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Asian MSM, transgenders not accessing HIV testing – APCOM

To better understand why MSM and transgender people are not accessing HIV-related health services, the Asia Pacific Coalition on Male Sexual Health (APCOM) is joining other regional development and community partners to convene a consultation on the matter. “It is important that community voices are heard, they have to be central in creating demand and improving the take-up for these vital services,” said Midnight Poonkasetwattana, executive director of APCOM.

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A great concern of many public health professionals is the large numbers of men who have sex with men (MSM) and transgender people in Asia not accessing HIV testing and counselling (HTC). Even with such great concerns, there is very little real data that exists adequately measuring the scale of this problem, or the reasons behind it.

In order to better understand why MSM and transgender people are not accessing these vital health services, the Asia Pacific Coalition on Male Sexual Health (APCOM) is joining other regional development and community partners to convene a consultation on “Regional Meeting on Community-based HIV testing: Challenges and Opportunities” this October in Bangkok, Thailand. Having such information would greatly increase future efforts at regional and country level to ensure that community demand for HIV testing is created, alongside new testing delivery models that will better address community needs.

“It is important that community voices are heard, they have to be central in creating demand and improving the take-up for these vital services and it is hoped this event will provide real insights into how this can be achieved,” said Midnight Poonkasetwattana, executive director of APCOM.

Concerns over poor coverage, access and supportive environments, held by a number of community members, will be high priority for the many community-based organisations attending the consultation.

“Many current testing models still have a lot to achieve in terms of reaching communities and enabling them access to testing services. However, in scaling up we should ensure the rights of people being tested, and that ethical guidelines are in place. Such issues will also be taken up in the consultation,” said Malu S. Marin, regional coordinator of the Coalition of Asia-Pacific Regional Networks on HIV/AIDS (7 Sisters), one of the conveners of the Regional Consultation.

While access to HIV treatment and care services have expanded in Asia and the Pacific region (44 % of people in need had access to treatment in 2011), access to and uptake of HIV testing among key populations (MSM; sex workers; transgender, people who use drugs and their partners) remains low. More than 50% of people living with HIV are not aware of their HIV status. Many individuals learn of their HIV status at the hospital when diagnosed with an opportunistic infection occurring from advanced disease. This late diagnosis drives the steady increase of annual AIDS-related deaths. There are already some examples of effective interventions. In China in 2012, GZTZ used the Internet to mobilize as many as 5,389 MSM into HIV testing, accounting for 83% of the city’s yearly total.

The consultation will have representatives from the government sectors, essential to understand the communities’ views of HTC and their experiences with service providers, and perform a critical analysis of the current HIV testing models in the region.

Figure1. Percentage of key populations (KP) who received an HIV test in the last 12 months and know their results (selected countries)
KAP

“We know people reach HIV treatment, care, and the full range of prevention options through the gateway of HIV Testing and Counseling (HTC). Our colleagues in China, at GZTZ, highlighted to us how innovation, through the use of the Internet, could prove effect in scaling up HIV testing services amongst MSM. We hope this meeting with facilitate more sharing and learning on this important topic,” Poonkasetwattana said.

APCOM hopes to draw attention to more examples, similar to that in China, through the launch of their new Highlight series focusing on evidence-based examples of good practices in the region.

NEWSMAKERS

Tech-related jealousy is real… including LGBTQIAs

According to the Pew Research Center, about one-third of LGB partnered adults whose significant other uses social media report that they have felt jealous or unsure in their current relationship because of how their partner interacted with others on social media (versus 22% of straight people who say this).

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Social media can be a source of jealousy and uncertainty in relationships – especially for younger adults.

This is according to a Pew Research Center study (with the survey conducted in October 2019, though the study was only released recently) that found that, indeed, many people encounter tech-related struggles with their significant others.

In “Dating and Relationships in the Digital Age”, Pew Research Center noted that “younger people value social media as a place to share how much they care about their partner or to keep up with what’s going on in their partner’s life.” However, “they also acknowledge some of the downsides that these sites can have on relationships.”

Twenty-three percent (23%) of adults with partners who use social media say they have felt jealous or unsure about their relationship because of the way their current spouse or partner interacts with other people on social media.

Now get this: the number is higher among those in younger age groups.

Among partnered adults whose significant other uses social media, 34% of 18- to 29-year-olds and 26% of those ages 30 to 49 say they have felt jealous or unsure in their current relationship because of how their partner interacted with others on social media. This is definitely higher than the 19% of those aged 50 to 64 who say this, and 4% of those ages 65 and up.

The insecurity is also common among those not married – i.e. 37% of unmarried adults with partners who are social media users say they have felt this way about their current partner, while only 17% of married people say the same.

