Resilience to the Clinical and Social Impacts and Risk of HIV/AIDS: Perspectives of Middle-Aged and Older Men Who Have Sex with Men - A Community Report -
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Table of Contents
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Message from our Primary Community Partner
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Introduction
Our research questions for this project include:
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Approach
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Participant Demographics All MAO MSM participants (n = 55)
Percentage of HIV Positive
75% 7
Demographic breakdown by HIV Status
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Findings Perspectives of MAO MSM Living with HIV/AIDS: Resources
“We all became increasingly aware of how amazing drag queens are at fund-raising for causes in our community” - Gary - 0227-3
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Findings
“I lived at Casey House for 8 months. They took care of me. They saved my life” - Jack -0328-2
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Findings
“I will put my hands over fire for him [my family physician]” - Jose - 0304-3
“My doctor’s the best! He’s very knowledgeable, goes out of his way to explain things to me, and he builds me up…” - Francis - 0320-1
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Findings Perspectives of MAO MSM Living with HIV/AIDS: Protective Factors
“I still have my faith. I go to church and pray regularly…this keeps me strong!” - Pat - 0521-5
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Findings
“My dearest, oldest friends…they are my chosen family” - Jeremiah - 0521-2
“We take care of each other. We’re not exclusive, we sleep around…but our companionship and trust go a very long way” Stephen - 0410-1
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“Being monogamous in the earlier years did delay HIV transmission” - Bart 0311-2
Findings
“I just separated my work life in Chinatown from my sex life…it worked for me” - Jim - 0328-1
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Findings
“Sounds odd, but without drugs all those years, I may not have lasted this long” - Dan - 0327-1
“It was important to me; our work was raising awareness on how HIV criminalization is institutionalizing stigma” - Donald - 0304-1
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Findings Perspectives of MAO MSM Living with HIV/AIDS: Personal Strengths
“I took charge of my life…looked after my health…made the right decisions” - David - 0321-1
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Findings
“I just kept carrying on till things eventually got better…” - Vincent - 0531-1
“I acquired the will to live!” - Gregory - 0227-1
“You create your own life. It’s knowing what you need to do…making it happen” - Bob - 0228-1
“There is no one else to blame. I take responsibility for my fate…” - Michael - 0311-1
“I have to be a strong, good person. More conversations, less sex…” - Jake - 0508-1
“Bath houses are where you get hooked on drugs so I avoid them at all costs” - Ben - 0412-2
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Findings Perspectives of HIV-negative MAO MSM at Risk of HIV/AIDS
“Having a gay doctor is great! I don’t have to do so much explaining…” - Abe - 0313-2
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Findings
“I needed to be with someone with the same values as I had.” - Tim - 0619-1
“My need for emotional attachment lowered my risks and strengthened my bond with significant others” Anthony - 0313-3
“Having a committed, long-term relationship was the safest way to go!” - Tim- 0619-1
“Seeing so many of my friends drop like flies…it scared the shit out of me!” - Vic - 0319-1
“So much death in so little time. I knew I had to get out of the Toronto bath house scene!” Gary - 0227-3
“I was married to my ex-wife and we had kids back then. I really didn’t have a lot of opportunities to explore my sexuality” - Lance - 0521-1
“To be honest, in my 20s, I wasn’t really very adventurous when it came to sex” Ike - 0304-2
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Findings
“It took a while, but friends helped me accept the fact that meaningless sex didn’t really help me with my loneliness” - Ricky - 0523-1
“I’m not into risky sex, not into groups, not into public sex, and not into drugs.” - Vic - 0319-1
“At the heat of the moment in bath houses, there is no talk about HIV…” - Alex - 0405-1
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Findings Perspectives of Racial Minority, Immigrant, and Refugee MAO MSM
“In my country, you can be killed for being [openly] gay!” - Agwe - 0319-2
