The Experts below are selected from a list of 166632 Experts worldwide ranked by ideXlab platform
Axel J. Schmidt - One of the best experts on this subject based on the ideXlab platform.
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European Men-Who-Have-Sex-With-Men Internet Survey (EMIS-2017): Design and Methods
Sexuality Research and Social Policy, 2019Co-Authors: Peter Weatherburn, Ford Hickson, David S. Reid, Ulrich Marcus, Axel J. SchmidtAbstract:Men-who-have-sex-with-men (MSM) carry a disproportionate burden of sexually transmitted infections across Europe. Health planners require sexual health needs assessment data to respond appropriately. In addition, surveillance of risk and precaution behaviours in this population enables evaluative judgements of policy responses. The European MSM Internet Survey (EMIS-2017) aimed to repeat the pan-European online Survey on male homosexual behaviour conducted in 2010, both to update information required to plan and monitor health promotion interventions and consolidate harmonisation of existing behavioural surveillance approaches. Our study team collaborated with more than 200 partners from academia, public health and civil society across 50 countries. Starting from our previous EMIS-2010 questionnaire, partners engaged in three rounds of iterative Survey development and piloting until the final content was agreed. Transfer to an online Survey application was followed by further pre-testing before translation into 32 additional languages, final testing and sign-off. The Survey was available to complete online in 33 languages simultaneously from 18 October 2017 to 31 January 2018. Ten international MSM dating mobile apps were paid to send short promotional messages, and national partners promoted the Survey via at least another 272 websites and social media accounts. Real-time monitoring of responses facilitated targeted advertising by country and recruitment source. Ultimately 144,305 cases were submitted of which 137,358 (95.2%) were eligible for inclusion. EMIS-2017 demonstrated the feasibility of multi-country online MSM Surveying with public funding. Meaningful involvement of a large number of collaborators in the Survey design and its execution ensured successful recruitment. Careful design, piloting and presentation ensured the Survey was acceptable and had authority and perceived community benefit. Partners in 38 countries have already been supplied with a national database of 100 or more respondents for national analysis, while the study team has focussed on international comparisons among 137,358 respondents in 50 countries.
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factors associated with unprotected anal sex with multiple non steady partners in the past 12 months results from the european men who have sex with men Internet Survey emis 2010
BMC Public Health, 2015Co-Authors: Sarah C Kramer, Axel J. Schmidt, Rigmor C Berg, Harm J. Hospers, Martina Furegato, Cinta Folch, Ulrich MarcusAbstract:Practising unprotected anal intercourse (UAI) with high numbers of partners is associated with increased risk for acquiring and transmitting HIV and other sexually transmitted infections. Our aim was to describe factors associated with UAI with multiple partners in a large sample of MSM from 38 European countries recruited for an online Survey in 2010. Data are from the European Men-Who-Have-Sex-With-Men Internet Survey (EMIS). The analysis was restricted to men who reported any anal sex with a non-steady partner in the past 12 months, and who were either never diagnosed with HIV, or who had been diagnosed with HIV more than 12 months ago, reported a detectable viral load and did not exclusively serosort (n = 91,477). Multivariable logistic regression was used to compare men reporting UAI with four or more (4+) non-steady partners to two comparison groups: a) no UAI with non-steady partners, and b) UAI with 1-3 non-steady partners. Overall, 9.6 % of the study population reported UAI with 4+ partners in the past 12 months. In both models, factors consistently associated with this behaviour were: having been diagnosed with HIV, lower educational levels, use of nitrite inhalants, drugs associated with sex and parties, or erectile dysfunction drugs in the past 4 weeks, using sex-on-site venues in the past 4 weeks, buying or selling sex in the past 12 months, having experienced physical violence due to sexual attraction to men in the past 12 months, reporting sexual happiness, being out to all or almost all of one’s acquaintances, and knowing that ART reduces HIV transmissibility. Effective antiretroviral treatment drastically reduces HIV transmission for men diagnosed with HIV, irrespective of partner numbers. Apart from reducing partner numbers or increasing condom use no other recommendations are currently in place to reduce the risk of HIV acquisition and onward transmission for HIV-negative men practicing UAI with multiple partners. A range of factors were identified as associated with UAI with four or more partners which allow the strengthening and targeting of prevention strategies to reduce HIV transmission risks resulting from condomless anal intercourse with multiple partners.
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hidden from health structural stigma sexual orientation concealment and hiv across 38 countries in the european msm Internet Survey
AIDS, 2015Co-Authors: John E Pachankis, Ford Hickson, Ulrich Marcus, Rigmor C Berg, Peter Weatherburn, Mark L Hatzenbuehler, Axel J. SchmidtAbstract:Objective Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however.
