MSM Sexual Health & HIV Prevention

In Singapore, the Human Immunodeficiency Virus (HIV) epidemic has been on the public health agenda since 1985. Men who have sex with men (MSM) have been identified as a group at high risk of contracting HIV (UNAIDS, 2012). In 2011, the proportion of men who contract HIV via homosexual intercourse has risen sharply from 19% in 2001 to 55% (MOH, 2012). As such, there is an urgent need to develop safe sex interventions for the MSM community in Singapore.   MSM form a particularly vulnerable segment of the population because of their marginalized status. Heteronormative ideals of family and society, as well as social structures (e.g., laws, media regulation) which delegitimize and/or criminalize homosexuality, erase the MSM population from mainstream discourse (Cheng, 2009; Goh, 2008; Tan & Lee, 2007). The voices of MSM are absent in discussions about their health, especially in development of programs and policies directly targeted at this group.   In addition, this study eschews conventional research methodologies which use individualistic and highly cognitive models of behavioral change, such as the Theory of Reasoned Action (Ajzen & Fishbein, 1980) and the Extended Parallel Processing Model (Witte, 1992), as basis to develop health interventions. Such efforts have been criticized by health communication scholars (Airhihenbuwa & Obregon, 2000; Dutta 2007, 2008; Lupton, 1994) for their top-down approach and lack of relevance and efficacy for the target population.   The study employs a narrative approach to explore the sexual behavior of Singaporean MSM. Stories enable cultural actors to articulate their lived experiences within their socio-structural context and cultural framework (Dutta, 2008; Harter, Japp, & Beck, 2005). The study will utilize semi-structured, in-depth interviews with MSM community members to gather culturally-grounded knowledge of their sexual behaviors. In collaboration with LGBT welfare organisation Oogachaga, the researchers hope that this database will become the basis for developing community-based and culturally-centered interventions for HIV prevention and safe sex promotion.

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