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Introduction: New Zealand has a unique illicit drug market, gay cultures and drug use patterns. Minimal attention has been given to how drug use shapes sexual practice, especially in the era of biomedical HIV prevention among gay and bisexual men (GBM). Methods: An online cross‐sectional study of GBM ('Flux NZ') adapted from an Australian study was undertaken to explore connections between drug use, sexual practice, health and community. We describe drug use patterns, then identify three discrete groups determined by intensity of recent (past 6 months) sexual practice: no recent sex, recent sex and recent sexualised drug use. We examine factors associated with these groups and identify factors independently predicting sexualised drug use. Results: Of 739 participants, almost a third had engaged in group sex (29%), 17.5% were taking pre‐exposure prophylaxis (PrEP), 6.5% were HIV positive. Overall, 59.5% had recently used illicit drugs (16.9% methylenedioxymethamphetamine, 6% methamphetamine, 3.3% gamma‐hydroxybutyrate acid, 1.4% ketamine). Sexualised drug use was common (35.7%). Those engaged in sexualised drug use were connected to gay community and had a high uptake of biomedical HIV prevention. Independent predictors of sexualised drug use included being sexually adventurous, knowing their HIV status, having more than 10 recent sexual partners, engaging in group sex and sex at a sex‐on‐site venue. Discussion and Conclusions: Many GBM engaging in sexualised drug use manage HIV transmission risks through regular testing, PrEP and HIV treatment. HIV prevention efforts should target GBM with less intensive sexual behaviour but who may be at comparatively higher risk of HIV transmission. [ABSTRACT FROM AUTHOR]

Background and Objectives: Gay and bisexual men (GBM) are deferred from donating blood in many countries. Perceptions by GBM that blood donor deferral policies are unjustifiably discriminatory, especially due to advances in HIV prevention, could contribute to non‐compliance and need to be understood. We explore blood donation interest and history among GBM and attitudes towards donor deferral policies for the first time in New Zealand (NZ). Materials and Methods: Data from a cross‐sectional online survey of GBM in NZ were examined. We constructed three groups: (1) never donated blood and not interested; (2) never donated but expressed interest; and (3) previously donated blood. We tested these for association with demographic and behavioural variables, as well as attitudes towards blood donation policy. Results: A total of 607 GBM were eligible for the study, of whom 32.9% reported having donated blood previously, 44.3% had never donated blood but expressed interest and 22.7% expressed no interest in donating. Among previous donors, a third (8.6% of the total sample) reported non‐compliance with the deferral policy. Most participants found the 12‐month deferral policy to be too strict (81.8%), unfair (75.4%) and homophobic (68.8%). Conclusion: We estimate that, for the first time in NZ, almost 10% of the sample did not report compliance with the 12‐month deferral policy for men who have sex with men (MSM). Negative attitudes towards the deferral policy were common and could potentially increase the risk to the blood supply if compliance reduces. Further work is needed to inform a deferral policy that is accepted by GBM while maintaining the safety of NZ's blood supply. [ABSTRACT FROM AUTHOR]

Inequities in pre-exposure prophylaxis (PrEP) experiences will impede HIV epidemic elimination among gay and bisexual men (GBM). Ethnicity is a strong marker of inequity in the United States, but evidence from other countries is lacking. We investigated experiences on-PrEP to 12 months follow-up in a prospective cohort of 150 GBM in Auckland, New Zealand with an equity quota of 50% non-Europeans. Retention at 12 months was 85.9%, lower among Māori/Pacific (75.6%) than non-Māori/Pacific participants (90.1%). Missed pills increased over time and were higher among Māori/Pacific. PrEP breaks increased, by 12 months 35.7% of Māori/Pacific and 15.7% of non-Māori/Pacific participants had done so. Condomless receptive anal intercourse partners were stable over time. STIs were common but chlamydia declined; 12-month incidence was 8.7% for syphilis, 36.0% gonorrhoea, 46.0% chlamydia, 44.7% rectal STI, 64.0% any STI. Structural interventions and delivery innovations are needed to ensure ethnic minority GBM gain equal benefit from PrEP. Clinical trial number ACTRN12616001387415. [ABSTRACT FROM AUTHOR]

