An Assessment of the HIV Prevention Needs of Men who have Sex with Men in Montana
The purpose of this study was to collect information about the HIV prevention needs of men who have sex with men (MSM) living in Montana. Prevention needs were explored by identifying the environmental factors and behaviors that put MSM at risk for HIV infection, describing the demographic and contextual factors that influence those behaviors, and comparing current prevention needs to existing resources and services. To evaluate the prevention needs, primary qualitative data was collected in the form of four focus groups and nine key informant interviews. Supporting secondary quantitative and qualitative data in the form of an online survey and interviews with men on the “down low” were also assessed. The results of this assessment identified behaviors that contribute to HIV infection including unprotected anal intercourse, alcohol and drug use, using the Internet to find sexual partners, and hiding one’s sexuality. Aspects of the environment that increase risk of HIV infection were also identified including geographic and social isolation, and communal hostility towards MSM. Factors contributing to HIV risk behaviors include depression and poor mental health, HIV testing issues, misperceptions about HIV and HIV medications, lack of social support, skills, younger age, and lack of comprehensive sex education. Finally, a number of HIV prevention needs were identified including needed resources such as more gay community centers, outreach efforts such as publicizing HIV rates in Montana and its communities, and health-related interventions such as comprehensive sex education, more support groups, and anonymous HIV testing. Other needed resources include cultural changes such as cultural competency training for individuals working with the public and greater acceptance of individuals who are two-spirit; social changes such as more MSM community and socializing events and greater political clout of the MSM community; and policy changes such as equal rights for lesbian, gay, and bisexual individuals, along with greater funding for HIV testing, treatment and education. The findings from this study will be used by the Montana Department of Public Health and Human Services and the Montana HIV Prevention Community Planning Group to further shape the programs and resources offered to MSM.
HIV, HIV Prevention, Montana, MSM, Rural
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