Investigaytors

Investigaytors (2.0)

The Investigaytors program is a participatory, community-based, capacity-building intervention for cis and trans Two-Spirit, gay, bisexual, and queer (2SGBQ+) men and other men who have sex with men (MSM) who are interested in health and community research. 

If you've ever wondered how research works in the real world or wanted to learn more about how research can help change the world for 2SGBQ+ folks and their health, this program is for you. Participants learn valuable skills and develop research literacy over several sessions:

• Community-based research and the history of 2SGBQ+ health research

• Context of community health for 2SGBQ+

• Manitoba and the 2SGBQ+ Men's Health Study - Developing a research question

• Knowledge translation, or what the data say

• Presentation of research findings

• Meeting the key players

Ultimately, the goal of Investigaytors is to understand the usefulness of research in addressing health inequities and knowledge gaps. As well, this program allows for relationship building and engages guys in developing research potential.

Investigaytors program is hosted by the Faculty of Social Work at the University of Manitoba with support from the Canadian Institutes of Health Research (Principal Investigator: Dr. Rusty Souleymanov)

Investigaytors is being offered as part of a joint initiative between Community-Based Research Centre (CBRC.net/investigaytors) and the Village Lab (villagelab.ca).

To be a part of this amazing program, email the Village Lab at villagelab@umanitoba.ca.

Investigaytors (1.0) Research Reports

The first cohort of Investigaytors in Winnipeg applied their research analysis skills to the preparation of blog posts that merge personal experience with research results. These blog posts are featured below!

Research Report: Chris Campbell (2021)

Who are you?

My name is Chris, and I helped to plan and coordinate the first cohort of the Investigaytors program with Jared Star in 2020. I am a white, gay and queer, cisgender man and I’m a settler in Winnipeg on Treaty 1 land, which brings certain privileges and responsibilities with it. I have made my career in research, working for a variety of academic studies involving 2SLGBTQ+ education and equity (primarily with Dr. Catherine Taylor at The University of Winnipeg on the RISE Research Program, www.uwinnipeg.ca/rise), and I am currently working on my PhD in Education at the University of Manitoba. In 2019, I began working on the Manitoba 2SGBQ+ Men’s Health Study with Dr. Rusty Souleymanov—which collected data on the experiences of 2SGBQ+ cis and trans men in Manitoba’s health-care system. 

I see research as a vital part of working toward greater social equity and addressing various forms of oppression in social relations, including systemic and institutional structures like education and health care. Research is often seen as something that is highly specialized and reserved for those in formal positions, but I’ve increasingly seen how we all engage in research to live our lives and make decisions. It’s something that is available to all of us and, I hope, can help us understand our social and cultural relationships better—even helping us to advocate for social change to redress inequities perpetuated by heteronormativity, cisnormativity, racism, colonialism, and ableism. This is why I get excited about research and working with people and on topics related to 2SLGBTQ+ communities.

What is your research question?

In thinking about how to frame a question using data from the Manitoba 2SGBQ+ Men’s Health Study, I decided to take up a question that engaged with two of the major themes of the study, looking at participants’ perceptions of discrimination and how this may affect access to health care for 2SGBQ+ cis and trans men. Specifically: How do perceptions of discrimination in health-care settings affect 2SGBQ+ men’s ability to access health care that is responsive to their needs as 2SGBQ+ men? 

To answer this question, I looked at bivariate crosstabs comparing recent experiences of discrimination across six questions from the survey related to respondents’ openness about their sexual orientation with health providers, their rating of the importance of having a 2SGBQ+ doctor, and their practices regarding HIV/STI testing (whether they had ever had HIV/STI tests and with what frequency).

Why I picked this research question?

I wanted to look at experiences of discrimination (as my independent variable) to see how respondents’ experiences of discrimination may have affected their ability to access health care and the frequency with which they access it. My initial thinking was that experiences of discrimination among 2SGBQ+ men will have a negative impact on their inclination to access health care. This would not necessarily mean that they are not accessing health care, but they may be doing it less frequently and have greater apprehension when doing so. I suspect that those with experiences of discrimination in health-care settings would access health care less frequently and report that it is more important for them to have a health-care provider that they can be open with about their sexual orientation.

What do the results say?

As I mentioned above, I chose to look at how recent experiences of discrimination in health-care settings affected how 2SGBQ+ men’s accessed health care. 

When asked “Over the past two years, how often have you experienced discrimination (i.e., treated badly or unfairly, denied equal treatment or services, verbally harassed or disrespected, physically assaulted or attacked) in health care settings?” the majority (65.3%) of respondents reported they had experienced some form of discrimination in the past two years (34.7% had not; n=343). Specifically, 2.3% reported that they had “Always” experienced discrimination in the past two years, 13.4% selected “Usually,” 31.5% “Sometimes,” and 18.1% “Rarely,” with 34.7% of respondents saying they had “Never” experienced discrimination in the past two years. 