“Growing up Muslim, being gay is not something you talk about with your parents or family” - Moh - 0508-2
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Findings “It’s great to go to ACAS. They have case workers who look like me and have the same or similar culture and language as mine” Jin - 0328-2
“Although they don’t have as much resources as the bigger ASOs, Latinos Positivos is really good for newcomers with language barriers and don’t speak English much.” - Juan - 0403-1
“I get a lot of useful information from Black CAP – both on their website and when I go there” - Phillip -0306-1
“In our [Chinese] culture, it’s like in the US military when it comes to your sexual orientation, it’s don’t ask, don’t tell. Your family won’t ask, and you shouldn’t tell.” - Yun - 0328-1
“I don’t want to struggle with this for the rest of my life…I need to make it better” - Jake - 0508-1
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Findings Perspectives of MAO MSM Living Outside of Downtown Toronto
“There are no adequate sexual health or HIV services available near the [Indigenous] reserve.” - Pat - 0521-5
“We have ignorant doctors here who don’t know anything about HIV. A few are unaware of drug interactions related to HIV meds.” - Jeremiah - 0521-2
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Findings
“If you’re shy, closeted, or afraid to be outed in the suburbs, you won’t be able to get what you need from out here. You have to be comfortable about being gay and HIV-positive, proactive, and resourceful…at the least know how to use the internet…and you’ll have access to the things you need in terms of health and support services” - Chuck - 0503-1
“Our regional ASO is a one-stop-shop and all-in-one-roof service. It’s adjacent to my family doctor’s office, it’s got a lab, case worker, massage therapist, food bank, workshops, drop-in, housing support services…you name it.” - Vincent - 0531-1
“There is a huge MSM community online in the suburbs that not a lot of people know or talk about. Mostly only MSM who go online to meet other MSM do.” - Jeremiah - 0521-2
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“Downtown Toronto has more MSM on PrEP. In the suburbs, MSM don’t even talk about using PrEP or U=U.” - Ricky 0523-1
Findings Perspectives of MAO Trans MSM
“The 519 is where I got information on where I can find the right doctors.” - Kyle - 0329-1
“They have trans-specific training programs at Rainbow Health Ontario [of Sherbourne Health]. I think that it’s great that they have something specific for us.” - Eric - 0412-1
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Findings “Experiencing complex grief over many deaths [due to HIV/AIDS] over those many years, on top of traumatic experiences as a trans man, and being impoverished…it’s been a lot to take.” – Kyle - 0329-1
“I was proactive…being socially engaged in order to find social supports, identifying and addressing [sexual health] issues as they came, and challenging myself…” - Kyle - 0329-1
“It didn’t take long for me to realize that it was important to me…having sex only with same guys I trust.” - Eric - 0412-1
“I kept looking for help on my own. When I first came to Canada, I got help from Red Cross. Then, I got help from Seaton House, then St. Michael’s [Hospital], where I was diagnosed with HIV. I was later referred to McEwan House for more assistance. I knew I had to keep going and looking for help to survive.” - Charlie - 0328-4
“It was huge for me to see other trans men transition successfully despite the anticipated challenges. Once I saw it as possible, even though I knew it wasn’t going to be easy, I was sure that I could do it too.” - Eric - 0412-1
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Findings
“Downtown Toronto is the most resource-rich area in Canada. As a trans man, there are less challenges here in terms of accessing healthcare and support services.” Kyle - 0329-1
When it comes to safety and staying healthy, for many of us [trans men], paying attention to consent and consensus is crucial!” - Eric - 0412-1
For a trans man and his needs, I was certain that Toronto is the place to be.” - Eric - 0412-1
“I have significant experiences [as a trans man] in different sexual communities. A focus on clarity and clear communication is always key in my engagement with others to secure sexual safety” - Kyle - 0329-1
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“Being polyamorous and kinky is an important part of survival for a trans man. Under the right conditions, I get to enjoy sex, and at the same time, feel safe in my environment.” - Kyle 0329-1
Findings Barriers to Forging Resilience to HIV/AIDS