Australian legal and medical institutions grappled with the changing status of homosexuality during the 1970s. Historians have argued that psychiatry, as a prominent institution on the subject of homosexuality, was key to its de-medicalisation and therefore contributed to homosexuality's increasing social acceptance. Following key legal reforms, and the 1973 Clinical Memorandum released by the Australian and New Zealand College of Psychiatry, psychiatrists shifted away from treating homosexuality as a pathology. However, several prominent psychiatrists continued to practise therapy on homosexual men. Though aimed at alleviating the distress of their 'patients', these therapies reinforced the medical status of homosexuality. This, in spite of progressive reforms by the broader institution of psychiatry, contributed to a medical and social understanding of homosexuality as a medical condition, within a pathological framework. In short, psychiatry in 1970s Australia was a social pressure point on the issue of homosexuality, a place of both relief and medicalisation. [ABSTRACT FROM AUTHOR]

HIV infection is an issue for all gay and bisexual men in New Zealand, including men of Asian ethnicity among whom HIV infection is increasing. This study identifies the ways Filipino gay and bisexual men living in New Zealand talk about and understand issues related to HIV and HIV health-promoting behaviours. A qualitative descriptive methodology was used. Individual face-to-face interviews were analysed using a general inductive analytic approach. Three themes are evident across the men's talk in relation to knowledge and practices around HIV and HIV health-promoting behaviours: (a) safe-sex is about condom use, (b) low levels of engagement with HIV testing, and (c) barriers to engagement with HIV-health promotion. The study results have implications for HIV health promotion and prevention programmes. Specifically, improved health literacy around HIV and prevention technologies is required. Culturally appropriate services and health promotion interventions need to be developed. Improved support and advocacy for gay and bisexual men in the broader Filipino community to counter stigma appear warranted. [ABSTRACT FROM AUTHOR]

In 1952, D'Arcy Cresswell published a verse play, The Forest, set in New Zealand's forested Southern Alps. In what Cresswell called a 'tremendous defense of homosexuality', The Forest depicts a pair of gay male poets pitted against the archangel Lucifer and women, who are in league together to force men to work the land and thereby desacralize it. Cresswell argues that the pressures on Pākehā men to be economically productive and heterosexually reproductive are manifestations of a literally Satanic plot to alienate men from one another and Nature. While many of Cresswell's New Zealand literary contemporaries espoused a Pākehā masculinity involving matey comradeship and a life spent working the land, Cresswell celebrates a New Zealand wilderness he perceives as the last refuge of male love and inspired poetry. Simultaneously queering Milton, inverting Judeo-Christian history by relocating Eden in the Antipodes, and reversing New Zealand history by undoing the modernity that settler colonialism had created, Cresswell counters the terms of his own exclusion from the literary canon by imagining a world upside-down – and inside-out. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Gay and bisexual men (GBM) who inject drugs are disproportionately affected by human immunodeficiency virus (HIV) because of dual transmission risks. New Zealand has a progressive history of harm reduction and was the first country to publicly fund needle exchange programs in 1988 for people who inject drugs (PWID). We combine national HIV epidemiological and bio-behavioural surveillance data to understand HIV risk among this subpopulation.Design and Methods: We examine trends in new HIV diagnoses 1996-2018 by mode of transmission, and compare HIV cases attributed to sex between men (MSM-only), MSM/injecting drug use (IDU) and IDU-only. IDU among GBM in a national HIV behavioural surveillance survey was also examined. We compare GBM by IDU status (never, 'recent', previous) and identified predictors of recent IDU.Results: Of 1653 locally-acquired HIV diagnoses 1996-2018, 77.4% were MSM-only, 1.5% MSM/IDU, 1.4% IDU-only and 14.2% heterosexual mode of transmission. On average, just one HIV diagnosis attributed to MSM/IDU and IDU, respectively, occurred per annum. MSM/IDU cases were more likely than MSM-only cases to be indigenous Māori ethnicity. Of 3163 GBM survey participants, 5.4% reported lifetime IDU and 1.2% were recent IDU. Among GBM, HIV positivity was 20% among recent IDU and 5.3% among never injectors. Predictors of recent IDU were: age under 30; more than 20 male partners; female partner; condomless intercourse; HIV positivity.Discussion and Conclusion: New Zealand has averted high endemic HIV rates seen among GBM and PWID in other countries and results have been sustained over 30 years. [ABSTRACT FROM AUTHOR]

