Engaging ‘gay’ businesses in HIV prevention ‘Everywhere’: Findings from a qualitative study in eight European cities

Abstract

Objective: ‘Gay’ businesses providing physical and virtual sex spaces for men who have sex with men (MSM) have been shown empirically to be useful sites for public health and health promotion interventions. While HIV incidence in Europe has been more or less stable in recent years, the number of infections attributed to MSM has continued to increase with new cases almost doubling in Western and Central Europe between 2000 and 2006. Set within the context of the Everywhere Project, the objective of this study was to explore the feasibility and acceptability to ‘gay’ businesses of developing and implementing a European model of HIV prevention focusing on MSM that provides common prevention standards across eight European countries. Design: A qualitative study Setting: ‘Gay’ businesses that bring men together and facilitate sex between them in ‘gay’ tourist destinations and other European capital cities. Method: Semi-structured qualitative interviews were conducted with 54 ‘gay’ business representatives from different European cities. Interviews were recorded, transcribed, translated, and analyzed using a ‘framework’ approach. Results: Many representatives of ‘gay’ businesses reported being willing to provide HIV prevention activities that target MSM in their venues and perceive this as part of improving their corporate image of being a socially responsible enterprise. However, concerns were voiced around issues such as fear of alienating customers, and inciting stigma and discrimination, safe-sex fatigue and lack of knowledge of prevention messages, as well as the need for appropriate condom and lubricant distribution networks. Businesses also reflected on the potential benefits and disadvantages of being involved in a scheme that provides a common and recognizable framework for HIV prevention across multiple European countries. Conclusions: Early conclusions from this exploratory research suggest that a European-wide model of HIV prevention is acceptable and feasible to those working in ‘gay’ businesses. Further investigations, however, are required to develop solutions in order to overcome identified social, cultural and practical barriers.