Women are reportedly more likely to express displeasure with how their significant other interacts with others on social media (29% vs. 17% for men).

Meanwhile, college graduates are less likely to report having felt this way than those with some college experience or a high school degree or less.

And yes, LGBTQIA community members are no different.

According to the Pew Research Center, about one-third of LGB partnered adults whose significant other uses social media report that they have felt jealous or unsure in their current relationship because of how their partner interacted with others on social media (versus 22% of straight people who say this).

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For people in diverse areas, community identity supersedes racial, ethnic differences

Social diversity challenges people to think in new ways, and those people end up seeing other social groups as more similar. This is associated with more positive attitudes toward other groups and positive well-being outcomes.

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In an increasingly polarized world, many see people who are different from them as “outsiders,” or even a threat. Yet, around the world, this tends to be more common in traditionally homogenous societies, according to a series of studies led by Princeton University.

The analysis, published in the Proceedings of the National Academy of Sciences, found that people living in more diverse areas were more likely to perceive themselves and others as being part of the same local community — e.g., New Yorkers — regardless of ethnic and cultural differences. This finding held true globally, nationally, and individually. People living in more homogeneous areas, however, maintain racial, ethnic and religious stereotypes that are less accepting of people outside of that identity.

“This is a hopeful and optimistic message, showing that people can get used to anything. In other words, the ‘melting pot’ lives,” said Susan Fiske, the Eugene Higgins Professor of Psychology in the Woodrow Wilson School of Public and International Affairs, who conducted the study with Princeton Ph.D. student Xuechunzi Bai, and Miguel Ramos, a former postdoctoral researcher at Princeton now at the University of Birmingham.

Fiske added: “They can adapt to being in quarantine, or living in a neighborhood with different people. What probably disrupts this process, however, are divisive political leaders who purposefully try to agitate or polarize, and exaggerate the differences between people.”

The researchers began the study with conflicting hypotheses. Fiske thought the more diversity you have, the more you realize how different everyone is, but Ramos thought the opposite — that diversity could bring people together. Ramos based his hypothesis on work he’d published with Princeton professor Doug Massey that found that people adapt to diversity over time. This, coupled with Bai and Fiske’s work on mental maps of stereotypes, motivated the work.

The authors analyzed a range of sources comprising data from 46 countries around the world, data from 50 states in the U.S., and longitudinal data from American university students who were followed during the entire period of their time in college.

In the worldwide study, participants were asked to list up to 20 different social groups they could spontaneously recall. They then ranked each group on competence and warmth, two key variables in shaping stereotypes, according to Fiske. The scores were combined, revealing what the researchers called “stereotype dispersion,” or differentiation, between ethnic groups.

A similar methodology was followed in the U.S. study, which asked more than 1,500 participants online to rate 20 immigrant groups on competence and warmth. They were then instructed to describe their perceived diversity of their home state on a five-point scale. Like the first study, the researchers combined the scores to calculate the stereotype dispersion between states.

In the third and final study, the researchers turned their focus to American college students who were asked questions about campus diversity and perceived stereotypes for Whites, Blacks, Hispanics, and Asians. They were also asked questions about life satisfaction and well-being. The scores were again combined.

Across all three studies, the findings held consistent: Social diversity challenges people to think in new ways, and those people end up seeing other social groups as more similar. This is associated with more positive attitudes toward other groups and positive well-being outcomes. The researchers say this is an optimistic finding, especially during uncertain times.

“If you can gather people together, you can encourage cooperation and equal status,” Fiske said. “It’s not going to happen everywhere, and it’s a delicate situation to set up, but the idea that mere exposure to diversity can improve relationships is hopeful news.”

The paper, “As diversity increases, people paradoxically perceive social groups as more similar”, appeared in PNAS.

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LGB individuals have less contact with, and live geographically farther from siblings

LGB individuals had less frequent contact with, and lived geographically farther from their siblings. The pattern of effects was similar for bisexual and gay or lesbian individuals, and stronger for male than female sexual minority individuals.

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Lesbian, gay and bisexual people tend to live geographically farther away from their brothers and sisters, and have less less frequent contact with them. This is according to new research from Australia, published in the Journal of Marriage and Family.

The study – “Sexual Orientation, Geographic Proximity, and Contact Frequency Between Adult Siblings“, authored by Francisco Perales and Stefanie Plage – suggests that (no surprise here) sexual stigma is a reason why this is so, as it can harm family relationships.

To compare the closeness of sibling relations between individuals with different sexual orientations, the study used data from an Australian national survey (Household, Income and Labour Dynamics in Australia Survey). The researchers analyzed data from 13,252 individuals with 35,622 individual‐sibling pairs.