INTRODUCTION: HIV pre-exposure prophylaxis (PrEP) is a new bio-medical means of reducing the risk of HIV infection. It's use by individuals at high risk of HIV acquisition is recommended. Aims: This study identifies the ways immigrant Asian gay men living in New Zealand talk about and understand issues related to PrEP. METHODS: A qualitative descriptive methodology was used. Individual interviews were conducted with 18 immigrant Asian gay men who were not users of PrEP. Participants were aged 21 – 36 years and one-third had arrived in New Zealand within 3 years of completing the interview. Data were analysed using thematic analysis. RESULTS: Three themes evident across the men's talk in relation to pre-exposure prophylaxis were identified: 'I'm not sure what PrEP is'; 'PrEP is not proven'; and 'PrEP is for others, not me'. DISCUSSION: PrEP is necessary for working towards the elimination of HIV. To improve uptake among Asian gay men, improved literacy around HIV and pre-exposure prophylaxis is required. This knowledge needs to be improved at both the individual level in primary care services and collectively through health promotion initiatives. These services and health promotion initiatives need to be provided in ways that encourage engagement by Asian gay men. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) minimises HIV risk and New Zealand was one of the first countries to publicly fund PrEP in 2018. However, no studies have explored in-depth the experience and meaning of living 'on PrEP' among individuals at elevated risk of HIV, such as gay and bisexual men. This qualitative study builds on findings from the NZPrEP demonstration project of early PrEP-adopting gay and bisexual men in Auckland, New Zealand. We interviewed 10 of the 150 NZPrEP participants using an ethnicity equity quota (five European ethnicities and five non-European ethnicities). A phenomenologically-inspired thematic analysis was conducted. We identified three themes. The first, Trusting in the Pill, focuses on the relationship between PrEP and its user, while the second theme, A Liberation of Sorts, details the freedom PrEP offered men, sexually, mentally and socially. The final theme, Reframing Risk, explores the risk perceptions and the conflicting discourses surrounding gay and bisexual men using PrEP. This first qualitative study in New Zealand about the experiences of PrEP early-adopters suggests that the role of PrEP extends well beyond HIV prevention and, for many, involves redefining safe sex even in a country with historically high levels of condom promotion and low HIV incidence.

Background Pre-exposure prophylaxis (PrEP) became publicly funded in New Zealand (NZ) on 1 March 2018. PrEP could have a substantial population-level effect on HIV transmission if scaled up rapidly. An accurate estimate of the size of the PrEP-eligible population would guide implementation.Methods: We drew on nine sources to estimate the PrEP-eligible population, namely Statistics NZ data, Pharmaceutical Management Agency (PHARMAC) data on adults receiving funded antiretroviral treatment (ART), expert advice, estimates of the HIV care cascade, surveillance of undiagnosed HIV in a community sample of gay and bisexual men (GBM), surveillance of HIV diagnoses, NZ Health Survey data on sexual orientation among males, behavioural surveillance among GBM and behavioural data among people living with HIV (PLWH) from the HIV Futures NZ study. From these sources we derived three estimates relating to GBM, non-GBM and total eligible population. Sensitivity analyses examined different assumptions (GBM denominators, proportion PLWH diagnosed, proportion of diagnosed PLWH treated).Results: We estimated that 17.9% of sexually active HIV-negative GBM would be eligible for PrEP, equating to 5816 individuals. We estimated that 31 non-GBM individuals would be eligible for PrEP. Thus, in total, 5847 individuals would be eligible for PrEP, comprising 99.5% GBM and 0.5% non-GBM. Sensitivity analyses ranged from 3062 to 6718 individuals.Conclusions: Policy makers can use enumeration to monitor the speed and scale in coverage as implementation of publicly funded PrEP proceeds. Sexual health and primary care services can use enumeration to forecast PrEP demand and plan accordingly. Better quality data, especially on transgender adults in NZ, would improve the accuracy of estimates. [ABSTRACT FROM AUTHOR]