Using this as my independent variable, I compared six questions that focused on health-care access to see whether experiences of discrimination affected respondents’ ability to be open about their sexual orientation with their health providers, respondents’ ratings on the importance of having a 2SGBQ+ doctor, and whether this variable affected respondents’ HIV/STI testing practices.

Talking openly about sexual orientation with health-care provider

In response to the question “Do you talk openly about your sexual orientation with your health care provider?” three-quarters of respondents (74.5%) reported that they could, while 25.5% said they could not (n=368). 

When we compared the responses of those that had experienced discrimination in health-care settings, we found there were no differences in their responses about whether they were open with their health-care provider about their sexual orientation (i.e., there were no statistically significant differences based on a Chi-square/X2 test with a p<0.05 significance threshold).

Importance of having a doctor or health-care provider who identified as a 2SGBQ+ man

When asked “How important is it to you that your doctor or health care provider is also a Two-Spirit gay, bisexual, or queer identified man?”, respondents were relatively evenly distributed (n=362), with 12.7% reporting “It’s necessary for me,” 20.4% “It’s extremely important, but not necessary,” 18.8% “It’s very important, but not necessary,” 20.4% “I’d prefer it, but am fine either way,” and 27.6% saying “It doesn’t matter to me” (n=362).

When we compared the results of those who reported having experienced discrimination with respondents’ ratings of how important it was to have a 2SGBQ+man, we found that there were statistically significant differences (p<0.05). While I won’t report the entire crosstab results, I would generally summarize the difference by noting that higher numbers of those who reported having experienced discrimination in health-care settings said that it was necessary or very important to them to have a 2SGBQ+ doctor or health-care provider. 

We can see this more clearly represented in the data if we look at those who reported having “Never” experienced discrimination in healthcare settings in the past two years (34.9% of sample). Respondents who reported not having been discriminated in the past two years were less adamant about having a 2SGBQ+ doctor or health-care provider, with 60.7% of those who said “It doesn’t matter to me” having reported never having experienced discrimination and 53.5% of those saying “I’d prefer it, but am fine either way,” and lower numbers reported among those who said it was necessary (18.2%), extremely important (15.5%), or very important (12.1%) to them.

HIV and STI testing practices

We asked about HIV and STI testing in separate questions in the survey, finding slight variations in responses. When we asked “Have you ever been tested for HIV? (HIV tests involve either a blood draw, a point of care test [rapid testing – finger prick], or both)?”, the majority of respondents (78.5%) reported having been tested at some point (21.5% had not been tested for HIV; n=382). When asked “Have you ever been tested for a sexually transmitted infection (STI, also known as sexually transmitted disease/STD) other than HIV? (STI tests include a combination of blood draw, throat and rectal swabs and urinalysis),” almost three-quarters (72.7%) reported having received an STI test at some point (27.3% had not received an STI test; n=385). However, when we used participants’ responses about their experiences of discrimination in health-care settings to compare whether this impacted whether they had ever received an HIV or STI test, we found there were no significant differences for either question.

There were, however, significant differences (p<.005) when it came to frequency of testing. Overall, when asked “Typically, how often are you tested for HIV?” respondents reported the following: 19.4% reported they were tested for HIV every 3 months, 24.5% said they were tested every 6 months, 32.0% said they were tested once per year, 7.1% said they were tested once every two years, and 17.0% said they were tested less frequently than once every two years (n=294). When we compared the results of those who reported having experienced discrimination with how frequently they reported being tested for HIV, we found that those who had never experienced discrimination reported being tested less frequently than those who had—contrary to what I expected to see. For instance, there were higher numbers of those who reported never having experienced discrimination in the less frequent testing range (50.0% in the category of less than every two years, 42.1% once every two years, and 44.9% once per year) than in the more frequent and recommended 3 and 6 month testing schedule (27.8% and 27.5% respectively). However, among those who reported “sometimes” experiencing discrimination, the main differences seemed to located in higher representation for those who were tested every 6 months (42.0%) and once every two years (42.1%), and in lower representation for those tested less frequently than once every two years (17.5%).