Key results indicated that — when compared with heterosexual individuals — LGB individuals had less frequent contact with, and lived geographically farther from their siblings. The pattern of effects was similar for bisexual and gay or lesbian individuals, and stronger for male than female sexual minority individuals.

According to the researchers, the findings are consistent with theoretical perspectives highlighting the unique barriers to socioeconomic inclusion experienced by individuals from sexual minorities. They suggest that these barriers begin within the nuclear family.

As quoted by PsyPost, study author Perales said: “We know that people who identify as LGB tend to experience poorer outcomes across life domains than heterosexual people… The dominant explanation for this is that these individuals receive lower levels of social support from their family and the broader community. This is because non-heterosexuality remains a stigmatized and not fully accepted social status.”

Family support – or its lack – is an important issue for members of the LGBTQIA community. A 2016 study, for instance, noted that more than 42% of the individuals who self-identified as transgender or gender nonconforming reported a suicide attempt, and over 26% had misused drugs or alcohol to cope with transgender-related discrimination. After controlling for age, race/ethnicity, sex assigned at birth, binary gender identity, income, education, and employment status, family rejection was associated with increased odds of both behaviors. Odds increased significantly with increasing levels of family rejection.

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LGBTQIA people think domestic violence is a cis-straight issue – study

A study found that domestic and family violence (DFV) and intimate partner violence (IPV) were perceived by community members and professional stakeholders to be a “heterosexual issue that did not easily apply to LGBTQIA relationships.”

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Members of the LGBTQIA community think domestic violence is a cis-straight issue. This is according to a study conducted by Relationships Australia New South Wales (RANSW) and ACON (formerly the AIDS Council of NSW), and was published by Australia’s National Research Organisation for Women’s Safety.

As stated in “Developing LGBTQ programs for perpetrators and victims/survivors of domestic and family violence”, many LGBTQIA people think domestic violence is an issue only faced by people who are both cisgender and straight.

The study found that domestic and family violence (DFV) and intimate partner violence (IPV) were perceived by community members and professional stakeholders to be a “heterosexual issue that did not easily apply to LGBTQIA relationships.”

“In particular, many community members held the view that relationships between (LGBTQIA) people could avoid the inherent sexism and patriarchal values of heterosexual, cisgender relationships, and, by implication, avoid DFV/IPV.”

In a way, this doesn’t come as a complete surprise, considering the language and framework used when discussing DFV and IPV.

The study noted that “although DFV and IPV have received increased attention in recent years, the focus has been on addressing intimate abuse between cisgender, heterosexual people with greater attention paid to male perpetrators.”

Also, “clients and potential clients did not have a full understanding of what constitutes domestic violence and felt this term related only to physical forms of abuse.”

And so “although (LGBTQIA) perpetrator interventions, and research around them, are emergent at best, the scant literature does provide a little information which can be used
to inform program developers and clinical practice.”

The researchers also noted particular kinds of abuse not seen among cis-straight people.

For instance, there are “identity-based tactics of abuse” where the fear of exposure or outing is used as a weapon within queer relationships.

After an individual has appraised that he/she may be experiencing abuse, seeking appropriate intervention may also be challenging because of non-inclusive services currently available.

The researchers recommended the following:

  • Make LGBTQIA inclusivity training required learning for all DFV/IPV sector staff, particularly those employed in specialized DFV/IPV roles.
  • Advocate that inclusivity training be made mandatory within clinical organizations, and among police and legal professionals.
  • Develop referral pathways into LGBTQIA-friendly DFV/IPV programs for key professionals, such as court support workers and magistrates.
  • Increase representation of LGBTQIA people in promotional material about DFV/IPV.
  • Use social media platforms to increase DFV/IPV awareness in LGBTQIA communities and use these channels to engage clients for future programs.
  • Provide ongoing funding to develop, trial and implement tailored programs. Short funding cycles do not provide adequate time to populate groups within an underdeveloped community area.
  • Ensure programs respond to diverse needs within mixed LGBTQIA groups and manage transphobia and biphobia.

This isn’t the first time DFV and IPV within the LGBTQIA community was tackled – even if it remains to be under-researched, and not widely tackled within the LGBTQIA community. In 2018, for instance, a study found that nearly half of men in same-sex couples suffered some form of abuse at the hands of their partner, according to a study that surveyed 320 men (160 male couples) in Atlanta, Boston and Chicago in the US to measure emotional abuse, controlling behaviors, monitoring of partners, and HIV-related abuse.

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Use of religious beliefs to justify rights violations must be outlawed – UN expert

States have an obligation to guarantee to everyone, including women, girls and LGBT+ people, an equal right to freedom of religion or belief, including by creating an enabling environment where pluralist and progressive self-understandings can manifest.