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hidden from health structural stigma sexual orientation concealment and hiv across 38 countries in the european msm Internet Survey
AIDS, 2015Co-Authors: John E Pachankis, Ford Hickson, Ulrich Marcus, Rigmor C Berg, Peter Weatherburn, Mark L Hatzenbuehler, Axel J. SchmidtAbstract:OBJECTIVE: Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however. DESIGN: Data come from the European MSM Internet Survey (EMIS), which was administered between June and August 2010 across 38 European countries (N = 174 209). METHODS: Country-level stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of attitudes held by the citizens of each country. We also assessed concealment, HIV status, number of past 12-month male sex partners, and eight HIV-preventive services, knowledge, and behavioural outcomes. RESULTS: MSM living in countries with higher levels of stigma had reduced odds of diagnosed HIV and fewer partners but higher odds of sexual risk behaviour, unmet prevention needs, not using testing services, and not discussing their sexuality in testing services. Sexual orientation concealment mediated associations between country-level stigma and these outcomes. CONCLUSION: Country-level stigma may have historically limited HIV transmission opportunities among MSM, but by restricting MSM's public visibility, it also reduces MSM's ability to access HIV-preventive services, knowledge and precautionary behaviours. These findings suggest that MSM in European countries with high levels of stigma are vulnerable to HIV infection. Although they have less opportunity to identify and contact other MSM, this might change with emerging technologies.
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The European Men-Who-Have-Sex-With-Men Internet Survey (EMIS): Design and Methods
Sexuality Research and Social Policy, 2013Co-Authors: Peter Weatherburn, Ford Hickson, Axel J. Schmidt, Rigmor C Berg, Harm J. Hospers, David Reid, Ulrich MarcusAbstract:Community-based opportunistic self-completion Surveying for sexual health programming is common among men-who-have-sex-with-men (MSM) in Europe, being used to generate evidence of unmet prevention need, for behavioural surveillance and as a platform for advocating HIV precautions. However, comparing Survey findings across Europe is difficult because of varying measures and recruitment designs, and Surveying has not occurred in all countries. EMIS (the European Men-who-have-sex-with-men Internet Survey) aimed to develop a pan-European Internet Survey on HIV-related male homosexual behaviours and prevention needs both to increase research capacity and to move towards harmonisation of existing systems. Six associated partners (APs) recruited another 77 collaborating partners from academia, public health and civil society across 35 countries. Partners’ existing MSM Surveys were collected and collated, producing a meta-Survey which was discussed by all partners through rotating round-tables at a 2-day summit. Survey development continued iteratively through user piloting and partner feedback until the English language content was agreed. Transfer to an online Survey application was followed by further testing before on-screen translation into 24 other languages, final testing and sign-off. The project’s visual identity and promotional materials were developed in close collaboration with national leads, tailoring products to match country specific needs while maintaining an overall project identity. Five international MSM dating websites were contracted to send carefully crafted instant messages to members in a series of waves. The Survey sought common ground with stakeholders and respondents by endorsing ‘the best sex with the least harm’ for MSM. Real-time monitoring of responses allowed targeted spending of the advertising budget to maximise coverage and depth of responses. Fieldwork occurred during June–August 2010. Over 184,469 responses were submitted of which 94.4 % were eligible. Partners in 38 countries were supplied with a national database of 100 or more respondents for national analysis and outputs, while the AP team proceeded on international comparisons among 174,209 respondents in 38 countries. EMIS demonstrated the feasibility of multi-country community-based MSM Internet Surveying with limited public funding. The concept of ‘the best sex with the least harm’ provided a common ground for a diverse range of stakeholders to collaborate. Meaningful involvement of a large number of collaborators in the Survey design, its visual identity and in promotional strategies ensured unprecedented coverage and depth of recruitment. Flexible planning was essential and a patchwork of recruitment was required across a range of commercial and community partners. Careful design, piloting and presentation ensured the Survey was acceptable and had both authority and perceived community benefit.
Ulrich Marcus - One of the best experts on this subject based on the ideXlab platform.
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European Men-Who-Have-Sex-With-Men Internet Survey (EMIS-2017): Design and Methods
Sexuality Research and Social Policy, 2019Co-Authors: Peter Weatherburn, Ford Hickson, David S. Reid, Ulrich Marcus, Axel J. SchmidtAbstract:Men-who-have-sex-with-men (MSM) carry a disproportionate burden of sexually transmitted infections across Europe. Health planners require sexual health needs assessment data to respond appropriately. In addition, surveillance of risk and precaution behaviours in this population enables evaluative judgements of policy responses. The European MSM Internet Survey (EMIS-2017) aimed to repeat the pan-European online Survey on male homosexual behaviour conducted in 2010, both to update information required to plan and monitor health promotion interventions and consolidate harmonisation of existing behavioural surveillance approaches. Our study team collaborated with more than 200 partners from academia, public health and civil society across 50 countries. Starting from our previous EMIS-2010 questionnaire, partners engaged in three rounds of iterative Survey development and piloting until the final content was agreed. Transfer to an online Survey application was followed by further pre-testing before translation into 32 additional languages, final testing and sign-off. The Survey was available to complete online in 33 languages simultaneously from 18 October 2017 to 31 January 2018. Ten international MSM dating mobile apps were paid to send short promotional messages, and national partners promoted the Survey via at least another 272 websites and social media accounts. Real-time monitoring of responses facilitated targeted advertising by country and recruitment source. Ultimately 144,305 cases were submitted of which 137,358 (95.2%) were eligible for inclusion. EMIS-2017 demonstrated the feasibility of multi-country online MSM Surveying with public funding. Meaningful involvement of a large number of collaborators in the Survey design and its execution ensured successful recruitment. Careful design, piloting and presentation ensured the Survey was acceptable and had authority and perceived community benefit. Partners in 38 countries have already been supplied with a national database of 100 or more respondents for national analysis, while the study team has focussed on international comparisons among 137,358 respondents in 50 countries.