Again, there was a significant difference between respondents who had experienced discrimination in health-care settings and those who had not when it came to frequency of STI testing. When asked “Typically, how often are you tested for STIs?” respondents reported the following: 20.5% said they were tested for STIs every 3 months, 31.8% said they were tested every 6 months, 26.4% said they were tested once per year, 8.9% said they were tested once every two years, and 12.4% reported they were tested for STIs less frequently than once every two years (n=258). When we compared the results of those who reported having experienced discrimination with how frequently they reported being tested for STIs, we found that those who had never experienced discrimination were less frequently tested, with 61.3% being tested once every two years and 40.3% once per year; there were fewer respondents who said they had never experienced discrimination among those tested once every 6 months (22.4%). Again, I found that there were notable differences among those who reported “sometimes” experiencing discrimination, with higher numbers among those tested every 6 months (47.4%) and lower numbers for those tested every 3 months (24.0%) and less frequently than once every two years (16.1%).

What are your reflections on the results?

Overall, I think there is more research needed on how experiences of discrimination impact 2SGBQ+ men’s access to health care. This is especially important when thinking about respondents’ frequency of testing for HIV and for STIs, where results seem to indicate that those who had experienced discrimination in health-care settings were tested more frequently than those who had not—or that more frequent experiences of discrimination did not deter respondents from frequent testing. (Note: It’s also possible that other confounding variables are at play in this relationship.)

Respondents’ preference for a 2SGBQ+ doctor or health-care provider is a clear indicator that 2SGBQ+ men would like a health practitioner who understands their needs, especially among those who have experienced discrimination at some point. For those who have experienced discrimination in health-care settings, particularly if they had experienced discrimination based on their sexual orientation (as 23.3% of those who reported having experienced discrimination indicated) or gender identity (as 24.5% of those who had experienced discrimination indicated), it makes sense that they would be more inclined to want a health practitioner who identified as 2SGBQ+. 

I am not entirely sure how to make sense of the significant differences in the findings on frequency of testing for HIV and STIs. There are not clear trends between the two crosstab analyses, nor is it clear why those who had experienced discrimination seem to be represented among those tested more frequently. These are not necessarily definitive trends, but they are, I think, suggested by the data. I can think of two possible explanations here: 

(1) Those who are tested more frequently are those who recognize the importance of frequent testing for their own health and may have more frequent exposure to a variety of health settings, increasing their likelihood of encountering discriminatory behaviours. For example, we might consider participant responses to questions about other health conditions, results of previous HIV or STI testing, or their sexual practices to see if they may have reason to more regularly frequent health-care settings. 

(2) Recruitment for the survey was conducted among marginalized populations (for instance, among clientele of Nine Circles clinic), who may have had experiences of discrimination elsewhere and who, as a result, have sought out “alternative” health services and ended up being connected with a health provider who provides regular testing services as part of their mandate.

Finally, it is encouraging that there are no significant differences among those who had experienced discrimination and their ability to discuss their sexual orientation with their health provider. This suggests that those who do disclose their sexual orientation are no more likely to experience discrimination as a result—although again this may be the result of participants seeking out health-care providers who respondents knew to be affirming. However, it is also worth noting here that only three-quarters of the sample did feel they could be open with their health provider, suggesting that one-quarter has misgivings about disclosing or feels unable to do so for some reason, leaving 2SGBQ+ specific health needs unaddressed.

Research Report: Steven Nero (2021)

About me

Hey there, my name is Steven Nero; I am a twenty-four-year-old gay male living just outside of Winnipeg, Manitoba. I am a university student with a Bachelor of Arts degree with a major in psychology and a minor in sociology from the University of Winnipeg. I am currently studying for my Bachelor of Social Work degree at the University of Manitoba, graduating in 2021. After my Bachelor of Social Work degree, I plan on completing my Master of Social Work degree, specializing in clinical social work. Outside of my studies, I love to travel, hang out with my family and friends, walk my dog, watch real crime shows, and do word searches. Two significant passions in my life are travel and Ukrainian dance. My favourite place that I have travelled to is Athens, Greece and six Ionian Greek islands. Since the age of six, I have been Ukrainian dancing; I also teach Ukrainian dance to youth as a part-time job. 

Research Questions 

1.     How does an individual’s relationship status effect when they were last tested for HIV and other STIs? 

2.     How does the relationship status of an individual affect their sexual behaviours and harm reduction practices?

Why did I choose these questions? 

In the survey, participants were asked what their current relationship status was and asked to choose from the list provided, which included single, dating, married or partnered, or separated/divorced or widowed (note: I mainly analyzed data for single, dating, and married/partnered men as there were too few responses for separated/divorced/widowed men to draw conclusions). Using their responses, I compared across several other questions from the survey, including a question asking whether they had ever been tested for HIV, whether they had ever been tested for STIs, how frequently they were tested for HIV, how frequently they were tested for STIs, and a series of questions about their sexual practices/behaviours and what their harm reduction or HIV prevention strategies they used.

