Publications

Young adult sex workers may benefit from sexual and reproductive health care, but little research has documented their access experiences. A community-based mixed-methods study in Toronto, guided by a youth advisory committee of four people with lived experience of sex work, surveyed 54 people aged eighteen to twenty-nine and held focus groups and interviews with seventeen more. Access was suboptimal: fifteen percent had no regular source of care and only eleven percent disclosed sex work to providers. Anticipated or actual provider stigma was the dominant barrier, while non-judgmental providers, especially those with sex work experience, helped. Participants proposed seven practices to improve services.

So-called conversion practices aim to suppress the sexual and gender identities of Two-Spirit, lesbian, gay, bisexual, trans and other queer people, and are linked to serious psychosocial harm, though how that harm unfolds has been poorly documented. This qualitative interpretive description study thematically analysed in-depth interviews conducted between January and July 2020 with 22 people who had lived through SOGIECE. Participants described shame and a sense of brokenness, isolation that cut them off from partners and 2SLGBTQ+ communities, and profound emotional distress including anxiety, depression and suicidality. The authors call for legislation, family education and targeted mental health supports.

How do gay, bisexual and queer men understand the link between their drug and alcohol use and their mental health? Twenty-four interviews with GBM in Toronto reveal deep ambivalence. Participants described substances as therapeutic aids that eased distress, and also as corrosive to wellbeing, drawing a fine line between use that felt self-productive and use that felt self-destructive. Some framed their choices as problematic or unhealthy; others presented themselves as controlled, responsible actors simply doing what a normal gay man would do. The authors connect this ambivalence to polarizing community and scientific binaries around addiction, control and rationality.

Gay men aging with HIV occupy a gap in services, as one participant's remark about no slot existing for them captures. This qualitative Canadian study draws on interviews with 16 gay-identified men living with HIV aged 50 and over, using intersectionality to account for the interlocking forms of marginalization they face. The analysis maps their practical, social, and mental health needs, and considers which services could be designed or adapted in response. The authors also stress the value of specialized training for caring professionals and argue that older gay men living with HIV should help develop and deliver those services.

Undetectable equals untransmittable is now settled science, but everyday understanding lags behind. Researchers conducted in-depth, semi-structured interviews with 25 sexual minority men in Vancouver, including men living with HIV, and analysed the transcripts using grounded theory. Most participants took undetectable to mean low or slim risk of passing on HIV, rather than no risk at all. They described discussing undetectability in person and on sexual networking apps, sometimes confusing it with PrEP. HIV-negative men voiced scientific scepticism and lingering fear about sex with a partner living with HIV, a pattern the authors name untransmittable scepticism, showing stigma endures.