Assessment of the Perceptions of Local Sexual Health Stakeholders, Surrounding the Sexual and Associated Health Needs of ‘Men who have Sex with Men’ in North Lincolnshire. Researcher: Meigan Oxley Supervisors: Dr Jennifer Burr (The University of Sheffield ) & Giles Ratcliffe (North Lincolnshire Council) Sexual Health Needs

Background Service Accessibility

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Emotional barriers of being frightened and scared were also prevalent, especially around accessing services for the first time. •

Methods •

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• Seven semi-structured interviews were conducted with sexual health and related professionals in the North Lincolnshire area. • A thematic framework approach was used to systematically identify themes through classifying and coding textual data3 following data transcription. • The data was interpreted, considering commonalities, relationships, theoretical constructs, overarching patterns and explanatory principles3.4.

Barriers were associated with social stigmatisation around the activities undertaken by the MSM population.

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Needs associated with Drugs and Tobacco, were not considered a particular problem locally.

MSM is not a term which the general population associate with.

Awareness of Services •

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The younger generation still associate with previous sexual health service branding and therefore may not be as aware of the new service.

1. To assess the perceptions of the stakeholders regarding the sexual and associated health needs of MSM living in the North Lincolnshire.

• This study is the first to address the needs of MSM in North Lincolnshire.

4. To gain an insight into the views of the stakeholders and how the services could be improved to adequately address the perceived sexual health needs of MSM.

• Un-met needs have been identified and services and commissioning improvements have been highlighted. • Although this study is small, it has provided a unique insight which could be used to help shape future services and commissioning locally. • Due to the complexed nature of MSM, further research with the MSM population is suggested to further local understanding.

Training, regarding the social and emotional aspects of MSM, including but not limited to: MSM risk taking behaviour, awareness of MSM emotional issues, MSM activities in larger cities and the types of MSM relationships were regarded as important. •

There was some scepticism regarding how aware the MSM population would be of the services in place. Suggestions were made that patients may have to specifically seek out information through the internet or their GPs.

Conclusion

3. To assess if the stakeholders feel adequately knowledgeable, trained and have access to the resources needed to address the needs of MSM in the local area.

Addressing the Needs of the MSM Population through Services •

Research Aims 2. To evaluate the extent to which the stakeholders perceive that the services in place adequately address the sexual and associated health needs of MSM.

The extent to which services reach the highrisk MSM population was questioned, with a participant describing the services as quite rudimentary, highlighting that it may not be the most appropriate way to deliver sexual health to MSM.

Key Findings

Needs associated with Alcohol, seem to be prevalent, specifically within the younger MSM generation. Emotional needs of MSM were particularly prevalent throughout, with denial, guilt and worry amongst others being highlighted by participants.

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Understanding of the MSM term varies between professionals. •

Associated Health Needs

• An exploratory qualitative research methodology was used, due to the limited information and data availability on MSM in North Lincolnshire. • A purposive, non-probability, expert sampling technique was used selecting participants based on their characteristics2. Participants were chosen based on their expertise and professional relationships with the MSM population.

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MSM patients are choosing to access services outside of the local area to minimise the risk of being seen.

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• Participants generally considered the integrated sexual health service to be inclusive and appropriate.

MSM terminology is considered useful in a sexual health professional environment.

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• The services were generally regarded as accessible, considering opening times and location.

· Sexual health and the Human Immunodeficiency Virus (HIV) · Mental health · The use of alcohol, drugs and tobacco. There is no previous research exploring the sexual health needs of MSM in North Lincolnshire, no MSM specific services and no knowledge of the MSM demographic structure or population numbers. The purpose of this research was to develop an overview of the MSM sexual health and associated needs locally. Furthermore, to highlight possible areas for current service and commissioning improvements, to address knowledge gaps and meet the needs of the local MSM population.

High rates of HIV, Gonorrhoea and Syphilis were considered by participants to be prevalent in the MSM population.

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Approximately 2.6% of the UK male population are ‘men who have sex with men’ (MSM). MSM are a diverse group of individuals, who suffer from great inequalities. These inequalities often negatively affect their health and wellbeing1. PHE (2015) highlights three main areas where inequalities are prevalent in the MSM population:

Service Inclusivity and Appropriateness

Increasing awareness within the MSM population including: awareness of the services in place, the risks MSM are taking through their sexual activity and how to engage in safer sexual activities were prevalent. Social media platforms such as apps and gay websites were considered useful to help engage those who are the highest risk. •

Community groups were suggested to address the emotional needs of the population, providing a service where MSM can support each other, but also encourage engagement with local services. •

Current outreach services ideally need to engage with those high-risk MSM who do not ordinarily access services.

References 1. Varney J, Guerra L, Watson S, Makurah L, Shukla H, Brown A, et al. Public Health England action plan 2015-16- Promoting the health and wellbeing of gay, bisexual and other men who have sex with men [Internet]. London: Public Health England; 2015. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/401005/PHEMSMActionPlan.pdf (Accessed: 2015 Mar 26 ). 2. Higginbottom GMA. Sampling issues in qualitative research. Nurse Researcher [Internet]. RCN Publishing Ltd; 2004;12(1):7–19. Available from: http://dx.doi.org/10.7748/nr2004.07.12.1.7.c5927 (Accessed: 2015 Aug 04). 3. Bryman A, Burgess RG, editors. Analyzing Qualitative Data. London: Routledge; 1994. 176-181 p. 4. Lapadat JC. Thematic Analysis. Encyclopedia of Case Study Research. SAGE Publications, Inc. [Internet]. California: SAGE Publications; 2010. p. 926–8. Available from: http://dx.doi.org/10.4135/9781412957397 (Accessed: 2015 Aug 15). Image source: World Health Organisation. Men who have sex with men [Internet]. World Health Organisation HIV/AIDS. 2015. Available from: http://www.who.int/hiv/topics/msm/en/ (Accessed:2015 Sep 09).