Background In New Zealand, pre-exposure prophylaxis (PrEP) should target gay and bisexual men (GBM), and equity is an important principle. Baseline characteristics of GBM offered PrEP in a demonstration project with an enrolment quota of 50% non-Europeans are described.Methods: An open-label, single-arm treatment evaluation study design ('NZPrEP') was used. The settings were four publicly funded sexual health clinics in Auckland in 2017. The study population was 150 GBM recruited from clinics, community sources and social media. Participants self-completed an online questionnaire about PrEP awareness, attitudes and sexual risk behaviour in the last 3 months. Baseline characteristics are described and examined to determine whether these were associated with PrEP initiation status (self-referral vs doctor/nurse recommendation).Results: In total, 150 GBM of whom half (52%) were non-European, including 21.3% Maori, 19.3% Asian and 8.7% Pacific, were enrolled into the study. Two-thirds (65.3%) self-referred for PrEP and one-third (34.7%) were recommended PrEP by the doctor/nurse. Participants reported a high number of male condomless receptive anal intercourse partners (MenAICLR) (median 3, range 0-50), with 10% reporting 10 or more MenAICLR and 45.3% reporting group sex. In the previous year, 65.3% had a sexually transmissible infection (STI); 18% had rectal chlamydia or gonorrhoea at enrolment. Almost half (47.7%) had recently used drugs with sex, including 8.1% who used methamphetamine. Participants recommended PrEP had lower education, lived less centrally and had a higher STI prevalence than PrEP self-referrers, but their risk behaviour was similar.Conclusions: Early PrEP adopters in New Zealand have high HIV risk. Demonstration projects should consider equity mechanisms so that minorities can participate meaningfully. [ABSTRACT FROM AUTHOR]

Memory is increasingly understood as a source of both vulnerability and resilience within the experience of disasters associated with natural hazards. In this article, we investigate how members of marginalised populations impacted by disasters in Australia and New Zealand drew on forms of memory tied to their minority identity. Gay men, along with other sexual and gender minority groups, experience increased vulnerability in disaster contexts resulting from discrimination and stigmatisation. We draw on interviews with two gay men, each of whom had lived through the crisis of HIV/AIDS beginning in the 1980s and who had, more recently, been seriously impacted by a disaster associated with a natural hazard. Memories of HIV/AIDS informed these men’s experiences of the later disaster in ways which bolstered resilience but which conversely resulted in feelings of vulnerability and isolation. [ABSTRACT FROM PUBLISHER]

Aims and objectives To explore men who have sex with men's views about condom use when having anal intercourse. Background Internationally, health promotion campaigns use behavioural change strategies to support men who have sex with men to always use condoms when having anal sex with other men. The health promotion message given to this group is consistent and explicitly stated that 'use a condom every time for anal sex regardless of relationship status'. Design Qualitative analysis of data from a cohort of New Zealand men who have sex with men. Methods A total of 960 useable questionnaires were completed: 571 online and 389 in hard copy. Qualitative data were analysed using a thematic data analytic process. Results Three themes relating to condom use in men who have sex with men were identified. These are as follows: 'Safer sex is good sex', 'Condom use is good but ...' and 'I use condoms sometimes'. Conclusions The range of responses towards condom use for anal sex in men who have sex with men in our sample reveal this as a complex public health issue, with not all men who have sex with men willing to consistently use condoms. Relevance to clinical practice It is important that nurses do not assume that all men who have sex with men are willing to use condoms for anal sex, and should create opportunities for men who have sex with men to raise any concerns about the use of condoms. In this way, nurses can assist in providing information that may help men who have sex with men to make decisions that will minimise risk of contracting infections associated with sexual activity. [ABSTRACT FROM AUTHOR]