Results

Question 1

The results for question one include the following. First, when analyzing the data, it was found that there is no significant difference between a person’s relationship status and when they were last tested for HIV. However, there is a significant difference between a person’s relationship status and when they were last tested for various STIs. More frequent testing was reported between single and married/partnered or in dating relationships in the three-month STI testing range (with 42.9% for single men and 25.5% for married/partnered men, and 23.5% for those who were dating). 

Question 2 

a.     “Please tell us if you bottomed (got fucked) without using a condom in the last 6 months with a male partner whose HIV status you did not know.”

When analyzing the data for this question, it was found that significantly more men with a relationship status of single and married or partnered bottomed without using a condom in the last six months with a male partner whose HIV status they did not know (single 53.2%, married/partnered 38.3%). Additionally, it was also found that significantly fewer men with the relationship status of dating bottomed without using a condom in the last six months with a male partner whose HIV status they did not know (4.3%) 

b.     “Please tell us if you bottomed (got fucked) without using a condom in the last 6 months with an HIV-positive male partner whose viral load you did not know.”

When analyzing the data for this question, it was found that significantly more men with a relationship status of single and married or partnered bottomed without using a condom in the last six months with an HIV-positive male partner whose viral load they did not know. Additionally, it was also found that significantly fewer men with the relationship status of dating bottomed without using a condom in the last six months with an HIV-positive male partner whose viral load they did not know.

c.     “Please tell us if you bottomed (got fucked) without using a condom in the last 6 months with an HIV-positive male partner who told you their viral load was detectable.”

There was no statistically significant difference in this question. 

d.     “Please tell us if you topped (fucked someone) without using a condom in the last 6 months with a male partner whose HIV status you did not know.”

There was no statistically significant difference in this question. 

e.     “Please tell us if you topped (fucked someone) without using a condom in the last 6 months with an HIV-positive male partner whose viral load you did not know.”

When analyzing the data, it was found that significantly more men with the relationship status of married or partnered topped someone without using a condom in the last 6 months with an HIV-positive male partner whose viral load they did not know. Additionally, it was also found that significantly fewer men with the relationship status of dating and single topped someone without using a condom in the last 6 months with an HIV-positive male partner whose viral load they did not know.

f.      “Please tell us if you topped (fucked someone) without using a condom in the last 6 months with an HIV-positive male partner who told you their viral load was detectable.”

There was no statistically significant difference in this question. 

g.     “What sexual harm reduction or HIV risk prevention strategies did you use in the past 6 months? Looking at condom use.” 

When analyzing the data, it was found that slightly fewer men in the single and married or partnered categories used condoms as an HIV risk prevention strategy. Additionally, it was also found that more men in the dating category used condoms as an HIV risk prevention strategy. 

h.      “What sexual harm reduction or HIV risk prevention strategies did you use in the past 6 months? Looking at engaging in sex other than anal sex.”

There was no statistical difference in this question. 

i.      “What sexual harm reduction or HIV risk prevention strategies did you use in the past 6 months? Took PrEP (Pre-Exposure Prophylaxis) before sex to prevent HIV transmission.”

When analyzing the data, it was found that fewer men in the single and dating category used PrEP as an HIV risk prevention strategy. Additionally, more married or partnered men used PrEP as an HIV risk prevention strategy.

j.      “What sexual harm reduction or HIV risk prevention strategies did you use in the past 6 months? Having sex with one partner only (monogamous, closed relationship).”

When analyzing the data, it was found that fewer men in the single category utilized this HIV risk prevention strategy. Additionally, it was also found that slightly more men in the married or partnered and more in the dating categories used this HIV prevention strategy.  

Discussion

• Question one: I find the results for question one to be interesting for two reasons. The first reason is that I find it thought-provoking that the participants consider HIV and STI testing to be a separate entity. The second notion that I find interesting is that 42.9% of single men are getting tested in the three-month STI testing range. I wonder why that percentage is high, what type of sex these single men are having, and what type of harm reduction practices are being used if any? 

• Question two a: The results for this question surprised me. I did not think that 53.2% of single men and 38.3% of married/partnered men bottomed without using a condom in the last 6 months with a male partner whose HIV status you did not know. I wonder if these men are not using condoms as a harm reduction method, what are they using to prevent STIs? 

• Question two b: The results for this question surprised me because, as the results state,  significantly more men with single, married or partnered relationship status bottomed without using a condom in the last six months with an HIV-positive male partner whose viral load they did not know. Again, I wonder what harm reduction methods are used if condoms are not being used? 

