Fear Less Live More campaign

Development of a national education Development of a national education campaign for gay men on HIV-related campaign for gay men on HIV-related stigma and discriminationstigma and discrimination

Dean A MurphyDean A Murphy

BackgroundBackground

A two-phased approach to the development of a multi-year A two-phased approach to the development of a multi-year program of activitiesprogram of activities

The first phase being one of research; the second being the The first phase being one of research; the second being the development and execution of a range of interventions.development and execution of a range of interventions.

Research:Research: A series of discussion groups with HIV-negative and HIV-positive A series of discussion groups with HIV-negative and HIV-positive

gay and bisexual men, about stigma and discrimination within gay gay and bisexual men, about stigma and discrimination within gay communities and settings (GfK Blue Moon)communities and settings (GfK Blue Moon)

The HIV Stigma Barometer SurveyThe HIV Stigma Barometer Survey Commissioning a national round of consultations with the NAPWA Commissioning a national round of consultations with the NAPWA

membership and associated networksmembership and associated networks

Qualitative researchQualitative research

Qualitative research undertaken by GfK Blue MoonQualitative research undertaken by GfK Blue Moon 11 discussion groups and 4 in-depth interviews with gay 11 discussion groups and 4 in-depth interviews with gay

men and other MSM (in NSW, Qld, Vic, SA)men and other MSM (in NSW, Qld, Vic, SA)

22ndnd round of research specifically targeting <35 year old HIV- round of research specifically targeting <35 year old HIV-positive menpositive men face-to-face or telephone interviews and mini group face-to-face or telephone interviews and mini group

discussions (incl. WA)discussions (incl. WA)


HIV-negative men:HIV-negative men:11 would never have sex with someone they believed had HIVwould never have sex with someone they believed had HIV22 would not knowingly have sex with someone they knew to would not knowingly have sex with someone they knew to

be HIV positive, but readily engage in casual, one-off, be HIV positive, but readily engage in casual, one-off, sexual encounters in certain situationssexual encounters in certain situations

33 were comfortable having sex with HIV positive men. (Had were comfortable having sex with HIV positive men. (Had personal experience of a serodiscordant relationship.)personal experience of a serodiscordant relationship.)

High expectations of disclosureHigh expectations of disclosure Varying knowledge of HIVVarying knowledge of HIV Felt that HIV-related stigma was not greatFelt that HIV-related stigma was not great


HIV-positive men:HIV-positive men:11 Very few selected causal partners based on HIV statusVery few selected causal partners based on HIV status22 Some specifically targeted other HIV positive men online Some specifically targeted other HIV positive men online

(or in venues, etc.) to minimise the impact of rejection. (or in venues, etc.) to minimise the impact of rejection. Protected sex in a serodiscordant relationship would be a Protected sex in a serodiscordant relationship would be a

particular difficultyparticular difficulty Felt that they were unfairly burdened with responsibility for Felt that they were unfairly burdened with responsibility for

disclosuredisclosure


Recommendations:Recommendations:

To assist overcoming fear of HIV-positive partners by making HIV a To assist overcoming fear of HIV-positive partners by making HIV a topic of discussion in general, again, rather than something that is topic of discussion in general, again, rather than something that is not discussed (except by prevention campaigns)not discussed (except by prevention campaigns)

To encourage social interaction between HIV-positive and HIV-To encourage social interaction between HIV-positive and HIV-negative mennegative men

To create awareness that that serodiscordant relationships can and To create awareness that that serodiscordant relationships can and do exist do exist

HIV Stigma Barometer Survey HIV Stigma Barometer Survey

To explore the extent to which HIV-positive gay men experience To explore the extent to which HIV-positive gay men experience HIV-related stigma HIV-related stigma

To explore the extent to which non-HIV-positive gay men with To explore the extent to which non-HIV-positive gay men with express HIV stigmaexpress HIV stigma

To develop a stigma assessment tool that captures key To develop a stigma assessment tool that captures key dimensions of experienced and expressed stigmadimensions of experienced and expressed stigma

To explore the personal and social factors that contribute to To explore the personal and social factors that contribute to HIV-related stigmaHIV-related stigma

HIV Stigma Barometer SurveyHIV Stigma Barometer Survey

Disclosure of HIV statusDisclosure of HIV status (HIV-positive respondents only) (HIV-positive respondents only) HIV-related stigmaHIV-related stigma

– Attributions of responsibilityAttributions of responsibility– Negative emotional reactionsNegative emotional reactions– Social distancingSocial distancing– Sexual exclusionSexual exclusion

Gay and PLHIV community engagementGay and PLHIV community engagement Perceived risk of HIV transmissionPerceived risk of HIV transmission Serostatus identitySerostatus identity Reliance on disclosureReliance on disclosure