Purpose – In light of the fact that the “baby boomer” generation is moving into early old age, the purpose of this paper is to examine what aspects of ageing and old age concerned an age cohort of 25 gay men aged 60 plus. Design/methodology/approach – The primary data for this paper came from interviews with 25 men aged 60 and older who were recruited in Auckland, London, Manchester, Melbourne, and New York. Interviewees were contacted by a variety of means, such as by e-mail introductions, advertisements placed on social media, and recommendations of mutual friends or acquaintances. Once contacted, the men were sent a plain-language statement outlining the purpose of the study and the intention to publish the results and were asked to sign and return a consent form. Narrative identity was central to understandings of the men’s lives got from analysing their interview transcripts. Findings – Analysis of extracts from their life stories showed the men interviewed for this paper drew on two principal narratives when discussing their apprehensions about growing old. The first related to general fears or concerns about old age that would be fairly common among members of the general population. The second narrative related to gay-specific fears or concerns. Significant claims: that class affects gay men’s experience of old age just as it does for everyone else; and that fears of being ostracised because of their sexuality were strongest when the men spoke about aged-accommodation settings. Research limitations/implications – More research is needed on gay men’s experience of in-home supported care and residential care to see if the reality of the heterosexism and/or homophobia matches the fears of some in this sample. Originality/value – This is a relatively new field and there is a growing number of researchers examining the ageing concerns and experiences of the GLBT population. The originality of this paper lies in the international sample on which it is based, its use of narrative analysis, and its relevance to policy makers as well as to members of the GLBT population, carers, and owners/managers of aged-care accommodation facilities. [ABSTRACT FROM AUTHOR]

Ethnic minority gay, bisexual, and other men who have sex with men (MSM) are considered to have a high risk for HIV infection. The aim of this study was to identify some of the ways Chinese and South Asian MSM talk about and understand issues related to HIV/STI and health promotion, as well as highlighting some of this group's health promoting behaviours. A qualitative study using face-to-face interviews with 44 Chinese and South Asian MSM living in Auckland, New Zealand, was undertaken. Following data analysis, four major themes were identified: the importance of condoms, condom use, HIV/STI practices, and HIV health promotion. The results showed that the men interviewed had a good understanding of the benefits of using condoms for anal sex. They also reported strong recall of the local HIV health promotion campaigns which seek to influence men's behaviours through promotion of a single, unequivocal message to always use a condom for anal sex. The men however did not always report consistent condom use, and a range of reasons why this happened were identified. Among the men who discussed testing practices, regular testing was much more likely to have occurred in men who have lived in New Zealand for more than 5 years. These results suggest that future health promotion initiatives should be tailored to ensure the needs of Chinese and South Asian MSM are appropriately addressed when promoting condom use for anal sex. [ABSTRACT FROM AUTHOR]