• Question two e: Reading the results of this question, I am curious to know the difference in partnership style between married or partnered and dating men? I wonder if married or partnered men are more of an open relationship style because significantly more men with the relationship status of married or partnered topped someone without using a condom in the last 6 months with an HIV-positive male partner whose viral load they did not know.  
  Question 2 g: As stated by the results, slightly fewer men in the single and married or partnered categories used condoms as an HIV risk prevention strategy. I wonder what HIV risk prevention is being used? 

• Question 2 i and j: I wonder if the difference in taking PrEP in single and married or partnered relationships was due to cost?

Research Report: Trevor J. Smith (2021)

Who are you?

My name is Trevor J. Smith (he/him), and I am proud to have been part of the first cohort of Investigaytors in 2020. I acknowledge my privilege as a white, gay and cisgender male, and a settler on Treaty 1 territory. I am graduating June 2021 from the University of Manitoba with a Bachelor of Arts (Hons.) degree, majoring in psychology. I have served as the 2SLGBTQ+ Representative for the University of Manitoba Students’ Union since May 2019 and I will continue in the position until April 2021. I also served as President of the Rainbow Pride Mosaic, which is the U of M’s 2SLGBTQ+ student club. I have always been involved in giving back to the community, and I volunteered for several years with the Pride Winnipeg Coffee House event, including giving a speech about building bridges between the 2SLGBTQ+ community and allies. I have also given speeches about the 2SLGBTQ+ community and the importance of diversity at elementary and middle schools, and I am passionate about education. I grew up in rural Manitoba, and my love of flamboyantly debating Queer issues with rural Manitobans has been described as “a unique form of activism” – I proudly marched in the first Steinbach Pride, and I love being a social butterfly at country music festivals. I try to use my privilege to expand the Queer community’s collective safe space in Manitoba where I can. My dream and goal is to bring my passion and advocacy for the community to my future career as a clinician.

What is your research question?

I wanted to have a look at the possible implications of disclosing one’s sexual orientation with one’s health care provider in the context of sexual health. More precisely, I wanted to see if men openly discussing their sexual orientation with their health care provider was related to: (a) whether or not they had ever been tested for HIV and other STIs, and (b) the frequency with which they were tested for HIV and other STIs. Using the data from the Manitoba 2SGBQ+ Men’s Health Study, I analyzed bivariate crosstabs which compared whether or not men openly discussed their sexual orientation with their health care provider across four questions from the survey pertaining to whether men had ever been tested for HIV/STIs and how frequently. 

Why did you pick this research question?

As someone who knows many men who do not feel comfortable or safe openly disclosing that they have sex with other men, this question hits close to home for me. While many Queer folks can relate to having at least one negative interaction with health care providers on the basis of our sexual orientation and/or gender, we ultimately may not be receiving the care we need if we cannot freely discuss our sexual orientation with our providers. My personal experience is with the stigma and shame that might be prevalent in some rural Manitoban communities, but I also have friends whose families come from various other backgrounds that are also less than accepting of diverse sexual orientations, which could result in men not discussing their sexual orientations with their health care providers. My prediction was that openly discussing one’s sexual orientation with one’s health care provider would be related with an increased likelihood of having ever been tested for HIV/STIs, as well as an increased frequency of those tests.

What do the results say?

Again, I looked at whether openly discussing one’s sexual orientation with one’s health care provider was related with ever being tested for HIV/STIs, as well as with the frequency of HIV/STI testing.

When asked, “Do you talk openly about your sexual orientation with your health care provider?” on the survey, 74.5% of respondents said yes, and 25.5% said no (n=368). I used this as my independent variable, and compared four questions pertaining to ever having been tested for HIV/STIs, as well as with the frequency of HIV/STI testing, to see if there was any relation.

HIV testing practices

Responding to the survey question, “Have you ever been tested for HIV? (HIV tests involve either a blood draw, a point of care test [rapid testing – finger prick], or both),” most respondents (78.5%) indicated that they had been tested for HIV before, while 21.5% of respondents indicated that they had not ever been tested for HIV (n=382). When comparing the responses of men who did or did not openly discuss their sexual orientation with their health care provider, there were differences in their responses about whether they had ever been tested for HIV (i.e, there were statistically significant differences based on a Chi-square test with a p<0.05 significance threshold; in this case, p<0.001). Of respondents who had been tested for HIV, most (83.6%) spoke openly to their health care provider, while 16.4% did not; of respondents who had never been tested for HIV, more than half (57.9%) did not discuss their sexual orientation with their health care provider, while 42.1% talked openly about it.

