I had the pleasure of attending the MSM sexual health conference which occurred at our home site at Fenway Health. The convening hosted, “some of the United States’ top researchers, key stakeholders, and public health leaders to discuss the current state of knowledge about the sexual health of American men who have sex with men (MSM)” (Fenway Website).
Putting the “man” back into manifesting resiliency
The first session i attended looked at resiliency factors in gay men and how this untapped resource can be used to better gay men’s health, both physically and emotionally. The first speaker on the panel was Dr. Ron Stall, Ph.D., MPH from the University of Pittsburgh School of Public Health. One of the big influences on resiliency cited was childhood. We only have one shot at development , and even if you do not identify as GLBT as a child, homophobia affects ALL. I know I felt different growing up, and I have heard this story time and time again. As a future LGBT-identified individual goes through childhood and adolescents, they experience homophobia and victimization at a young age with no way of understanding, nor role models or community to support. These scars carry with you, but how can one grow stronger from them?
Dr. Stall used a syndemic theory model to show how the above psychosocial factors can influence gay men’s resilience. For instance in adolescence, psychosocial health issues leads to higher substance use and depression, as well as more likely to engage in risky behavior and increased HIV prevalence. I was pleased to see Dr. Stall cite decreased tobacco use in population-based studies as an example on how resilent gay men can be with public health efforts. About half of MSM’s examined in the limited data analyzed used tobacco in the 90’s. Over the course of a decade, the number decreased to approximately 25%. Half of them had cited quiting over the past decade and achieving it cold turkey. MSM’s want to quit, they just need to have the knowledge and resources to aide them along.
So, how can public health providers help to manifest gay men’s strength in health promotion efforts? By promoting strength-based interventions to work on changing peer norms and raise skills to face homophobia. An example given was of the house/ball community. It has produced a community for individuals that may not have anywhere to go for support, in addition to giving them a positive atmosphere not to be shameful about how they feel. Programs like HRSA’s “Stop Bullying Now Campaign” helps to de-normalize same-sex behavior and helping to hinder the psychosocial influences from the of homophobia from the get-go.
Lastly, the accessibility of equal marriage rights for same-sex couples and its health benefits was highlighted in this session, discussed further by Dr. Gilbert Herdt, Ph. D., from San Francisco State University. Healthy marriages have been shown to decrease the prevalance of diabetes and hypertension. By acknwoledging our love and families on the same plane as heterosexual couples, it decreases the stigma and discrimination that can have grave psychosocial consequences on LGBT individuals.
Policy to Practice: Next Steps
The second day covered what is next to do on a federal level with resesarch and policy. As we have seen time and time again in tobacco, chronic disease was a frequent theme that came up in policy implications, especially with AIDS now falling under the chronic disease umbrella. Some important ideas to take away from this session:
Holistic health: Did you know that in the UK, sexual health looks at not just the individual and the disease but the systems that influence the prevalence? Well, that is what researchers in sexual health are trying to do now here in the States! Center for Mental Health Research on AIDS priorities were covered by Dr. Dianne Rausch, Ph.D. Behavior change and chronic disease management needs to be examined further than the 6 month point with a wellness approach incorporated to influence the development of the virus through proper nutrition and stress management including tobacco use.
Access: I use this term broadly to describe the numerous institutions and protective factors that are necessary to have a successful prevention program. Having access to evidence-based research that is scaleable depending on the area is one. Sufficient infrastructure to apply the programs and evaluation measures to confirm success. Prevention programs are only reaching 25% of MSM’s, so accessing populations not normally targeted is key, including rural residents, young MSM black men, and runaway/”throwaway” youth.
De-stigmatization: How do we implement new prevention programs and increase wellness without solicitating further stigma? Train the providers in cultural competency. When having the invalueable conversations, discussing the adverse outcomes in a community framework. Terminology is important: even using “MSM” versus “Gay” helps to de-stigmatize the identity that is associated with HIV/AIDS. Empower men to have healthy and consensual sexual relationships will aid in mobilizing MSM sexual health as well.
Sharing Lessons Learned: Why re-invent the wheel if we already have one that spins well? The Network utilizes best community organization practices through our Sharing Our Lessons series, and conference participants reiterated such application time and time again. Research and public health communities can collaborate research and public health initiatives to produce a toolbox of interventions while saving funds. The conference drew upon Massachusetts Department of Health as a successful program to highlight. Here in the Commonwealth, we collect data to show that our programmatic responses and policies follow the needs of the communities. This can be in state surveys or surveys that are released by LGBT rights organizations, such as in this case of Massequality. They have numerous programs that target vulnerable populations and individuals as a whole such as violence recovery programs and programs specific to youth.
ACT UP! Fight AIDS! (or any other LGBT disparity for the matter): Empowering our communities to speak up like in the days of ACT-UP can help raise awareness that HIV/AIDS is still an issue in our communities and our needs are still dire. If we dont speak up for ourselves, who will advocate for us? A great way to get involved is making sure that elected officials who support LGBT communities and their health disparities. 38 governor races are happening this fall; the house and senate both on a state and national level. Electing leaders that will advocate for us and our needs is crucial to have the support to keep up the fight!
While tobacco is still a major issue in the LGBT communities, this presentation helped to shed some positive light on how tobacco use can be decreased. By giving individuals the support to empower themselves, one can overcome psychosocial factors. It will be very interesting to see how the policy changes and healthcare reform influences sexual health and psychosocial factors on LGBT health. The government wants to hear us and mobilize. We are the ones who can put the flame under the officials, let us be heard!