Party ‘n play has major control over the MSM community in Toronto…especially over the newcomers” - Bart - 0311-2
“Drugs changed everything…did a lot of damage…ruined a lot of lives” - David - 0321-1
Party ‘n play’s effects: big money for drug traffickers; big health and security risks for MSM” - Francis 0320-1
“I was raised as an ‘urban Indian’ and found out that there was not a lot of acceptance for MSM and HIV at the reserve” - Pat - 0521-5
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Findings There’s a lot of denial about being gay in the African Caribbean Black community.” Al -0318-1
“I started becoming depressed as I slowly realized how they kept criminalizing HIV because of the huge stigma attached to it.” - Ricky 0523-1
“Gay men would talk as if a man could actually be too gay” - Jose 0304-3
“It was sad. People, especially Black men, who were not out [at the start of the epidemic] got help way too late.” - Malcolm 0606-1
Back in the day, doctors secretly tested their patients for HIV. Then would let them go if they turned out to be positive.” - Phillip 0306-1
A nurse at a clinic said to me once, ‘I don’t really deal with [HIV-positive] people like you’. Then, she just walked away and didn’t come back.” - Derek - 0531-2
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Findings
“The aboriginal [sexual health and HIV] services we have were ghettoized.” - Gary 0227-3
“I was fired [from work] for supposedly smelling differently...” – Amir 0508-3
“Many Muslim gay men pretend to be white just to get laid.” - Randy - 0321-2
“It would say right there on their profile: ‘no fatties, no femmes, no Asians’. When you confront them, they would say, ‘It’s not racism, it’s preference’. But if you read the rest of their profile, it’s clearly racism.” - Irving - 0408-1
When it comes to dating, the pecking order in this community is based on the choices of [racist] white young men. Racism in the gay community is more prominent than in the straight community!” - Randy - 0321-2
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“One set of Latinos from one country feels superior over Latinos from other countries. They bring attitudes of superiority from their own country to Canada.” - Juan 0403-1
“It’s rough enough to have to deal with homophobia and HIV stigma, I’d have to deal with xenophobia and racism too - Edgar - 0328-3
Findings
“There was a lot of gossip and talking behind your back in the Latino community back then. I stayed away to avoid raising suspicions and rumours about my sexuality.” - Jose - 0304-3
As a Muslim immigrant, I found the gay culture of ‘playing games’ really difficult. A lot of it is cold and superficial.” - Moh 0508-2
“This was in the’80s. People, including refugees, in the African Caribbean Black communities loved to talk and introduce their own prejudices from their own country.” - Agwe - 0319-2
“In the gay community, it felt like someone was always just trying to get something out of you.” - Amir - 0508-3
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“A lot of Filipinos were nosy and liked to know about other people’s business. They’d ask you if you had a wife, who you were dating, etc. They don’t realize you just want to be left alone.” - Martin - 0306-3
They would mock you if you didn’t do drugs. They would mock you for not having sex without condoms. Unless you follow their ‘rules’, and do drugs, you can’t get to play.” - Jose - 0304-3
Findings MAO MSM: Special Topics
“They’re unaware of the level of trauma raised at the start of the epidemic!” - Jeremiah - 0521-2
“Now, they can be themselves with HIV, they have everything they need.” - Bob - 0228-1
Warn them about something…their response to you is, ‘there’s a pill for that!’.” - Jeremiah - 0521-2
Messaging about U=U hasn’t really worked so far…it’s not really reaching who it needs to reach. It’s not discussed online… and certainly not in the bath houses.” - Derek - 0531-2
“Oh, I believe in U=U. It’s not science that I don’t trust, it’s gay men that I don’t trust!” - Jake - 0508-1
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Relevance and Implications of Study Findings
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Relevance and Implications of Study Findings
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Limitations and Recommendations of the Study
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Glossary
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References
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CHAMPION Mental Health Research Lab
Toronto Research Team
Our Community Advisory Board
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Our Community Partnerships and Collaboration
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