Heterosexual-identifying males who possess intercourse with males: a population that is understudied

Authored by Tyrone Curtis, PhD prospect, Institute for worldwide wellness

Because the start of HIV/AIDS epidemic when you look at the 1980s, much general public wellness focus happens to be in the intimate health insurance and intimate behavior of males that have sex with males, or MSM, as well as in specific, guys whom identify as homosexual or bisexual. But, we all know a lot less about MSM whom identify as straight or heterosexual. These guys, whom we make reference to as heterosexual-identifying males who possess intercourse with males, or HI-MSM, will be the focus of my research.

That are heterosexual-identifying MSM?

Many people, once they contemplate this team, have a tendency to think about men who possess some attraction that is same-sex are “in the closet”; that is, males who will be “actually homosexual or bi” but just have actuallyn’t been in a position to acknowledge it yet. This may be because they’re from a tradition that stigmatises homosexual or bisexual identification, or because these identities conflict along with other identities these guys hold. Nevertheless, some HI-MSM have actually little to no attraction that is same-sexor otherwise not sufficient, inside their view, to justify calling by themselves bisexual), yet still enjoy intercourse along with other males. The intercourse they will have with males could be experimental, or something like that they are doing along with feminine partners ( e.g. swingers). Sex with males might provide some HI-MSM by having a release that is sexual no more get along with their feminine partners, minus the risk of psychological connection that will end that relationship. Other people that are alot more calm about their sex ( ag e.g. heteroflexibles or mostly straights), so that same-sex behavior is not a risk with their heterosexual identification. Whatever the case, their behaviour that is same-sex is essential sufficient in their mind to determine their identification.

Information from NATSAL-3, a nationally representative study of Uk grownups aged 16-74 carried out in 2010-2012, claim that around 22percent of males with same-sex lovers within the previous year identified as heterosexual, a tad bit more than those pinpointing as bisexual (19%).

Just how can we learn heterosexual-identifying MSM?

There clearly was a apparent challenge in learning this populace, and that’s: where do we locate them? Many studies of MSM recruit in-person at homosexual venues such as for instance pubs, groups and saunas, or online via homosexual sites or networking that is social/sexual and apps. But, discernment is frequently vital that you HI-MSM, and in addition they are less likely to want to check out these places. As such, many types of MSM recruit extremely HI-MSM that are few around 1-2%), helping to make analysis extremely tough. That is a factor that is significant our current bad comprehension of this population.

Exactly why are we thinking about heterosexual-identifying MSM?

There was valid reason to believe that HI-MSM might be susceptible to bad intimate wellness. HI-MSM are less likely to want to disclose the intercourse they usually have with guys to healthcare providers, meaning they’re less inclined to get relevant intimate wellness information, provided regular testing for STIs and HIV, or offered precautionary measures such as for instance HIV pre-exposure prophylaxis (PrEP) or vaccinations for Hepatitis A & B. In addition, HI-MSM are usually less included with the LGBT community, either passively (it) or through actively avoiding it because they have no connection to. This means these are generally less confronted with intimate health promotions that are promoted in the neighborhood, are less subjected to the norms of the community ( ag e.g. regular HIV evaluation, condom use), and may also feel less comfortable resources that are accessing as intimate wellness solutions within that community, particularly if they are targeted towards homosexual males. As a result, they may be badly informed in regards to the dangers of these intimate behavior.

In addition, these guys are less likely to want to reveal men to female partners to their sex, possibly making those lovers less informed as it pertains with their very own intimate decision generating, especially around condom usage along with other HIV/STI protective measures. This way, HI-MSM might also become a connection involving the gay and communities that are heterosexual HIV as well as other STIs.

What exactly is my project about?

The aims of my task are to explain and characterise the intimate behaviour and sexual wellness of HI-MSM in Western Europe, united states, Australia and brand brand New Zealand; to compare their intimate behavior and wellness to those of gay- and bisexual-identifying MSM; also to know how HI-MSM perceive their danger during intimate encounters with men and women, their experiences of and attitudes towards intimate health care, including HIV/STI testing recommendations; and in addition their emotions about HIV prevention measure like PrEP.

In recognition of this challenges of recruiting big examples of this population, I’m conducting my research utilizing practices that prevent the need certainly to recruit a sample that is large of. One part of my task involves performing specific participant information meta-analysis of behavioural surveys of MSM from Western Europe, Canada, Australia and brand brand New Zealand. Really, this requires pooling data from all of these studies, every one of which might just have a number that is relatively small of, to be able to build a big sufficient test of HI-MSM on which to handle analysis. Special analysis practices are employed that take into consideration clustering within study examples and countries (in other terms. males within one nation are more inclined to behave like other guys within that country).

I’ll additionally be undertaking 15-20 semi-structured qualitative interviews with HI-MSM in the UK. This can permit me to ask more appropriate questions than had been expected into the various surveys contained in the meta-analysis (that have been written for MSM more basic), as well as let me probe more deeply into HI-MSM’s experiences, attitudes and emotions concerning the intercourse they have (with both women and men) along with relation to intimate health insurance and sexual health care.

By understanding more about the way HI-MSM take part in intercourse making use of their lovers, and about and feelings to their experiences regarding intimate health care supply, we could better realize their intimate health care requirements, and determine any gaps between these needs and present solution supply. This may ukrainian women for marriage ideally induce more effective engagement with HI­-MSM, causing better sexual health both for them and their partners.

key words: intimate wellness, intimate behavior, intimate orientation, hidden populations, males who possess intercourse with males


Tyrone Curtis is a 2nd 12 months phd pupil with an intention within the intimate behavior and intimate wellness of MSM. Initially from Australia, he learned math at the University of Queensland before going to London in 2008. He completed an MSc in Applied Statistics with Medical Applications at Birkbeck College in 2014. If not at their desk, he is able to usually be located in another of London’s parks hanging from a trapeze that is flying.