Ever at the margins? Expert views on the challenges of defining and reaching heterosexually-identified men who have sex with men for health promotion and care

Stream: Identities and Relationships among MSM
Date: Friday, 1 April 2016
Time: 11.15 am – 1.00 pm


Introduction: The NSW HIV Strategy aims to achieve an 80% reduction in HIV among men who have sex with men (MSM) by 2020. Prevention and testing activities are well established for MSM who identify as gay or bisexual, but up to 20% of HIV diagnoses in NSW are outside this group, including heterosexually-identified MSM, who may not identify with or be reached by existing health promotion strategies. Almost no Australian research exists on this group and the international literature is scant or not translatable to this context.
Methods: Semi-structured interviews were conducted with ‘key informants’ holding either professional experience or community knowledge of this population to understand expert views on how to define and reach men fitting this description, with a focus on health promotion and care.
Results: Findings highlight the complexity of defining MSM, which includes diverse sub-groups, such as those who are ‘culturally straight’ due to social and family expectations, and those who are ‘straight but sexually fluid’, that is, they strongly identify as heterosexual but do or have had sex with men on occasion. These different groups may require different forms of engagement, creating considerable challenges for clinical and health promotion systems.
Implications: This project addresses a major gap in knowledge of MSM, which will critically inform health policy and testing and prevention activities. The feasibility of conducting research with men fitting this description will be explored as a means to further expand understanding, but is complicated by their enduring location ‘at the margins’, and well beyond easy reach of existing forms of health care and promotion.


Christy Newman (Presenter), Centre for Social Research in Health
Christy Newman is a Senior Research Fellow at the Centre for Social Research in Health. Christy has a background in health sociology and cultural studies and broad interests in expert and lived accounts, as well as social representations, of medicine ‘at the margins’. Her research explores contemporary social ideals and concepts underpinning the delivery and uptake of health services and health promotion, such as engagement, responsibility, trust, diversity and inclusion, as well as everyday understandings and cultures of health, illness and medicine.

Asha Persson, Centre for Social Research in Health
Dr Asha Persson is a Research Fellow at the Centre for Social Research in Health.

John de Wit, Centre for Social Research in Health
Professor John de Wit is Director of the Centre for Social Research in Health.

Denton Callander, The Kirby Institute
Dr Denton Callander is a Research Fellow at The Kirby Institute.

Heather-Marie Schmidt, NSW Health

Tina Gordon, NSW Health

Pene Manolas, Pozhet

Alison Rutherford, South Western Sydney Sexual Health Clinics

Catriona Ooi, Western Sydney Sexual Health Centre