Sexual Health Research: HIV and sexual wellness in LGBTQ+ communities

Sexual health and wellness is arguably an under-discussed topic, but Mount Royal University is home to a researcher and professor who is counteracting this problem by contributing to important research. His name is Brent Oliver, whose community-based studies have surrounded the topic of HIV/AIDS issues. Oliver also works at Mount Royal University as a program coordinator in the Department of Child Studies and Social Work, and has also conducted research on how students in universities learn best in their environments.

Oliver is opening up the discussion by addressing marginalized groups, namely men who have sex with men. He has studied how it would be best to assist the health of gay men, to spread awareness about sexually transmitted infection testing, and how it would be most beneficial to support men who are HIV positive.

‘The Calgary Men’s Wellness Initiative,’ research project was established in 2012, where Oliver said he used a mixed methods approach when conducting the investigative work necessary for the needs assessment.

“There was a survey which men could do online and just fill out questions about any problems they have with the healthcare system, any access issues that they’re experiencing, what are some of the things they liked about service they received in the healthcare field, and then we also did some interviews with particular people,” said Oliver.

Oliver’s main goal when conducting his research is to engage in participatory work, or hands-on work that involves speaking to people who are actually experiencing the research issues being studied. He believes that immersion in a study gets through to people more so than theoretical reports do, and the main idea is that you involve community members in the research so that it is information that is palpable and relatable to the general public.

“I have become fairly pragmatic over the years. I think the most important thing in the HIV community based research sector is that whatever methodology you use helps or can be to put to use, and so that those in the field can actually apply the results to make a meaningful difference,” said Oliver.

A strong belief in bringing people together is what has led Oliver to find in his studies that people co-create knowledge. This notion is rooted in something known by research professionals as grounded theory. Based on this idea, those whose research follow this method find that results are

founded in the perspectives of its research participants, rather than in a rigid hypothesis and outcome.

“The most important thing is that a lot of our conclusions didn’t come from theories we made up, but actually came from the research participants themselves and from what they said,” said Oliver.

A particular aspect of this study that stood out to Oliver from research participant perspectives was STI testing and what level of risk gay men in Calgary thought they were at for HIV in particular. Oliver wanted to find out if there was a disconnect between practices and the perceptions of whether or not they felt they were at risk for HIV.

What Oliver found when addressing this topic was in regard to access to testing. Oliver said that the way that a lot of services are set up are not as accessible as they could be, in that there are really long wait times for results, hours to visit these clinics are not especially convenient and so forth.

Access to testing and stigmatizing experiences with the healthcare system are something Oliver and his co-researchers Brian Hansen, Floyd Visser, and others, found to be something that many men are worried about when addressing their own sexual health.

Oliver mentioned that there is only one place in Calgary where men can go to get rapid testing for HIV, whereas other clinics will take 2-3 weeks to come back with test results.

“Often they’ll lose people in that lag time, so one of the things that the survey suggested was that more people would go for testing if they got their results right away,” said Oliver.

A lot of Oliver’s research has been directed toward finding palpable research that shows concretely that more services should be available for gay men specifically so that there’s less apathy and stigma around getting tested.

Decisions around what Oliver chooses to research is based on need, wherein he waits to see what the community is signifying, and is then propelled into his research that way. In the case of research around gay men’s wellness, he realized that there was a great need in the community for research to strengthen support systems for those who signified their need for it

“I think in the HIV sector the most important thing is that people living with HIV and the community agencies that represent them are the ones making decisions about what the research questions should be,” said Oliver.

When considering ethics about research during this project, Oliver said that every decision goes through the ethics board. Common concerns that arise around ethics when discussing HIV is protecting community member’s confidentiality who are living with HIV, and ensuring that no one feels coerced to engage in the studies.

One element of Oliver’s research that he realized was lacking in this study initially, was that particular sub-populations, such as indigenous or trans men weren’t being represented as adequately as possible.

“We realized we didn’t have enough diversity, so we decided to do some qualitative interviews too, we did about 15,” said Oliver.

“You’re always looking at the limitations of your study, and one of our limitations that we hit up against constantly was hearing from sub-populations. We really wanted to hear from youth, we really wanted to hear from trans men, we wanted to hear from people of colour if possible, because we think that they possibly have the most stigmatizing experiences of anybody,” said Oliver.

Oliver said that they weren’t as successful as they would have liked in obtaining data from sub-populations of gay men, and Oliver thinks that it may be due to cautiousness and concern about confidentiality. This may have been because they’re a part of communities who are less accepting of sexual orientation and gender diversity.

Some strategies were put in place to try to get representation from more diverse groups, like using community networks to get the word out about the survey, but at the end of the day Oliver thinks that perhaps they weren’t the right group to be reaching out to sub-populations. Oliver suggested that if other agencies reached out, that their deeper understanding of particular groups would better mitigate any barriers between research and sub-communities.

“We would encourage and hope that somebody else will pick up the next piece, which would be how do we better understand healthcare access and experiences for, you know, gay men of colour, and then how would we support that community to do that work, ” said Oliver.

When deciding what type of analysis would be best to conduct this study, Oliver said that it was clearly a survey for gay men - so random sampling was not the goal. Not only that, but the analysis was straightforward in that the results were descriptive statistics and frequencies.

“At the end of the day, our intent wasn’t to generalize and say whatever these findings are would apply to all gay men in Calgary. What they are saying is that these service providers needed this information to continue their work, and it is very useful to these groups so they can start to think about how they can improve services,” said Oliver.

Further information about the study and the online survey can be found at www.calgarymenswellness.com