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illicit drug use among gay and bisexual men in 44 cities findings from the european msm Internet Survey emis
International Journal of Drug Policy, 2016Co-Authors: Axel J Schmid, Ulrich Marcus, David Reid, Adam Ourne, Pete Weatherbu, Ford HicksoAbstract:BACKGROUND: Anecdotal evidence suggests that men who have sex with men (MSM) are increasingly combining sex and illicit drugs (an activity referred to as 'chemsex'), in particular GHB/GBL, ketamine, crystal meth, or mephedrone (here called 4-chems). Use of such drugs has been associated with mental health and sexual health harms. We aim to compare patterns of illicit drug use among MSM in 44 European urban centres. METHODS: In 2010, EMIS recruited 174,209 men from 38 countries to an anonymous online questionnaire in 25 languages. As harm reduction services for drugs and sex are organised at a local level, we chose to compare cities rather than countries. We defined 44 cities based on region/postal code and settlement size. For multivariable regression analyses, three comparison groups of MSM not living in these cities were applied: MSM living in Germany, the UK, and elsewhere in Europe. RESULTS: Data from 55,446 MSM living in 44 urban centres were included. Use of 4-chems (past 4 weeks) was highest in Brighton (16.3%), Manchester (15.5%), London (13.2%), Amsterdam (11.2%), Barcelona (7.9%), Zurich (7.0%) and Berlin (5.3%). It was lowest in Sofia (0.4%). The rank order was largely consistent when controlling for age, HIV diagnosis, and number of sexual partners. City of residence was the strongest demographic predictor of chemsex-drug use. CONCLUSION: Use of drugs associated with chemsex among MSM varies substantially across European cities. As city is the strongest predictor of chemsex-drug use, effective harm reduction programmes must include structural as well as individual interventions.
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factors associated with unprotected anal sex with multiple non steady partners in the past 12 months results from the european men who have sex with men Internet Survey emis 2010
BMC Public Health, 2015Co-Authors: Sarah C Kramer, Axel J. Schmidt, Rigmor C Berg, Harm J. Hospers, Martina Furegato, Cinta Folch, Ulrich MarcusAbstract:Practising unprotected anal intercourse (UAI) with high numbers of partners is associated with increased risk for acquiring and transmitting HIV and other sexually transmitted infections. Our aim was to describe factors associated with UAI with multiple partners in a large sample of MSM from 38 European countries recruited for an online Survey in 2010. Data are from the European Men-Who-Have-Sex-With-Men Internet Survey (EMIS). The analysis was restricted to men who reported any anal sex with a non-steady partner in the past 12 months, and who were either never diagnosed with HIV, or who had been diagnosed with HIV more than 12 months ago, reported a detectable viral load and did not exclusively serosort (n = 91,477). Multivariable logistic regression was used to compare men reporting UAI with four or more (4+) non-steady partners to two comparison groups: a) no UAI with non-steady partners, and b) UAI with 1-3 non-steady partners. Overall, 9.6 % of the study population reported UAI with 4+ partners in the past 12 months. In both models, factors consistently associated with this behaviour were: having been diagnosed with HIV, lower educational levels, use of nitrite inhalants, drugs associated with sex and parties, or erectile dysfunction drugs in the past 4 weeks, using sex-on-site venues in the past 4 weeks, buying or selling sex in the past 12 months, having experienced physical violence due to sexual attraction to men in the past 12 months, reporting sexual happiness, being out to all or almost all of one’s acquaintances, and knowing that ART reduces HIV transmissibility. Effective antiretroviral treatment drastically reduces HIV transmission for men diagnosed with HIV, irrespective of partner numbers. Apart from reducing partner numbers or increasing condom use no other recommendations are currently in place to reduce the risk of HIV acquisition and onward transmission for HIV-negative men practicing UAI with multiple partners. A range of factors were identified as associated with UAI with four or more partners which allow the strengthening and targeting of prevention strategies to reduce HIV transmission risks resulting from condomless anal intercourse with multiple partners.
