HIV and Men Who Have Sex with Men: Where is the Canadian Epidemic Headed?

Jennifer A. Siushansian, Mai Nguyen, and Chris P. Archibald, Centre for Infectious Disease Prevention and Control, Health Canada.

Available data suggest that there was an increase in HIV infections among men who have sex with men (MSM) in 1999-2000 compared to preceding years, at least in some parts of Canada. This finding is substantiated by data on ongoing sexual risk behaviour among MSM, as well as data showing increases in rectal gonorrhea or outbreaks of other sexually transmitted infections (STIs) among MSM in several large urban centres across the country. Recent national studies have shown similar increases in rates of STIs in the general population as well. The Canadian situation in relation to MSM is discussed in the context of recent data that are emerging on the extent of HIV, STIs and associated risk behaviours among MSM internationally. Increases in HIV incidence have been observed in San Francisco and Madrid. An upswing in HIV-associated risk behaviours and/or STIs has also been observed among MSM in major cities in the US, the Netherlands, England, and Australia. Possible explanations for these trends are discussed, and specific recommendations are made to revitalize HIV prevention efforts among MSM, to conduct more research on gay men’s health and wellness, and to improve surveillance of HIV and sexual risk behaviours. (The Canadian Journal of Human Sexuality, 2000: 9: 219-238).

Friendship Patterns Among Lesbian and Gay Youth: An Exploratory Study.

Margaret Schneider and Jennifer Jo Witherspoon, Ontario Institute for Studies in Education, University of Toronto.

Research and commentary on lesbian and gay youth indicates that this population is in particular need of social support, especially from peers, both lesbian and gay as well as heterosexual. Yet, very little is known about the friendship patterns of lesbian and gay youth. This study explores these friendship patterns in the expectation that such research will suggest new ways of assisting lesbian and gay youth in finding social support. Data were collected from 22 lesbian and gay youth and 29 heterosexual youth between the ages of 16 and 21 years. Results indicated that lesbian and gay youth lived further away from friends and had not known their friends as long as their heterosexual counterparts. Gay males and heterosexual females talked more often to friends on the phone with friends than did lesbians or heterosexual males. Gay males were more likely than anyone else to have friends of the opposite sex and least likely to have friends of the same sexual orientation. Lesbians were the most likely to have sexual contact with people they considered to be friends. The implications of these findings are explored. (The Canadian Journal of Human Sexuality, 2000; 9: 239-246).

Method-Related Experiences of Canadian Women Using Depo-Provera for Contraception

Mary Rucklos Hampton, University of Regina, Barb McWatters, Planned Parenthood Regina, and Bonnie Jeffery, University of Regina.

A chart review of current and recent users of Depo-Provera at a community-based Canadian clinic documented the experiences of young women with this method of contraception and identified their reasons for choosing it and either continuing or discontinuing use. A snapshot sample of active charts over a 3-month period yielded 40 visits of clients who had received an injection during that period and 19 who were prior users. Average age at first injection for the total sample (N = 59) was 19 years. All had previously used another method (pill, 65%, condom, 31%), 38% had one or more prior pregnancies, and 15% had had an induced abortion. The primary reason for choosing Depo-Provera was convenience (primarily forgetting to take birth control pills) with effectiveness, pill side effects, post pregnancy, and regulation of periods cited less often. Satisfaction with the method was the major reason given for continuation and single or multiple side effects as the reasons for discontinuation. Side effects were reported by 21% three months after first injection and by 30-34% after each of the subsequent three injections. The high estimated one-year continuation rate of 83% was thought to be due to effective ongoing counselling since continuers also experienced side effects. (The Canadian Journal of Human Sexuality; 2000; 9: 247-257).