The survey says educated men who have sex with men have access to testing, with the majority of respondents (80%) having received at least one HIV test result.
Action
At the CARIMIS launch in Port of Spain, Trinidad last week Tuesday, Dereck Springer, Director of the Pan Caribbean Partnership against HIV and AIDS (PANCAP) said the challenge now is to translate the findings into policy.
“Now that we have called attention to the issue, how do we really begin to have the conversations in our homes, churches, mosques, temples and parliaments?” he asked.
At the level of PANCAP, he said the current focus is to reduce stigma, eliminate discrimination and uphold human rights for everyone. “But the real work has to be done at the level of the family and community,” he noted.
Addressing the findings that those men who are out tended to have more positive self-perception and exhibit better health-seeking behaviour, while those who were not were less vulnerable to homophobic abuse, UNAIDS Caribbean Director, Dr. Ernest Massiah is quoted as saying that it is “the paradox” of stigma. “Fear and secrecy may make a man less likely to experience harassment or violence, but also less likely to have safer sex,” UNAIDS Caribbean reports him as saying in its statement.
“There have been, are, and always will be adult men who have private, consensual relationships with other men,” he added. “We need to remove laws that perpetuate prejudice against these people. We need anti-discrimination legislation. We need more faith-based organisations to raise their voices against discrimination. And we need communities affected by HIV to assert their right to respect and dignity.”
Meanwhile, Chairperson of the Equal Opportunity Commission in Trinidad and Tobago, Lynette Seebaran-Suite said that lessons on addressing the vulnerability of men who have sex with men to violence may be drawn from the domestic violence movement.
“There is no need to reinvent the wheel,” Seebaran-Suite is quoted as saying. “There have been crisis interventions, hotlines, shelters and counselling services. Then you move on to legislation and initiating a national dialogue to change the mores of society and try to aim at prevention.”
She insisted that the public debates surrounding these issues are central to the process of public education and shifts in attitudes, the statement adds.
Also speaking at the launch, David Soomarie, coordinator of Community Action Resource (CARE), one of the region’s oldest non-governmental organisations serving people living with HIV, noted the value of responding to the new ways in which people express and negotiate their sexuality. “The study shows that there is a complex web of sexual identity expressed and experienced by men across the Caribbean. It provided a space for disclosure of sexual desire and behaviour that would otherwise be ridiculed in public spaces. Crimes of physical and sexual violence are often not reported for fear of this kind of ridicule. This approach shows a key avenue for behaviour change interventions,” Soomarie said.
The full report can be accessed at the UNAIDS Caribbean website: www.unaidscaribbean.org.