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hidden from health structural stigma sexual orientation concealment and hiv across 38 countries in the european msm Internet Survey
AIDS, 2015Co-Authors: John E Pachankis, Ford Hickson, Ulrich Marcus, Rigmor C Berg, Peter Weatherburn, Mark L Hatzenbuehler, Axel J. SchmidtAbstract:Objective Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however.
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hidden from health structural stigma sexual orientation concealment and hiv across 38 countries in the european msm Internet Survey
AIDS, 2015Co-Authors: John E Pachankis, Ford Hickson, Ulrich Marcus, Rigmor C Berg, Peter Weatherburn, Mark L Hatzenbuehler, Axel J. SchmidtAbstract:OBJECTIVE: Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however. DESIGN: Data come from the European MSM Internet Survey (EMIS), which was administered between June and August 2010 across 38 European countries (N = 174 209). METHODS: Country-level stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of attitudes held by the citizens of each country. We also assessed concealment, HIV status, number of past 12-month male sex partners, and eight HIV-preventive services, knowledge, and behavioural outcomes. RESULTS: MSM living in countries with higher levels of stigma had reduced odds of diagnosed HIV and fewer partners but higher odds of sexual risk behaviour, unmet prevention needs, not using testing services, and not discussing their sexuality in testing services. Sexual orientation concealment mediated associations between country-level stigma and these outcomes. CONCLUSION: Country-level stigma may have historically limited HIV transmission opportunities among MSM, but by restricting MSM's public visibility, it also reduces MSM's ability to access HIV-preventive services, knowledge and precautionary behaviours. These findings suggest that MSM in European countries with high levels of stigma are vulnerable to HIV infection. Although they have less opportunity to identify and contact other MSM, this might change with emerging technologies.
Rigmor C Berg - One of the best experts on this subject based on the ideXlab platform.
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factors associated with unprotected anal sex with multiple non steady partners in the past 12 months results from the european men who have sex with men Internet Survey emis 2010
BMC Public Health, 2015Co-Authors: Sarah C Kramer, Axel J. Schmidt, Rigmor C Berg, Harm J. Hospers, Martina Furegato, Cinta Folch, Ulrich MarcusAbstract:Practising unprotected anal intercourse (UAI) with high numbers of partners is associated with increased risk for acquiring and transmitting HIV and other sexually transmitted infections. Our aim was to describe factors associated with UAI with multiple partners in a large sample of MSM from 38 European countries recruited for an online Survey in 2010. Data are from the European Men-Who-Have-Sex-With-Men Internet Survey (EMIS). The analysis was restricted to men who reported any anal sex with a non-steady partner in the past 12 months, and who were either never diagnosed with HIV, or who had been diagnosed with HIV more than 12 months ago, reported a detectable viral load and did not exclusively serosort (n = 91,477). Multivariable logistic regression was used to compare men reporting UAI with four or more (4+) non-steady partners to two comparison groups: a) no UAI with non-steady partners, and b) UAI with 1-3 non-steady partners. Overall, 9.6 % of the study population reported UAI with 4+ partners in the past 12 months. In both models, factors consistently associated with this behaviour were: having been diagnosed with HIV, lower educational levels, use of nitrite inhalants, drugs associated with sex and parties, or erectile dysfunction drugs in the past 4 weeks, using sex-on-site venues in the past 4 weeks, buying or selling sex in the past 12 months, having experienced physical violence due to sexual attraction to men in the past 12 months, reporting sexual happiness, being out to all or almost all of one’s acquaintances, and knowing that ART reduces HIV transmissibility. Effective antiretroviral treatment drastically reduces HIV transmission for men diagnosed with HIV, irrespective of partner numbers. Apart from reducing partner numbers or increasing condom use no other recommendations are currently in place to reduce the risk of HIV acquisition and onward transmission for HIV-negative men practicing UAI with multiple partners. A range of factors were identified as associated with UAI with four or more partners which allow the strengthening and targeting of prevention strategies to reduce HIV transmission risks resulting from condomless anal intercourse with multiple partners.
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hidden from health structural stigma sexual orientation concealment and hiv across 38 countries in the european msm Internet Survey
AIDS, 2015Co-Authors: John E Pachankis, Ford Hickson, Ulrich Marcus, Rigmor C Berg, Peter Weatherburn, Mark L Hatzenbuehler, Axel J. SchmidtAbstract:Objective Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however.
