The relationship between gay community, other social networks, and HIV among gay, bisexual and other men who have sex with men

This thesis examines the relationship between social engagement with LGBTQ+ communities, broader social networks, and HIV prevention among gay, bisexual, and other men who have sex with men (GBMSM) in Australia. Chapter 1 introduces what is known about social networks, community, and HIV prevention among GBMSM. Chapters 2 and 3 use data from the Gay Community Periodic Surveys from 1998-2020 in Chapter 2 and 2017-2021 in Chapter 3. Chapter 2 assesses long-term trends in gay social engagement among GBMSM and shows that social engagement with gay men is associated with HIV testing, PrEP uptake, and sexual behaviour. Chapter 3 is an analysis of self-reported HIV/STI testing frequency among GBMSM that shows gay social engagement is associated with more frequent STI testing. Chapter 4 uses survey data from the Asian GBMSM to investigate whether social engagement and experiences of discrimination among Asian GBMSM are associated with the use of effective HIV prevention strategies and the risk of HIV acquisition. This analysis found that discrimination based on sexual identity is associated with a higher likelihood of reporting sexual behaviours with a risk of HIV acquisition. Chapter 5 uses qualitative interviews with migrant GBMSM to understand their connections to health services and various communities. This study found GBMSM were influenced through informal sharing of sexual health information and norms aboutsexual health from friends and sexual partners. Chapter 6 uses a latent class analysis of national survey data from GBMSM to assess their sources of social support. This analysis found that connection to gay men specifically had positive associations with HIV/STI testing and use of HIV pre-exposure prophylaxis (PrEP), but that there was a substantial proportion of GBMSM who were not well connected to or supported by other LGBTQ+ people. Chapter 7 discusses the implications of this thesis and makes recommendations about HIV prevention research and implementation among GBMSM in Australia. This thesis shows how social connection between GBMSM remains relevant for HIV prevention, but adaptation to existing approaches to HIV prevention is needed to reach GBMSM who are not socially engaged with LGBTQ+ people.

Grantor dc:publisher

UNSW, Sydney

Year dc:date

2025

Author dc:creator

• Chan, Curtis ; https://orcid.org/0000-0002-9581-1011

• HIV
• Gay and bisexual men
• Gay community
• Sexual health
• Men who have sex with men
• Social networks
• Migrant health
• HIV prevention
• Pre-exposure prophylaxis

Statement dc:rights

• open access
• CC BY 4.0
• free_to_read

Licence

• https://purl.org/coar/access_right/c_abf2
• https://creativecommons.org/licenses/by/4.0/

Language dc:language

en

Identifier

https://doi.org/10.26190/unsworks/31619

OAI identifier oai:identifier

oai:unsworks.library.unsw.edu.au:1959.4/105925