In response to, “Typically, how often are you tested for HIV?” approximately one third (32%) of respondents were tested once per year, followed in response frequency by every 6 months (24.5%), every 3 months (19.4%), less frequently than once every two years (17%), and once every two years (7.1%; n=294). Again, there was a significant difference (p<0.001) between respondents who spoke openly about their sexual orientation and those who did not. The analysis revealed the trend that men who spoke openly about their sexual orientation with their health care providers had a higher likelihood of pursuing more frequent HIV testing: for instance, of men who were tested for HIV once every 6 months, 91.5% openly disclosed their sexual orientation to their health care provider, while 8.5% did not. Conversely, of men who were tested less frequently than once every two years, a much lower 59.1% openly disclosed their sexual orientation to their health care provider, while 40.9% did not.

STI testing practices

When asked, “Have you ever been tested for a sexually transmitted infection (STI, also known as sexually transmitted disease/STD) other than HIV? (STI tests include a combination of blood draw, throat and rectal swabs and urinalysis),” around three quarters (72.7%) of respondents had undergone testing for an STI before, while 27.3% had not ever received an STI test (27.3%; n=385). There was again a significant difference (p<0.001) between respondents who spoke openly about their sexual orientation with their health care provider and those who did not. The STI testing practice results closely mirrored the results for HIV testing practices: of the respondents who had been tested for STIs besides HIV, 82.6% were open about their sexual orientation with their health care provider, while 17.4% were not. Of the respondents who had never been tested for STIs besides HIV, only 53.7% openly discussed their sexual orientation with their health care provider, while 46.3% did not.

In terms of frequency, when asked, “Typically, how often are you tested for STIs?” around half (52.3%) of the respondents were typically tested every three to six months as recommended for MSM (20.5% every 3 months; 31.8% every 6 months), while 26.4% of respondents were typically tested once per year, 8.9% once every two years, and 12.4% less frequently than once every two years (n=258). There was yet another significant difference (p<0.002) between those who discussed their sexual orientation with their health care providers and those who did not. For comparison’s sake, of respondents who were tested every 3 months, 82.4% openly discussed their sexual orientation with their health care provider, while 17.6% did not. In contrast, of participants who were tested less frequently than once every two years, only 64.5% discussed their sexual orientation with their health care provider, while 35.5% did not. 

What are your reflections on the results?

The data suggest that men who have sex with men who do not openly talk about their sexual orientation with their health care providers may be less likely to have ever been tested for HIV and other STIs at all, and if they had been tested, a high proportion of these men indicated being tested less frequently than once every two years, which may not be frequently enough to curb the spread of STIs or ensure proper treatment in the event of infection. Future research should further examine this population and develop strategies to increase the rate of testing. Perhaps health care facilities could do more to advertise that their staff are welcoming of diverse sexual and gender identities, which might make patients feel more comfortable disclosing their sexual practices by reducing the perception of stigma. As well, it may behoove health care providers to recommend occasional HIV and other STI testing to all their patients, or at the very least, discuss the importance of testing, recognizing that not every patient will feel comfortable disclosing the types of sexual activities they engage in, if they even volunteer being sexually active at all. This practice might logically reduce the number of people who have never had an HIV or other STI test, regardless of whether or not they disclose their sexual orientation.

Even among men who discussed their sexual orientation with their health care providers, many were getting tested less frequently than every 3-6 months. There are several explanations for this finding. One is that this could reflect barriers to access for certain Manitobans, such as living in a more remote location without convenient access to testing. Another is that they may not have up-to-date knowledge regarding recommendations for frequency of testing. A third possibility could be that the respondents reporting less frequent testing were choosing to abstain from sex or were in a monogamous relationship. It may be worthwhile to further examine men who have disclosed their sexual orientation to their health care providers but who may be getting tested less frequently than is recommended, to determine if this group might possibly benefit from a higher frequency of HIV/STI testing.

Lastly, it will be interesting to compare these findings to those of future survey iterations. As diverse sexual orientations become less taboo with time, I would be curious to see if, in the future, more men feel comfortable openly disclosing their sexual orientation to their health care provider, and if that might be associated with an increase in the overall frequency of testing.

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Hey everyone, my name's Jonah. I'm one of the volunteers who's been working with Investigaytors for the past year or so.  First thing that’s probably on your mind: WHO or WHAT are the “Investigayors”?

Long story short, it’s a volunteer research program centered around 2SGBTQ+ men’s health. It was founded in Vancouver by the Community Based Research Centre (CBRC) and has since branched out into Alberta and Manitoba, which is how myself and my (extremely talented and cool) colleagues got involved.  We’ve been learning how to conduct community research through a series of workshops, centered around the Sex Now survey which has been conducted throughout Canada by the CBRC. 

