Report on addressing MSM issues in Interior Health Region of BC using community based research.
The issue of men having sex with other men in clandestine, anonymous and transient settings presents a variety of issues and problems for health care providers and community educators. Impervious to the usual educational and supportive outreach of safer sex, resisting labels and identification, the rise of HIV positive status among men who have sex with other men, and their partners, indicates that practice of MSM requires action and responses beyond the innovative and effective outreach programs of “regular” HIV outreach.
Men who are part of the MSM community are particularly vulnerable and isolated. For whatever reasons they prefer to remain anonymous, to keep their same sex activities to safe, hidden edges of their lives. Identifying their sexual practices in ways that may disguise or obscure the levels of risk they are engaging, risking loss of status, employment relationships and family may be perceived as real risks. Attempts to undertake research or to provide services, support or education within the geographical locations men have found to explore this part of their sexuality may well be perceived as intrusive and drive the men to other, deeper locations putting them at even more risk. The homosexual community may also reject men who are ‘fence sitters” reaping the benefits of a heterosexual public lifestyle and the pleasures of same sex activities in private. Some men who pursue MSM may also be homosexual men in long term-committed relationships. All these factors become barriers to the desire to research and improve services and supports.
Thus, the challenges facing the group at the onset of this workshop seemed overwhelming and insurmountable. How would it be possible to undertake respectful and effective research that did not harm or put at further risk an already vulnerable group and at the same time gather meaningful and accurate information? It is a tribute to the skills, compassion of those present, and a testament to the power of a process designed to share those skills, that the results of this workshop not only meet the objectives of developing community capacity but developed a comprehensive and possible research design for a highly sensitive subject. Using the highly complex and seemingly impossible task of researching MSM, the workshop participants acquired an understanding of community based research, its potential for ethical and community led action and positive change in the community.
This report was intended to be a summary report of the workshop. This objective has expanded due to the richness and generosity of the participants. What is presented here is not only a summary report but also a “HOW TO” manual. The summary report presents the material presented to, and the material generated by, the workshop, including the vision, the research design and action plan, and the evaluative measures. Further, the report includes the first data set collected through the pilot test of the research design. As a manual, the report covers each section of the workshop in three themes: the why (or theory) of the section. The how (or methods) used in each section and the results (or findings) of the section.
As this report demonstrates, the foundations have been laid for a community based research team who feel ready and committed to engage on a sensitive but imperative research topic in their region, the needs of MSM in the Okanagan Valley.
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