Community responses to HIV
Community responses to HIV have been linked to successful HIV prevention among gay men. There is also extensive evidence of the success of peer and community engagement in facilitating sexual health improvement and HIV prevention. For the last decades, much of our research has focused on diverse and varied gay communities, as well as other communities most affected by HIV (for example, African communities in Scotland).
We examine community responses to HIV in order to inform health improvement interventions, and to improve sexual health and wellbeing. Examples of our work include:
- The Gay Men’s Sexual Health Survey (GMSHS), which was conducted by the us every three years from 1996-2014 and was funded by the MRC and Health Protection Scotland. The survey has provided robust evidence of sexual behaviours as well as prevention and testing activities of gay men in Scotland. These findings have shaped health policies in Scotland, the UK and Europe and continue to be used by health practitioners in NHS sexual health campaigns in Scotland. It has been complemented by SMMASHII, a cross-sectional, online survey of 2428 MSM recruited via gay sociosexual media in Scotland, Wales, Northern Ireland and the Republic of Ireland, which has collected data on a range of sexual, mental and physical health outcomes, along with related socio-demographics and behavioural and or health drivers for these
- Through GMSHS and the HIV & the Biomedical (2011 – 2014), we have explored the acceptability of new prevention technologies, PrEP, TasP and self-testing in Scotland
- Mathew Smith conducted a PhD study on sensitivities to HIV testing among African communities in Scotland
- With colleagues at University College London, the London School of Hygiene & Tropical Medicine, and Glasgow Caledonian University, we have conducted a NIHR-funded Haus study to develop and test the feasibility of an intervention of targeted distribution of HIV self-sampling kits to African communities within existing primary care and community services.
We have been the first to demonstrate that HIV testing levels among men who have sex with men (MSM) fall short of guidelines recommending that all MSM test annually, and those at “higher risk” test more frequently. While preparedness for the HIV self-test was high among MSM, there were concerns it could reduce opportunities to engage with wider services, wider health issues and the determinants of risk, as well as amplify existing health inequalities. Finally, despite policymaker and practitioner concern about chemsex – the use of drugs in sexual settings - we found only a small proportion of MSM in Scotland, Wales, Northern Ireland and the Republic of Ireland reported it, but those who do, reported substantial sexual risk inequalities.