The survey was held throughout Manitoba in 2019, and asks questions relating to substance use, healthcare access, mental health, sexual health and more. The goal of the survey is to develop an understanding of how 2SGBTQ+ men understand their own health, how they are taking care of their own health, how they are accessing healthcare, where they are accessing healthcare, and how we can help fill the gaps in any of these areas. 

Here’s a link on the <a href="https://www.cbrc.net/investigaytors">Investigaytors</a>, and the <a href=" https://ninecircles.ca/news-events/sex-now-online-home-grown-research-at-home/ ">Sex Now survey</a> if you want to know more.

Research Report: Jonah Wilde (2021)

Before we go any further, here’s a bit about me:

-        I graduated from the University in Manitoba with a double major in film & theatre

-        I realized that I was never going to make a career out of it.

-        COVID happened.

-        I realized that I was DEFINITIELY never going to make a career out of it.

-        I am now training to be a Library Technician at Red River College.

As you can see, I’m not a scientist at all. I came into this from an Arts background, without much experience in research beyond what I did for university, and having previously participated in a shorter program similar to Investigaytors (Totally Outright, 2014). My main area of experience is volunteering in the community, which I’ve done for several years now and I’m hoping to continue as soon as COVID gets out of here. My hope is to take that experience, do what I can to stay on top of the currents needs of the community, and address that in my research. That said, if I ever mess up or don’t seem like I know what I’m talking about, feel free to roast the hell out of me.

So… Back to Investigaytors. As part of the program, one of our jobs was to develop a research question based on the survey. We were given a list of survey questions, told to pick a range we wanted to see the results for. And based on that, each of us developed our own research question. Something WE wanted to know about queer men’s health in Manitoba, for which the data would hopefully provide some insight.

For my research question, I wanted to look at how people with disabilities accesses healthcare. More specifically, I wanted to how people’s perception of themselves as a person with a disability affects how they talk about their health to others, and how they choose to access healthcare.

I have ADHD and wasn’t diagnosed until my mid-20s. I spent years blaming myself for stuff that was actually the fault of my disability. That made it impossible to adequately take care of my mental health or talk to people about it, and it wasn’t until I got my diagnosis that I was able to start disentangling myself from that mindset and get help for the first time.

So, I wanted to know what experience other people had with their own disability. Did their perception of themselves as a person with a disability change how they access healthcare, or how they talk about their health? I narrowed it down to a set of questions questions asking whether or not people were accessing healthcare, how often they accessed it, and if they weren’t, what was the reason for that? I sent in the question, got my results, and the answer was…

There was very little difference, statistically. The number of people with disabilities accessing healthcare was basically the same as the number of people without, and out of the reasons given for not accessing healthcare, self-perception never really came up. My question was a dead-end, basically.

And that's just how things work sometimes! You have an idea, you start asking questions, you get blue-balled by science, and then you go write a paper about it. I think part of the problem is that I projected too much of myself into it and came out with a question that was too tailored to my own experience.

But there’s still plenty of directions I can go with it. For example: While the overall number of people accessing healthcare was similar between each group, the frequency with which they had difficulty accessing healthcare was very different. People with disabilities who said that they had difficulty accessing healthcare were either currently experiencing, or have previously experienced that difficulty far more often than people without.[1]

Building off that, I’d like to look at how this is split geographically. Where in Winnipeg, and Manitoba as a whole, are people having the most difficulty accessing healthcare?  Through questions like this, we can identify an area where people are actively having difficulty accessing health care and look at what kinds of changes are needed. So that’s what I’m hoping to do moving forward! Build off the first question and keep asking more, to develop a useful body of community-based research.

That’s it for now! If this is your first time on the site, go click the button up top and check out everyone else's blog entries too. I’ve been working with some incredibly cool and insightful people through the Investigaytors program, and every single one of them has something valuable to add to the conversation. So go take a 15-minute break, make yourself a snack and get reading

[1] There’s SO much more that can be said here, but it’s not something that can adequately be addressed in an intro post, or from my perspective alone as an able-bodied person with a learning disability.  So it’ll be the subject of a future post.

Research Report: Kenny Chee (2021)

Who are you?

My name is Kenny, I have had the privilege to join the first-ever Investigaytors program in Winnipeg coordinated by Chris Campbell and Jared Star in 2020. I am a first-generation immigrant to Canada from Malaysia, I arrived in the Treaty 1 land (Winnipeg) in 2012 as an international student studying Psychology at the University of Manitoba. I then graduated with a Bachelor of Arts (Honours) in Psychology in 2017. I started working in the community in different capacities, from a support worker for adults with intellectual disabilities to a case manager for youth and young adults who are facing employment barriers. I currently reside in  Waterloo, Ontario to pursue my Master’s degree in Community Psychology at Wilfrid Laurier University. I am currently involved in Social Inclusion and Health Equity Lab (SIHE; under the supervision of Dr. Todd Coleman). My current research interests involve examining the well-being of LGBT2SQ+ racialized youth through empowerment and intersectionality lens. I also have interests in epidemiology and biostatistics. 