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hidden from health structural stigma sexual orientation concealment and hiv across 38 countries in the european msm Internet Survey
AIDS, 2015Co-Authors: John E Pachankis, Ford Hickson, Ulrich Marcus, Rigmor C Berg, Peter Weatherburn, Mark L Hatzenbuehler, Axel J. SchmidtAbstract:OBJECTIVE: Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however. DESIGN: Data come from the European MSM Internet Survey (EMIS), which was administered between June and August 2010 across 38 European countries (N = 174 209). METHODS: Country-level stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of attitudes held by the citizens of each country. We also assessed concealment, HIV status, number of past 12-month male sex partners, and eight HIV-preventive services, knowledge, and behavioural outcomes. RESULTS: MSM living in countries with higher levels of stigma had reduced odds of diagnosed HIV and fewer partners but higher odds of sexual risk behaviour, unmet prevention needs, not using testing services, and not discussing their sexuality in testing services. Sexual orientation concealment mediated associations between country-level stigma and these outcomes. CONCLUSION: Country-level stigma may have historically limited HIV transmission opportunities among MSM, but by restricting MSM's public visibility, it also reduces MSM's ability to access HIV-preventive services, knowledge and precautionary behaviours. These findings suggest that MSM in European countries with high levels of stigma are vulnerable to HIV infection. Although they have less opportunity to identify and contact other MSM, this might change with emerging technologies.
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The European Men-Who-Have-Sex-With-Men Internet Survey (EMIS): Design and Methods
Sexuality Research and Social Policy, 2013Co-Authors: Peter Weatherburn, Ford Hickson, Axel J. Schmidt, Rigmor C Berg, Harm J. Hospers, David Reid, Ulrich MarcusAbstract:Community-based opportunistic self-completion Surveying for sexual health programming is common among men-who-have-sex-with-men (MSM) in Europe, being used to generate evidence of unmet prevention need, for behavioural surveillance and as a platform for advocating HIV precautions. However, comparing Survey findings across Europe is difficult because of varying measures and recruitment designs, and Surveying has not occurred in all countries. EMIS (the European Men-who-have-sex-with-men Internet Survey) aimed to develop a pan-European Internet Survey on HIV-related male homosexual behaviours and prevention needs both to increase research capacity and to move towards harmonisation of existing systems. Six associated partners (APs) recruited another 77 collaborating partners from academia, public health and civil society across 35 countries. Partners’ existing MSM Surveys were collected and collated, producing a meta-Survey which was discussed by all partners through rotating round-tables at a 2-day summit. Survey development continued iteratively through user piloting and partner feedback until the English language content was agreed. Transfer to an online Survey application was followed by further testing before on-screen translation into 24 other languages, final testing and sign-off. The project’s visual identity and promotional materials were developed in close collaboration with national leads, tailoring products to match country specific needs while maintaining an overall project identity. Five international MSM dating websites were contracted to send carefully crafted instant messages to members in a series of waves. The Survey sought common ground with stakeholders and respondents by endorsing ‘the best sex with the least harm’ for MSM. Real-time monitoring of responses allowed targeted spending of the advertising budget to maximise coverage and depth of responses. Fieldwork occurred during June–August 2010. Over 184,469 responses were submitted of which 94.4 % were eligible. Partners in 38 countries were supplied with a national database of 100 or more respondents for national analysis and outputs, while the AP team proceeded on international comparisons among 174,209 respondents in 38 countries. EMIS demonstrated the feasibility of multi-country community-based MSM Internet Surveying with limited public funding. The concept of ‘the best sex with the least harm’ provided a common ground for a diverse range of stakeholders to collaborate. Meaningful involvement of a large number of collaborators in the Survey design, its visual identity and in promotional strategies ensured unprecedented coverage and depth of recruitment. Flexible planning was essential and a patchwork of recruitment was required across a range of commercial and community partners. Careful design, piloting and presentation ensured the Survey was acceptable and had both authority and perceived community benefit.
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structural and environmental factors are associated with internalised homonegativity in men who have sex with men findings from the european msm Internet Survey emis in 38 countries
Social Science & Medicine, 2013Co-Authors: Rigmor C Berg, Peter Weatherburn, Michael W Ross, Axel J. SchmidtAbstract:Internalised homonegativity refers to a gay person's negative feelings about homosexuality and is believed to stem from negative societal stereotypes and attitudes towards homosexuality. Surprisingly, little research has centred on this link. In this research, we aimed to examine the associations between internalised homonegativity and structural forces, cultural influence, and access to sexual health promotion measures among a sample of 144,177 men who have sex with men (MSM) in 38 European countries. Participants were recruited as part of the European MSM Internet Survey (EMIS) during 2010. It was a self-completion, multilingual Internet-based Survey for men living in Europe who have sex with men and/or feel attracted to men. Assumed causal relations were tested through multiple regression models. Variables at the structure of rule-systems (macro-level) that were significantly and negatively associated with internalised homonegativity were the presence of laws recognising same-sex relationships and same-sex adoption. In the meso-level model, greater proportions of the population expressing that they would not like to have homosexuals as neighbours predicted higher internalised homonegativity. In the last model, five variables were significantly and negatively associated with internalised homonegativity: being exposed to HIV/STI information for MSM, access to HIV testing, access to STI testing, access to condoms, and experience of gay-related hostility. In turn, men who had tested for HIV in the past year evidenced lower internalised homonegativity. This is the largest and certainly most geographically diverse study to date to examine structural and environmental predictors of internalised homonegativity among MSM. Our results show that one insidious consequence of society's stigma towards homosexuals is the internalisation of that stigma by gay and bisexual men themselves, thus, drawing attention to the importance of promoting social equity for self-acceptance around gay identity in building a positive sense of self.
