This thesis explores the psychosocial dynamics of sexual risk-taking in men who
have sex with men, with particular focus on the dilemmas that gay men face in
establishing trust in themselves and reasonable trust and intimacy with their
sexual partners. As well, the practical function of this study is to analyze past and
current social marketing efforts aimed at reducing the spread of HIV/AIDS, and
to offer suggestions for how to approach a strategy to reduce HIV incidence in
gay men and at the same time bolster efforts to assist men who have sex with
men (MSM) in adhering to safer sex guidelines.
In part, this thesis uses a sample of participants of the Vanguard Project cohort
(St. Paul's Hospital, Vancouver, British Columbia), in order to explore the social
meanings attributed by MSM towards sex, risk, intimacy, and attitudes toward
HIV/AIDS. Through the use of first-person narratives, this thesis examines the
concordance or discordance of MSM beliefs and behaviour with long-standing
theoretical models of harm reduction methods concerning sexual risk.
The study reveals that, in great measure, due to past life course events, many gay
men suffer from a lack of trust in themselves, which results in a tendency to
make irrational or unreasonable decisions concerning their long-term sexual
health, and a lack of trust in other gay men. As welL through the misguided and
often untruthful health models that advocate fewer sexual partners and rely upon
the false assumption that all potential sex partners are carriers of contagion, the
sense of mistrust has been reinforced. The lack of confidence in self and others
further translates into a suspicion of the motives and/or efficacy of social
institutions entrusted with community health development and maintenance,
rendering their efforts even less effective. Moreover, traditional harm reduction
messages, especially 'fear campaigns', often act as a deterrent, rather than as an
incentive, to harm reduction. Of more appeal are supportive harm reduction
messages delivered by someone whom the recipient trusts, especially when the
social meanings of sex, risk, trust and intimacy are, for many gay men, less fixed
and more contingent than for the population at large. This means that attempts
to modify risky behaviour must acknowledge and negotiate multiple meanings,
shifting values and changing social climates, as well as routine epidemiological
concerns.
The research identifies four key themes within a problematic of trust, risk and
intimacy, and delineates the harm reduction social complexities experienced by
gay men in the study group; these recurring themes deal with family and early
sociahzation, internalized homophobia, contingency and instability of meanings
of risk, trust and sex, and the toistworthiness of the messengers of harm
reduction strategies. Out of these recurring themes come a number of
recommendations for remedial programs aimed at both mid- and long-term
reductions in HIV incidence. The recommendations are grounded in the
recognition that homophobic and/or dysfunctional social conditions are, to a
great extent, implicated in sexual risk behaviour, and therefore must be eliminated
or ameliorated before meaningful harm reduction gains can be realized. The
discussions with the gay men in the study reveal their need for positive role
models and communal social support in their efforts to combat HIV infection,
suggesting a need to rethink the meanings of what it is to be gay, a need to
redevelop and revitalize what was once a vibrant and cohesive corrimunity, and
bearing in mind the lessons of the past, a need to re-approach the task of
sternming the tide of HIV infection in ways that are sensitive to the factors that
adduce high-risk sexual behaviour.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:BVAU.2429/13299 |
| Date | 11 1900 |
| Creators | Botnick, Michael R. |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Relation | UBC Retrospective Theses Digitization Project [http://www.library.ubc.ca/archives/retro_theses/] |
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