Travelling for sex, attending gay-specific venues, and HIV-related sexual risk among men who have sex with men in Ontario, Canada

Abstract

Gay, bisexual, and other men who have sex with men (GBMSM) remain the group most affected by HIV in Canada. Travelling for sex and attendance at specific venues for sex have been linked to elevated HIV risk among GBMSM, but most research on these mobilities and sexual health has focused on GBMSM living in large cities. The purpose of this study was to explore HIV-related sexual risk among GBMSM from mid-sized cities and rural regions who attend gay-specific venues and/or travel for sex. A cross-sectional online survey was completed by a convenience sample of individuals (n = 526) self-identifying as LGBTQ who lived, worked, or studied in Waterloo Region, a mixed urban-rural region in the southwestern part of Ontario, Canada. Analyses for the current study were restricted to those identifying as GBMSM (n = 269). Multinomial logistic regression models were created to explore travelling outside of the Region for sex, as well as recent attendance at gay-specific venues, and their associations with a contextual measure of HIV-related sexual transmission risk. Individuals reporting high HIV risk were significantly more likely to travel outside of Waterloo Region for sex than individuals reporting no HIV risk (OR = 3.08; 95% CI: 1.20, 7.93). The association between travel and risk was strengthened after controlling for education, marital status, sexual orientation, gender modality, and social support (OR = 5.07; 95% CI: 1.73, 14.87). GBMSM who reside outside of large cities may travel farther, enter unfamiliar scenes, or be less privy to information disseminated through current health promotion initiatives for GBMSM in large cities. Due to the dynamic geographic status of GBMSM travelling for sex and attendance at venues, HIV prevention initiatives that target these individuals may benefit from additional conceptualization of health promotion delivery in terms of social and sexual networks, rather than simply by place of residence.