Peter Weatherburn - One of the best experts on this subject based on the ideXlab platform.
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European Men-Who-Have-Sex-With-Men Internet Survey (EMIS-2017): Design and Methods
Sexuality Research and Social Policy, 2019Co-Authors: Peter Weatherburn, Ford Hickson, David S. Reid, Ulrich Marcus, Axel J. SchmidtAbstract:Men-who-have-sex-with-men (MSM) carry a disproportionate burden of sexually transmitted infections across Europe. Health planners require sexual health needs assessment data to respond appropriately. In addition, surveillance of risk and precaution behaviours in this population enables evaluative judgements of policy responses. The European MSM Internet Survey (EMIS-2017) aimed to repeat the pan-European online Survey on male homosexual behaviour conducted in 2010, both to update information required to plan and monitor health promotion interventions and consolidate harmonisation of existing behavioural surveillance approaches. Our study team collaborated with more than 200 partners from academia, public health and civil society across 50 countries. Starting from our previous EMIS-2010 questionnaire, partners engaged in three rounds of iterative Survey development and piloting until the final content was agreed. Transfer to an online Survey application was followed by further pre-testing before translation into 32 additional languages, final testing and sign-off. The Survey was available to complete online in 33 languages simultaneously from 18 October 2017 to 31 January 2018. Ten international MSM dating mobile apps were paid to send short promotional messages, and national partners promoted the Survey via at least another 272 websites and social media accounts. Real-time monitoring of responses facilitated targeted advertising by country and recruitment source. Ultimately 144,305 cases were submitted of which 137,358 (95.2%) were eligible for inclusion. EMIS-2017 demonstrated the feasibility of multi-country online MSM Surveying with public funding. Meaningful involvement of a large number of collaborators in the Survey design and its execution ensured successful recruitment. Careful design, piloting and presentation ensured the Survey was acceptable and had authority and perceived community benefit. Partners in 38 countries have already been supplied with a national database of 100 or more respondents for national analysis, while the study team has focussed on international comparisons among 137,358 respondents in 50 countries.
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hidden from health structural stigma sexual orientation concealment and hiv across 38 countries in the european msm Internet Survey
AIDS, 2015Co-Authors: John E Pachankis, Ford Hickson, Ulrich Marcus, Rigmor C Berg, Peter Weatherburn, Mark L Hatzenbuehler, Axel J. SchmidtAbstract:Objective Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however.
-
hidden from health structural stigma sexual orientation concealment and hiv across 38 countries in the european msm Internet Survey
AIDS, 2015Co-Authors: John E Pachankis, Ford Hickson, Ulrich Marcus, Rigmor C Berg, Peter Weatherburn, Mark L Hatzenbuehler, Axel J. SchmidtAbstract:OBJECTIVE: Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however. DESIGN: Data come from the European MSM Internet Survey (EMIS), which was administered between June and August 2010 across 38 European countries (N = 174 209). METHODS: Country-level stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of attitudes held by the citizens of each country. We also assessed concealment, HIV status, number of past 12-month male sex partners, and eight HIV-preventive services, knowledge, and behavioural outcomes. RESULTS: MSM living in countries with higher levels of stigma had reduced odds of diagnosed HIV and fewer partners but higher odds of sexual risk behaviour, unmet prevention needs, not using testing services, and not discussing their sexuality in testing services. Sexual orientation concealment mediated associations between country-level stigma and these outcomes. CONCLUSION: Country-level stigma may have historically limited HIV transmission opportunities among MSM, but by restricting MSM's public visibility, it also reduces MSM's ability to access HIV-preventive services, knowledge and precautionary behaviours. These findings suggest that MSM in European countries with high levels of stigma are vulnerable to HIV infection. Although they have less opportunity to identify and contact other MSM, this might change with emerging technologies.