Background: Respondent-driven sampling (RDS) is a method of approximating random sampling of populations that are difficult to locate and engage in research such as gay, bisexual and other men who have sex with men (GBM). However, its effectiveness among established urban gay communities in high-income countries is largely unexplored outside North America. We conducted a pilot study of RDS among urban GBM in Auckland, New Zealand to assess its local applicability for sexual health research. Findings: Pre-fieldwork formative assessment explored RDS suitability among local GBM. Highly-networked initial participants ("seeds") and subsequent participants completed a questionnaire, took a rectal swab for chlamydia and gonorrhoea testing, and were asked to recruit up to three eligible peers over the subsequent 2 weeks using study coupons. Compensation was given for participating and for each peer enrolled. Feedback on the pilot was obtained through questionnaire items, participant follow-up, and a focus group. Nine seeds commenced recruitment, directly enrolling 10 participants (Wave One), who in turn enrolled a further three (Wave Two). Two of the 22 participants (9 %) had undiagnosed rectal chlamydia. The coupon redemption rate (23 %) was lower than the expected rate (33 %) for this population. Participants were motivated by altruism above financial incentives; however, time, transport and reluctance recruiting peers were perceived as barriers to enrolment. Discussion: Slow recruitment in our pilot study suggests that RDS might not be an effective or efficient method of sampling gay men in all high-income urban settings. However those who participated in the pilot were willing to provide anal swabs and information on their sexual behaviour, and also on the size of their GBM social network which is necessary to weight data in RDS. Refinements and adaptations such as reducing the transaction costs of taking part (e.g. offering online participation) could improve responses but these have their own drawbacks (higher set-up costs, difficulty collecting biological specimens). [ABSTRACT FROM AUTHOR]

Aim Explore the coming out narratives in a group of older gay men. Methods A narrative gerontological approach was employed to explore the coming out narratives of older gay men. Semi-structured digitally recorded individual interviews were undertaken with 12 gay men aged between 65 and 81 years who lived in the community. Data were analysed using a narrative data analytic process. Results Three collective narratives related to the coming out of older gay men were identified: 'early gay experiences', 'trying not to be gay' and 'acceptance'. Conclusion Older gay men come from diverse socio-cultural backgrounds. However, they all grew up in an era where same-sex attraction was a criminal offence. The path to accepting being a gay man was individualised and stressful for these participants. Consequently health and social service providers need to support the ongoing development of resilience and provide a person-centred approach to care that promotes wellbeing. [ABSTRACT FROM AUTHOR]

Lesbian, gay and bisexual (LGB) people have a higher prevalence of psychiatric problems. This is considered as a consequence of marginalisation of homosexuality. Despite much research and literature on lesbian and gay mental health, important questions remain largely unexplored regarding public mental health services (PMHS) for LGB. Two such questions are: Do clients feel able to disclose issues regarding sexual orientation to psychiatric services? How do PMHS services enable or hinder this? Foucauldian discourse analysis was used to explore these questions. Interviews were conducted with 13 same-sex-attracted male clients and 12 LGB staff in PMHS in New Zealand. Findings were that staff in PMHS rarely ask clients about sexual orientation. Correspondingly many clients report considerable difficulty disclosing their sexual orientation in PMHS, even when it is relevant to their mental health issues. The social and systemic conditions which create this barrier to effective treatment for LGB clients are explored. Practical suggestions are made for how staff in PMHS can raise the topic of sexual orientation with clients thereby improving access to and quality of treatment to LGB clients. [ABSTRACT FROM AUTHOR]

Increasing numbers of lesbian, gay and bisexual ( LGB) adults are entering into parenthood. Previous studies indicate many of these parents receive little or no support from their families of origin due to family members' negative attitudes toward homosexuality. This study looks at the extent to which LGB parents report a lower sense of connectedness to family of origin and friendship networks than heterosexual parents and whether this has an impact on psychological wellbeing in either of these groups. Data were derived from two studies of parents: Work, Love, Play, a study of Australian and New Zealand LGB parents (n=324); and the Longitudinal Study of Australian Children, a population-based study of young children and parents (n=6460). Structural equation modelling was used to explore the relationships between: parent sexuality and family/friendship connectedness, family/friendship connectedness and psychological wellbeing, parent sexuality and psychological wellbeing. LGB parents reported feeling less connected to their families of origin but more connected to their friendship groups than heterosexual parents. Counter to previous studies, we found no difference in the psychological wellbeing of LGB parents compared to heterosexual parents when examining the direct effect of sexuality on psychological wellbeing. Clinical implications for counsellors and family therapists are discussed. [ABSTRACT FROM AUTHOR]