My vision of advocacy work for marginalized communities is through research and education. Community-based research is an effective way to disseminate our research knowledge to the community, including policymakers, non-profit organizations, the general public. Hence, I started to get involved with community research (away from conventional psychological research) to get a sense of how research is conducted with community samples. I started my community research work by becoming one of the committee advisory members for the Manitoba 2SGBQ+ Men’s Health Study led by Dr. Rusty Souleymanov. After the committee work, I had the opportunity to participate in the Investigaytor program where we learned about community-based research through Dr. Souleymanov’s study. 

What is your research question?

Previous research has shown that those who are experiencing homelessness are less likely to receive equitable healthcare than those who are not experiencing homelessness, including getting HIV and STIs testing. Moreover, those who are experiencing homelessness might be sex workers, hence they are likely to engage in sexual activities that impose a higher risk of contracting HIV and STIs. Hence, my research questions encompass how accessible HIV and STIs testing for people who are experiencing homelessness, and what harm reduction strategies that people who are experiencing homelessness utilize to decrease the risk of HIV and STIs. 

Why I picked this research question?

I have been working with marginalized youth at an agency in the inner city of Winnipeg called Resource Assistance for Youth. Some youths who are accessing services from RaY are currently experiencing homelessness, hence I am particularly passionate about the advocacy for people who are experiencing homelessness to have equitable access to healthcare services. 

Moreover, I am also interested in health equity among those who are marginalized. How has the structural barriers and discrimination in healthcare settings prevent those marginalized from accessing healthcare supports? For example, transgender folks are reluctant to visit doctor offices because of the likelihood of them encountering transphobia from nurses or doctors.             

What do the results say?

A series of the chi-squared test had been conducted. The first chi-squared test analyzed HIV testing among the participants who are experiencing homelessness. The analysis showed that participants who are experiencing homelessness are more likely to get tested for HIV than those who are not homeless, X2 (1, N = 344) = 3.163, p = .075. Similarly, chi-squared test also showed that participants who are experiencing homelessness are more likely to report more frequent testing for HIV than those who are not experiencing homelessness, mainly every 3 months and every 6 months, X2 (1, N = 266) = 37.068, p > .001.

We did a similar chi-square analysis on the participants who are experiencing homelessness and whether they get tested for STIs. Similar to HIV testing, participants who reported experiencing homelessness are more likely to get STIs testing than those who are not experiencing homelessness X2 (1, N = 345) = 5.566, p = .018. Although people who are not experiencing homelessness are more likely to report that they get tested for STIs in the past 3 months than people who are experiencing homelessness, the latter group is more likely to report getting tested for STIs 4 to 6 months ago. X2 (1, N = 257) = 24.548, p > .001.  

We then examined the harm reduction strategies that people who are experiencing homelessness utilized. Surprisingly, those who are experiencing homelessness are more likely than those who are not experiencing homelessness to use PrEP (Pre-Exposure Prophylaxis) before sex to prevent HIV transmission, X2 (1, N = 228) = 24.876, p > .001. The Chi-Square test indicated that the individuals who are not experiencing homelessness are more likely to be in a monogamous relationship than those who are experiencing homelessness X2 (1, N = 225) = 6.504, p > .001. Similarly, based on the Chi-Square analysis, the individuals who are experiencing homelessness reported that they are less likely to ask their sexual partners about their HIV status than individuals who are not experiencing homelessness X2 (1, N = 226) = 5.483, p > .001.

What are your reflections on the results?

To be frank, I am very surprised and relieved that those who are experiencing homelessness are able to access HIV and STIs testing easily and frequently, which is the total opposite of my hypothesis. Similarly, I am also surprised that individuals who are experiencing homelessness are more likely to use PrEP than those who are not experiencing homelessness. My speculation is that the majority of the homeless population is indigenous (unfortunately), and individuals who are indigenous are able to access free PrEP as part of their health benefits. Nonetheless, individuals who are experiencing homelessness are still engaging in some high-risk sexual activities, including having multiple sexual partners and not asking about their sexual partner’s HIV status before sex. However, the majority of the individuals who are experiencing homelessness are utilizing other tools to alleviate the risk of getting HIV and STIs, such as using condoms