-
The European Men-Who-Have-Sex-With-Men Internet Survey (EMIS): Design and Methods
Sexuality Research and Social Policy, 2013Co-Authors: Peter Weatherburn, Ford Hickson, Axel J. Schmidt, Rigmor C Berg, Harm J. Hospers, David Reid, Ulrich MarcusAbstract:Community-based opportunistic self-completion Surveying for sexual health programming is common among men-who-have-sex-with-men (MSM) in Europe, being used to generate evidence of unmet prevention need, for behavioural surveillance and as a platform for advocating HIV precautions. However, comparing Survey findings across Europe is difficult because of varying measures and recruitment designs, and Surveying has not occurred in all countries. EMIS (the European Men-who-have-sex-with-men Internet Survey) aimed to develop a pan-European Internet Survey on HIV-related male homosexual behaviours and prevention needs both to increase research capacity and to move towards harmonisation of existing systems. Six associated partners (APs) recruited another 77 collaborating partners from academia, public health and civil society across 35 countries. Partners’ existing MSM Surveys were collected and collated, producing a meta-Survey which was discussed by all partners through rotating round-tables at a 2-day summit. Survey development continued iteratively through user piloting and partner feedback until the English language content was agreed. Transfer to an online Survey application was followed by further testing before on-screen translation into 24 other languages, final testing and sign-off. The project’s visual identity and promotional materials were developed in close collaboration with national leads, tailoring products to match country specific needs while maintaining an overall project identity. Five international MSM dating websites were contracted to send carefully crafted instant messages to members in a series of waves. The Survey sought common ground with stakeholders and respondents by endorsing ‘the best sex with the least harm’ for MSM. Real-time monitoring of responses allowed targeted spending of the advertising budget to maximise coverage and depth of responses. Fieldwork occurred during June–August 2010. Over 184,469 responses were submitted of which 94.4 % were eligible. Partners in 38 countries were supplied with a national database of 100 or more respondents for national analysis and outputs, while the AP team proceeded on international comparisons among 174,209 respondents in 38 countries. EMIS demonstrated the feasibility of multi-country community-based MSM Internet Surveying with limited public funding. The concept of ‘the best sex with the least harm’ provided a common ground for a diverse range of stakeholders to collaborate. Meaningful involvement of a large number of collaborators in the Survey design, its visual identity and in promotional strategies ensured unprecedented coverage and depth of recruitment. Flexible planning was essential and a patchwork of recruitment was required across a range of commercial and community partners. Careful design, piloting and presentation ensured the Survey was acceptable and had both authority and perceived community benefit.
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structural and environmental factors are associated with internalised homonegativity in men who have sex with men findings from the european msm Internet Survey emis in 38 countries
Social Science & Medicine, 2013Co-Authors: Rigmor C Berg, Peter Weatherburn, Michael W Ross, Axel J. SchmidtAbstract:Internalised homonegativity refers to a gay person's negative feelings about homosexuality and is believed to stem from negative societal stereotypes and attitudes towards homosexuality. Surprisingly, little research has centred on this link. In this research, we aimed to examine the associations between internalised homonegativity and structural forces, cultural influence, and access to sexual health promotion measures among a sample of 144,177 men who have sex with men (MSM) in 38 European countries. Participants were recruited as part of the European MSM Internet Survey (EMIS) during 2010. It was a self-completion, multilingual Internet-based Survey for men living in Europe who have sex with men and/or feel attracted to men. Assumed causal relations were tested through multiple regression models. Variables at the structure of rule-systems (macro-level) that were significantly and negatively associated with internalised homonegativity were the presence of laws recognising same-sex relationships and same-sex adoption. In the meso-level model, greater proportions of the population expressing that they would not like to have homosexuals as neighbours predicted higher internalised homonegativity. In the last model, five variables were significantly and negatively associated with internalised homonegativity: being exposed to HIV/STI information for MSM, access to HIV testing, access to STI testing, access to condoms, and experience of gay-related hostility. In turn, men who had tested for HIV in the past year evidenced lower internalised homonegativity. This is the largest and certainly most geographically diverse study to date to examine structural and environmental predictors of internalised homonegativity among MSM. Our results show that one insidious consequence of society's stigma towards homosexuals is the internalisation of that stigma by gay and bisexual men themselves, thus, drawing attention to the importance of promoting social equity for self-acceptance around gay identity in building a positive sense of self.
Ford Hickson - One of the best experts on this subject based on the ideXlab platform.
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European Men-Who-Have-Sex-With-Men Internet Survey (EMIS-2017): Design and Methods
Sexuality Research and Social Policy, 2019Co-Authors: Peter Weatherburn, Ford Hickson, David S. Reid, Ulrich Marcus, Axel J. SchmidtAbstract:Men-who-have-sex-with-men (MSM) carry a disproportionate burden of sexually transmitted infections across Europe. Health planners require sexual health needs assessment data to respond appropriately. In addition, surveillance of risk and precaution behaviours in this population enables evaluative judgements of policy responses. The European MSM Internet Survey (EMIS-2017) aimed to repeat the pan-European online Survey on male homosexual behaviour conducted in 2010, both to update information required to plan and monitor health promotion interventions and consolidate harmonisation of existing behavioural surveillance approaches. Our study team collaborated with more than 200 partners from academia, public health and civil society across 50 countries. Starting from our previous EMIS-2010 questionnaire, partners engaged in three rounds of iterative Survey development and piloting until the final content was agreed. Transfer to an online Survey application was followed by further pre-testing before translation into 32 additional languages, final testing and sign-off. The Survey was available to complete online in 33 languages simultaneously from 18 October 2017 to 31 January 2018. Ten international MSM dating mobile apps were paid to send short promotional messages, and national partners promoted the Survey via at least another 272 websites and social media accounts. Real-time monitoring of responses facilitated targeted advertising by country and recruitment source. Ultimately 144,305 cases were submitted of which 137,358 (95.2%) were eligible for inclusion. EMIS-2017 demonstrated the feasibility of multi-country online MSM Surveying with public funding. Meaningful involvement of a large number of collaborators in the Survey design and its execution ensured successful recruitment. Careful design, piloting and presentation ensured the Survey was acceptable and had authority and perceived community benefit. Partners in 38 countries have already been supplied with a national database of 100 or more respondents for national analysis, while the study team has focussed on international comparisons among 137,358 respondents in 50 countries.