Participant characteristicsParticipant characteristics

N=1,260 gay and other men who have sex with menN=1,260 gay and other men who have sex with men Mean age 37.9Mean age 37.9 NSW 42.6%; Vic 20.8%; QLD 19.6%; SA 5.4%; ACT NSW 42.6%; Vic 20.8%; QLD 19.6%; SA 5.4%; ACT

2.9%; Tas 2.6%; WA 2.5%; NT 1.5% 2.9%; Tas 2.6%; WA 2.5%; NT 1.5% Gay 88.9%; bisexual 8.9%; queer 1.4%; other 1.4%Gay 88.9%; bisexual 8.9%; queer 1.4%; other 1.4%

HIV statusHIV status HIV positive: n=214 (17.0%)HIV positive: n=214 (17.0%) HIV negative: n=915 (72.6%)HIV negative: n=915 (72.6%) Untested/status unknown: n=131 (10.4%)Untested/status unknown: n=131 (10.4%)

DisclosureDisclosure

Experienced and expressed stigmaExperienced and expressed stigma

HIV-positive menHIV-positive men

Among HIV-positive men, moderate levels of sexual exclusion Among HIV-positive men, moderate levels of sexual exclusion (M=2.8)(M=2.8)

– Older men and men who had any HIV-negative sex partners were Older men and men who had any HIV-negative sex partners were less likely to experience stigmaless likely to experience stigma

– Men who engaged more with PLHIV community and placed more Men who engaged more with PLHIV community and placed more importance on serostatus identity were more likely to experience importance on serostatus identity were more likely to experience stigmastigma

– No associations between stigma and disclosure to sex partners, No associations between stigma and disclosure to sex partners, health care workers, or disclosure in social settingshealth care workers, or disclosure in social settings

Non-HIV-positive menNon-HIV-positive men

Among HIV negative and unknown status men, moderate levels Among HIV negative and unknown status men, moderate levels of sexual exclusion (M=2.9)of sexual exclusion (M=2.9)

– Men who were older, had any HIV-positive sex partners, or were Men who were older, had any HIV-positive sex partners, or were more engaged with PLHIV community, expressed less stigmamore engaged with PLHIV community, expressed less stigma

– Men who had HIV-negative or unknown status sex partners, had Men who had HIV-negative or unknown status sex partners, had stronger serostatus identity, or perceived more risk of HIV stronger serostatus identity, or perceived more risk of HIV transmission from sex with an HIV-positive partner, expressed transmission from sex with an HIV-positive partner, expressed more stigmamore stigma

Disclosure expectations, practices, and serostatus Disclosure expectations, practices, and serostatus preferences (HIV-negative men)preferences (HIV-negative men)

Item Agree (%) Mean (SD)

‘I'd expect an HIV-positive man to tell me he was HIV positive before we had sex’

75.2% 4.09 (1.31)

‘I'd expect an HIV-negative man to tell me he was HIV negative before we had sex’

42.9% 3.17 (1.48)

‘I'd expect an untested man to tell me he was untested before we had sex’

45.1% 3.30 (1.46)

I always tell my sex partner what my HIV status is before we have sex’

44.1% 3.18 (1.53)

‘I always know the HIV status of my sex partner before we have sex’

29.4% 2.69 (1.39)

‘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 similar to mine’

37.9% 2.90 (1.52)

Campaign: Campaign: FearLessLiveMoreFearLessLiveMore

FocusFocus– disclosuredisclosure– sexual exclusionsexual exclusion– factors associated with stigma:factors associated with stigma:

» Fear of HIV transmissionFear of HIV transmission» Importance on serostatus identityImportance on serostatus identity» Social and sexual engagement with PLHIV (for non-HIV-positive men)Social and sexual engagement with PLHIV (for non-HIV-positive men)

AimsAims– Encourage non-stigmatising attitudes and behavioursEncourage non-stigmatising attitudes and behaviours– Promote resiliencePromote resilience

LinksLinks

http://www.fearlesslivemore.org.au/ https://www.facebook.com/fearlesslivemorehttps://www.facebook.com/fearlesslivemore

http://www.fearlesslivemore.org.au/

SolutionsSolutions– ‘‘trust what you know’; trust what you know’;

AchievableAchievable– ‘‘easy’; ‘simply’; ‘don’t worry’; ‘rising above’; ‘fear less, live more’; easy’; ‘simply’; ‘don’t worry’; ‘rising above’; ‘fear less, live more’;

CareCare– ‘‘protects’; ‘unnecessarily hurtful’; ‘why build barriers?’; protects’; ‘unnecessarily hurtful’; ‘why build barriers?’;

BenefitsBenefits– ‘‘have fun’; ‘great sex’; ‘let your love life take off’; don’t worry’, ‘fear less, live have fun’; ‘great sex’; ‘let your love life take off’; don’t worry’, ‘fear less, live

more’more’

Acknowledgements

Campaign development groupColin 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

AlsoJohn de Wit; Philippe Adam

Fear Less Live More campaign

Health & Medicine

Transcript of Fear Less Live More campaign