Most HIV behavioural surveillance programmes for gay, bisexual and other men who have sex with men (MSM) sample from location-based (offline) or web-based (online) populations, but few combine these two streams. MSM sampled online have been found to differ demographically and behaviourally from those sampled offline, meaning trends identified in one system may not hold for the other. The aim was to examine trends among MSM responding to supplementary repeat online behavioural surveillance surveys who had not participated in offline surveillance earlier that year in the same city, to see whether trends were parallel, converged or diverged. We recruited a total of 1613 MSM from an Internet dating site in Auckland, New Zealand in 2006, 2008 and 2011 using identical questionnaires and eligibility criteria to offline surveillance. Condom use was stable over time, HIV testing rates rose, the proportion reporting over 20 recent male partners declined, and anal intercourse rates increased, consistent with trends in offline surveillance conducted concomitantly and reported elsewhere. Variant trends included greater stability in condom use with casual partners among online-recruited MSM, and a rise in regular fuckbuddy partnering not identified among offline-recruited MSM. Among MSM recruited online, the frequency of checking Internet dating profiles increased between 2008 and 2011. In conclusion, supplementary web-based behavioural surveillance among MSM generally corroborates trends identified in offline surveillance. There are however some divergent trends, that would have been overlooked if only one form of surveillance had been conducted. As MSM populations increasingly shift their socialising patterns online and diversify, multiple forms of HIV behavioural monitoring may be required. [ABSTRACT FROM AUTHOR]

Main partners are a common source of new HIV infections among men who have sex with men (MSM). National behavioral surveillance data (2006-2011) for younger MSM (YMSM, aged 16-29) in New Zealand were analyzed to investigate condom use during anal intercourse with a regular partner (boyfriend/fuckbuddy) by sexual position (insertive/receptive). Backward-stepwise multivariate multinomial logistic regression was used to identify demographic, relational, behavioral, and cognitive factors associated with condom use frequency (high, medium, low). Most YMSM who reported a current regular partner ( n = 1,221) classified them as a boyfriend (59.5%) versus fuckbuddy (40.5%), though condom use was higher with the latter partner type. Condom use or nonuse was habitual across partners, although insertive sexual position was positively associated with condom use. YMSM who believed condoms reduce sensitivity reported lower condom use. Condoms remain the leading HIV/STI prevention tool for YMSM; efforts to improve condom use must consider sexual position and relationship factors. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the ageing experiences of gay men in New Zealand over the age of 65 years. Background An increased acceptance by many people in Western societies towards men who are same-sex attracted is likely to result in a corresponding increase in the number of visible older gay men being the recipients of nursing care. Previous research has shown that nursing has some way to go towards providing a service that is culturally safe and appropriate. Design A critical gerontological approach was employed to explore the ageing experiences of gay men in New Zealand over the age of 65 years. This methodology ensured the voices of older gay men were foregrounded in the research. Methods Semi-structured digitally recorded individual interviews with 12 gay men aged between 65-81 years who lived in the community were undertaken. Data were analysed using thematic analysis to identify the repeated patterns across the men's talk. Results Three main themes relating to the ageing experiences of these men were identified: 'homophobia', 'being with someone' and 'future care'. Conclusions Resilience was a significant factor in how well older gay men aged even in an environment where homophobia and heterosexism were common. Having a strong social support network was an important factor that contributed to supporting the ageing process. These gay men were wary about having to go into residential care, preferring to age in their own homes. Relevance to clinical practice Nurses and other healthcare professionals need to ensure healthcare services meet the needs of older gay men. Any interaction with older gay men should occur in a way that is open and respectful. The usage of best practice guidelines will assist organisations to deliver culturally safe and appropriate care to this group. [ABSTRACT FROM AUTHOR]

