Men who have sex with men (MSM), physicians, and non-government organizations (NGOs): finding agreement on the HIV risk environment and service provision for MSM in Russia

Published: July 21, 2010

A. Peryshkina1, D. Kizub2, I. Deobald1, V. Moguilnyi1, N. Masenior2, A. Wirtz2, I. Kostetskaya1, F. Sifakis2, C. Beyrer2

1AIDS Infoshare, Moscow, Russian Federation, 2Johns Hopkins Bloomberg School of Public Health, Epidemiology, Baltimore, United States

Background: HIV prevalence estimates among MSM in Russian urban areas range from 0.0-9.2%. The government estimate of HIV prevalence among MSM was 1.1% in 2007, but is likely low given Russia’s name-based reporting system and stigma affecting MSM.
Methods: Focus group discussions and in-depth interviews were conducted in 2008 to investigate health and HIV prevention needs for MSM in Russia. Using purposeful sampling, 70 MSM and 68 service providers participated in Moscow, Kazan, and Sochi.
Results: Common themes included a lack of consensus on the need for targeted services and concern that targeted efforts would further marginalize MSM. Providers felt that MSM were aware of sexual risks, yet some men disagreed and others suggested knowledge did not necessarily beget safe behavior.
MSM rarely disclosed sexual practices to physicians and avoided testing due to anticipated stigma; some did not understand the importance of disclosure. Men stated that stigma often leads to concealed relationships and high risk sexual encounters.
Migration to larger cities was common among men and perceived to be an important risk factor in HIV transmission. HIV and STI treatment requires official residency, yet this requirement limits access to migrant MSM populations.
Though some NGO’s offer services for MSM in these cities, men were often unaware of existing programs. Men suggested that telephone hotlines and the Internet would be beneficial to reaching migrants, married MSM, and others not gay-identified. Many men expressed desire for gay-friendly psychological and counseling services.
Conclusions: There is inconsistency in access to care and prevention services for MSM and in men’s and service providers’ perceptions of risk. Low awareness of available services prevents utilization while stigma and discrimination are real barriers to program access. National funding for HIV prevention programs is changing but these data suggest prevention programs for gay and other MSM should be prioritized.

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