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Laws underpinned by religious conviction that discriminate against women and members of the LGBTQIA community should be repealed, just as gender-based violence carried out in the name of religion by non-State groups should also be addressed.

This is according to Ahmed Shaheed, UN Special Rapporteur on freedom of religion or belief, who submitted a report to the Human Rights Council.

“I firmly reject any claim that religious beliefs can be invoked as a legitimate ‘justification’ for violence or discrimination against women, girls or LGBT+ people”, said Shaheed, who noted that “the right to freedom of religion protects individuals and not religions as such.”

In his report, the UN expert urges States to particularly repeal gender-based discrimination laws, including those enacted with reference to religious considerations that criminalize adultery; criminalize persons on the basis of their actual or perceived sexual orientation or gender identity; criminalize abortion in all cases; and facilitate religious practices that violate human rights.

The independent expert also expressed deep concern at the rise in political campaigns, and those carried out by religious institutions and their followers, which invoke religious freedom to seek to rollback human rights that are, he said, fundamental to gender equality, at both national and international levels.

“Women and LGBT+ people experience discrimination and violence inflicted in the name of religion by State and non-State actors that impedes their ability to fully enjoy their human rights, including their right to freedom of religion or belief,” said Shaheed.

For Shaheed, “religious communities are not monolithic. In many religions, a plurality of self-understandings exists, some of which may be more committed than others to advancing gender equality and non-discrimination.” And “while religious organizations are entitled to autonomy in the administration of their affairs, such deference should be extended within a holistic conception of rights grounded in the universality, indivisibility, interdependence and inalienability of all human rights.”

As such, “States have an obligation to guarantee to everyone, including women, girls and LGBT+ people, an equal right to freedom of religion or belief, including by creating an enabling environment where pluralist and progressive self-understandings can manifest,” Shaheed said.

Special Rapporteurs are part of what are known as the Special Procedures of the Human Rights Council. The appointed experts work on a voluntary basis; they are not UN staff and do not receive a salary. They are independent of any government or organisation and serve entirely in their individual capacity.

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LGB online daters report positive experiences… plus harassment

LGB online daters are more likely than their straight counterparts to experience a range of negative behaviors on dating platforms, varying from name-calling to physical threats. Among those who have ever used an online dating site or app, they reported experiencing at least one of the forms of harassment measured in this survey on those sites and apps (69%, compared with 52% of their straight counterparts).

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Lesbian, gay and bisexual (LGB) adults who use online dating sites and apps generally report that their experiences with online dating have been positive – even more than straight online daters (65% said their experience was very or somewhat positive, versus 56% of straight online daters).

This is according to a Pew Research Center survey, which found that a majority of LGB adults (55%) report that they have used an online dating site or app at some point, roughly twice the share of straight adults (28%) who say the same.

Among LGB adults who are married, living with a partner, or in a committed relationship, 28% say they met their current partner online. This is more than double when compared with 11% of partnered straight adults.

Also, among LGB people who are now single and looking for a relationship or dates, 37% are currently online dating (versus 24% of straight people who are single and looking).

However – and this is worth highlighting – LGB online daters are also more likely than their straight counterparts to experience a range of negative behaviors on dating platforms, varying from name-calling to physical threats. Among those who have ever used an online dating site or app, they reported experiencing at least one of the forms of harassment measured in this survey on those sites and apps (69%, compared with 52% of their straight counterparts).

More than half of LGB online daters (56%) say they have received a sexually explicit message or image they did not ask for, compared with 32% of straight online daters who say the same.

Stalking was also raised as an issue, with roughly half of LGB online daters (48%) saying that someone continued to contact them after they said they weren’t interested, compared with 35% of their straight counterparts.

About four in 10 LGB online daters (41%) say someone called them an offensive name on one of these sites or apps – 16 percentage points higher than the share of straight online daters (25%) who say the same.

Lastly, 17% of LGB online daters said that someone on a dating site or app threatened to physically harm them. This is more than twice the share of straight online daters (7%).

Perhaps not surprisingly, according to the Pew Research Center survey, LGB adults who have ever online dated are more likely than straight online daters to think harassment and bullying is a “common problem” on dating sites and apps (70%, compared to 61% of non-LGBs).

No matter the drawbacks, don’t expect online daters – LGBT or straight – to just dump it.

As per the Pew Research Center survey, even among those who experienced at least one of the asked-about forms of harassment on dating sites and apps, they still said that online dating is safe for the most part. Three-quarters of LGB people who have experienced at least one of the harassing behaviors saying it’s a very or somewhat safe way to meet someone, with 64% of straight online daters who have been harassed agreeing.

And with 78% of LGBT online daters (and 69% of their straight counterparts) still believing that dating sites and apps are a very or somewhat safe way to meet people, this trend isn’t going anywhere soon…

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