Abstract: Men Having Sex with Men (MSM) Negotiating Their Protection from Sexually Transmitted Infections (STI) (Society for Social Work and Research 27th Annual Conference - Social Work Science and Complex Problems: Battling Inequities + Building Solutions)

All in-person and virtual presentations are in Mountain Standard Time Zone (MST).

SSWR 2023 Poster Gallery: as a registered in-person and virtual attendee, you have access to the virtual Poster Gallery which includes only the posters that elected to present virtually. The rest of the posters are presented in-person in the Poster/Exhibit Hall located in Phoenix A/B, 3rd floor. The access to the Poster Gallery will be available via the virtual conference platform the week of January 9. You will receive an email with instructions how to access the virtual conference platform.

Men Having Sex with Men (MSM) Negotiating Their Protection from Sexually Transmitted Infections (STI)

Schedule:
Sunday, January 15, 2023
Camelback B, 2nd Level (Sheraton Phoenix Downtown)
* noted as presenting author
Daniele Bigoni, MA, Research Fellow, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
Jasmina Bogdanovic, MA, Research Fellow, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
Patrick Weber, PhD, Research Associate, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
Daniel Gredig, PhD, Professor, Head of Master Program, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
Background

Among MSM, STI have increased over the past decade. Although fully effective protection is not available for sexually active people, MSM pay attention to STI risk reduction. In contrast to HIV protection behavior, measures taken by MSM to prevent other STI have attracted little scholarly attention. While concepts such as condom negotiation for HIV prevention have been investigated since the early days of the HIV pandemic, strategies MSM use to protect themselves from other STI have remained scarcely elaborated. Since risk assessment and the implementation of risk reducing measures such as condom use require the cooperation of the sexual partner, this project aimed to establish how MSM assess their STI risk and negotiate strategies for STI risk reduction when having sex with non-steady partners.

Methods

We conducted in-person interviews with 26 MSM, combining three interview approaches: a) narrative and episodic interviewing to explore participants experiences; b) a virtual-reality serious game (VR-SG) developed in this project to immerse participants in situations similar to those they might have encountered in real life in order to stimulate further narratives; c) another narrative sequence reflecting the VR-SG and a short, structured survey. We analyzed the interview data using open coding.

Findings

When using internet platforms for dating, the MSM in our sample started by evaluating of their STI risk while chatting with a potential sex partner. In certain settings, e.g., gay saunas, silence is the implicit norm and verbal strategies to assess risk and negotiate protection with a non-steady partner cannot be employed before becoming involved. MSM then weighed their risk and decided whether to engage in sexual intercourse or not. The latter could imply leaving the place.

We identified three main categories of strategies used to assess and negotiate STI risk reduction in chats, during in-person dates or when having sex: i) strategies centered on risk communication, such as information seeking (e.g. regarding the frequency and recency of tests), reminding the partner of STI risks or deception regarding their own protection (e.g. by not disclosing that they were taking PrEP); ii) subject centered strategies expressing MSM’s preferences and will, such as a direct request (for condom use), direct question (as to whether condoms were necessary) or autocratic statements (enforcing condom use); iii) strategies centered on sexual arousal supporting the enforcement of MSM’s will and preferences, such as requesting condom use and promising enhanced sexual pleasure in condomless sex at a future date, or threatening to withhold sex.

Conclusions

In the era of digital dating, the three categories of strategies to evaluate STI risk and negotiate risk reduction are starting to be employed in chats. MSM aim to obtain the information needed to decide whether to meet a potential partner for sex. In the case of sex on the premises, MSM take the fundamental decision to stay and run a risk or to leave. MSM who rely on condom use implement negotiation strategies similar to those identified to enforce condom use to prevent an infection with HIV.