Ground-breaking study of Caribbean men who have sex with men launched

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The Caribbean Men’s Internet Survey (CARIMIS) is
the region’s largest study of gay, bisexual and other men who have sex with men as well as
the first such survey to be conducted online. While many respondents experienced
homophobic abuse and negative self-perception, others were open about their sexuality and
proactive about their sexual health. The study showed great diversity in the sexual identities
and behaviour of respondents. It also revealed several commonly-held aspirations relating to
life, safety and relationships.

The research was done by the Joint United Nations Programme on HIV and AIDS (UNAIDS) Caribbean Regional Support Team in collaboration
with Sigma Research of the London School of Hygiene and Tropical Medicine. It was partly
supported by the United States Agency for International Development (USAID).
The data collection period was November 2011 to June 2012. The study targeted men who
were 18 or older, lived in the Caribbean and were either attracted to men, had sex with men,
or thought they might do so in the future. The sample comprised 3,567 men living in 33
Dutch-, English-, French- and Spanish-speaking Caribbean countries and territories. Almost
half of CARIMIS respondents (47%) were university graduates, while 50% attained
secondary or post-secondary education. While the results are not representative of all men
who have sex with men in the Caribbean, they offer insight into the experiences of people
who do not typically participate in traditional behavioural surveys.

“Now that we have called attention to the issue, how do we really begin to have the
conversations in our homes, churches, mosques, temples and parliaments? How do we
translate a lot of these findings to inform policy?” challenged Director of the Pan Caribbean
Partnership against HIV and AIDS (PANCAP), Mr. Dereck Springer at the CARIMIS launch
in Port of Spain, Trinidad. “At the level of PANCAP the current focus is to reduce stigma,
eliminate discrimination and uphold human rights for everyone. But the real work has to be
done at the level of the family and community.”

About half the CARIMIS respondents (52%) had not come out to many of their family
members, friends, work or school colleagues. The survey found that while those who were
out tended to have more positive self-perception and exhibit better health-seeking behaviour,
those who were not were less vulnerable to homophobic abuse.

“This is the paradox of stigma. Fear and secrecy may make a man less likely to experience
harassment or violence, but also less likely to have safer sex,” UNAIDS Caribbean Director,
Dr. Ernest Massiah observed.

Many CARIMIS respondents experience intimidation, verbal abuse and violence because of
their sexuality. Within the past month of responding to the survey, one in three had been
stared at or intimidated, while almost one in four experienced verbal insults or name-calling.

About one in ten reported being physically assaulted in the past five years. Younger men and those who were more out were more vulnerable to intimidation and verbal abuse.

Chairperson of the Equal Opportunity Commission in Trinidad and Tobago, Lynette Seebaran-Suite, noted that lessons on addressing the vulnerability of men who have sex with men to violence, may be drawn from the domestic violence movement.

“There is no need to reinvent the wheel,” Mrs. Seebaran-Suite said. “There have been crisis interventions, hotlines, shelters and counselling services. Then you move on to legislation and initiating a national dialogue to change the mores of society and try to aim at prevention.”

She insisted that the public debates surrounding these issues are central to the process of public education and shifts in attitudes.

Many respondents had negative feelings about their sexuality because they internalised unfavourable social attitudes about same-sex attraction. This was linked with stress, higher rates of behaviour associated with HIV risk and worse sexual health outcomes. Younger men, those who have never tested for HIV, those who had sex with women only or with both men and women, and those who were less out were more likely to belong to this group.

Many respondents had negative feelings about their sexuality because they internalised unfavourable social attitudes about same-sex attraction. This was linked with stress, higher rates of behaviour associated with HIV risk and worse sexual health outcomes. Younger men, those who have never tested for HIV, those who had sex with women only or with both men and women, and those who were less out were more likely to belong to this group.

This phenomenon is more common among men who have sex with men in the Caribbean than in Europe where a similar study, the European MSM Internet Survey, was done. The findings suggest that health interventions should be coupled with psycho-social support that specifically addresses sexual identity and self-perception.

The group was very diverse. More than half (58%) described themselves as gay or homosexual, 24% said they were bisexual and 2% said they were straight. Another 15% indicated that they do not use a term to describe their sexual identity. The majority (91%) had sex with a man in the past year, and 23% had sex with both men and women. Many respondents said they want stable relationships, emotional connection, freedom from psychological and social barriers and safer sex.

David Soomarie, Coordinator of Community Action Resource (CARE), one of the region’s oldest non-governmental organisations serving people living with HIV, noted the value of responding to the new ways in which people express and negotiate their sexuality.

“The study shows that there is a complex web of sexual identity expressed and experienced by men across the Caribbean. It provided a space for disclosure of sexual desire and behaviour that would otherwise be ridiculed in public spaces. Crimes of physical and sexual violence are often not reported for fear of this kind of ridicule. This approach shows a key avenue for behaviour change interventions,” Mr. Soomarie said.

“There have been, are, and always will be adult men who have private, consensual relationships with other men,” Dr. Massiah said. “We need to remove laws that perpetuate prejudice against these people. We need anti-discrimination legislation. We need more faith-based organisations to raise their voices against discrimination. And we need communities affected by HIV to assert their right to respect and dignity.”

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