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hidden from health structural stigma sexual orientation concealment and hiv across 38 countries in the european msm Internet Survey
AIDS, 2015Co-Authors: John E Pachankis, Ford Hickson, Ulrich Marcus, Rigmor C Berg, Peter Weatherburn, Mark L Hatzenbuehler, Axel J. SchmidtAbstract:Objective Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however.
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hidden from health structural stigma sexual orientation concealment and hiv across 38 countries in the european msm Internet Survey
AIDS, 2015Co-Authors: John E Pachankis, Ford Hickson, Ulrich Marcus, Rigmor C Berg, Peter Weatherburn, Mark L Hatzenbuehler, Axel J. SchmidtAbstract:OBJECTIVE: Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however. DESIGN: Data come from the European MSM Internet Survey (EMIS), which was administered between June and August 2010 across 38 European countries (N = 174 209). METHODS: Country-level stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of attitudes held by the citizens of each country. We also assessed concealment, HIV status, number of past 12-month male sex partners, and eight HIV-preventive services, knowledge, and behavioural outcomes. RESULTS: MSM living in countries with higher levels of stigma had reduced odds of diagnosed HIV and fewer partners but higher odds of sexual risk behaviour, unmet prevention needs, not using testing services, and not discussing their sexuality in testing services. Sexual orientation concealment mediated associations between country-level stigma and these outcomes. CONCLUSION: Country-level stigma may have historically limited HIV transmission opportunities among MSM, but by restricting MSM's public visibility, it also reduces MSM's ability to access HIV-preventive services, knowledge and precautionary behaviours. These findings suggest that MSM in European countries with high levels of stigma are vulnerable to HIV infection. Although they have less opportunity to identify and contact other MSM, this might change with emerging technologies.
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The European Men-Who-Have-Sex-With-Men Internet Survey (EMIS): Design and Methods
Sexuality Research and Social Policy, 2013Co-Authors: Peter Weatherburn, Ford Hickson, Axel J. Schmidt, Rigmor C Berg, Harm J. Hospers, David Reid, Ulrich MarcusAbstract:Community-based opportunistic self-completion Surveying for sexual health programming is common among men-who-have-sex-with-men (MSM) in Europe, being used to generate evidence of unmet prevention need, for behavioural surveillance and as a platform for advocating HIV precautions. However, comparing Survey findings across Europe is difficult because of varying measures and recruitment designs, and Surveying has not occurred in all countries. EMIS (the European Men-who-have-sex-with-men Internet Survey) aimed to develop a pan-European Internet Survey on HIV-related male homosexual behaviours and prevention needs both to increase research capacity and to move towards harmonisation of existing systems. Six associated partners (APs) recruited another 77 collaborating partners from academia, public health and civil society across 35 countries. Partners’ existing MSM Surveys were collected and collated, producing a meta-Survey which was discussed by all partners through rotating round-tables at a 2-day summit. Survey development continued iteratively through user piloting and partner feedback until the English language content was agreed. Transfer to an online Survey application was followed by further testing before on-screen translation into 24 other languages, final testing and sign-off. The project’s visual identity and promotional materials were developed in close collaboration with national leads, tailoring products to match country specific needs while maintaining an overall project identity. Five international MSM dating websites were contracted to send carefully crafted instant messages to members in a series of waves. The Survey sought common ground with stakeholders and respondents by endorsing ‘the best sex with the least harm’ for MSM. Real-time monitoring of responses allowed targeted spending of the advertising budget to maximise coverage and depth of responses. Fieldwork occurred during June–August 2010. Over 184,469 responses were submitted of which 94.4 % were eligible. Partners in 38 countries were supplied with a national database of 100 or more respondents for national analysis and outputs, while the AP team proceeded on international comparisons among 174,209 respondents in 38 countries. EMIS demonstrated the feasibility of multi-country community-based MSM Internet Surveying with limited public funding. The concept of ‘the best sex with the least harm’ provided a common ground for a diverse range of stakeholders to collaborate. Meaningful involvement of a large number of collaborators in the Survey design, its visual identity and in promotional strategies ensured unprecedented coverage and depth of recruitment. Flexible planning was essential and a patchwork of recruitment was required across a range of commercial and community partners. Careful design, piloting and presentation ensured the Survey was acceptable and had both authority and perceived community benefit.