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Little is known about the health views of gay men. In this article we report on how gay men explained health and the ways they discussed how health for gay men can be improved. We conducted a thematic analysis of data collected from 45 gay men in 11 focus groups and identified that health was mainly explained in individual terms, as were the ways to improve health (personal health care services and health promotion). The second way health was explained drew on social and community factors, with the societal acceptance of gay men being reported as essential for health improvements. These individual and social/community approaches were in tension; overall, the individualized approaches dominated. In line with other theorizing in health, we argue that appropriate policy and service provision to meet the health needs of gay men require greater acknowledgment of the social and community explanations of health and ways of improving health. [ABSTRACT FROM PUBLISHER]

Drawing on interview data from a qualitative study that explored how gay men and lesbians create and maintain family in contemporary New Zealand society, this article highlights both the positive impacts of legislation on these families and the problems that can arise as a result of gaps in the recognition of the realities of some arrangements. The benefits of legal recognition of relationships between lesbian non-birth mothers and their children, the limited legal protection available for donor fathers (men who have donated sperm to lesbians on the understanding that they will jointly share the parenting of any resulting children), and the unintended consequences of their lack of protection for children are of particular concern. This article makes a case for further legislative reform and recommends that more than two parents should be able to be identified in law in some situations. [ABSTRACT FROM AUTHOR]

In this article we present findings from the Work, Love and Play (WLP) study: a survey completed by 445 same-sex attracted parents across Australia and New Zealand. Compansons of household division of labour are made between a sub-sample of WLP participants, who were currently cohabiting with a same-sex partner (n = 317), and 958 cohabiting opposite-sex parents surveyed as part of a major Australian study, Negotiating the Life Course. This comparison showed that same-sex couples divided household labour significantly more equally than heterosexual parents, and lesbian couples also shared parenting tasks more equally. Qualitative findings from the WLP study indicate that, for many same-sex couples, major decisions around who gives up paid work and how many hours parents choose to work, as well as decisions around work/family balance, are negotiated on the basis of couple's preferences and circumstance rather than an assumption that one parent will be the primary child carer It is speculated that this finding highlights an important point of difference between same-sex couples and heterosexual couples where the division of household labour is often based on the assumption that the mother will almost always be the primary child carer and homemaker. The research is a collaborative partnership between La Trobe University, Deakin University, The University of Melbourne, and Relationships Australia Victoria. [ABSTRACT FROM AUTHOR]

Research over the past decade on rape and sexual coercion among gay and bisexual men has shown that significant numbers of men report some form of unwanted or coerced sexual experience. Most studies have investigated the prevalence and impact of sexual assault, with little exploration of the nature and meanings of sexual coercion. This paper contributes to understandings of the latter, analysing the notion of 'risk' as it appeared in the talk of 23 key informants interviewed. These informants offered expert perspectives on the issue of sexual coercion and unwanted sex among gay and bisexual men, based on their professional and community experience. Thematic analysis led us to identify two predominant patterns of talk around risk: a focus on sociocultural contexts as risky for sexual coercion and a focus on certain types of individuals as vulnerable and 'at risk' of sexual coercion. Accounts of individual risk fit with currently dominant prevention models, which work to strengthen individuals' abilities to avoid or resist coercion. The accounts that emphasised context fit with recent theorising which suggests broader interventions are also necessary to prevent sexual coercion, ones that challenge normative constructions of sexuality and sexual practice. [ABSTRACT FROM AUTHOR]

The article discusses policies related to caregiving in the academic world from a gay male perspective. Examples are drawn from the author's personal experience as a senior lecturer at a university, and as a gay man. Topics addressed include the GLBT (Gay, Lesbian, Bisexual and Transgender) community in academic culture, same-sex marriage and domestic partnership rights, and the sociocultural differences between India, the United States and New Zealand. Issues related to caring for others are discussed with reference to the philosophy of Emanuel Levinas.

This paper explores the ways in which representations of masculinity and sexuality in schools operate to reinforce limited opportunities for male students in New Zealand. Data were gathered from in-depth interviews with ten young gay men and focus group interviews with seven young gay men. The discussion demonstrates how schools currently restrict opportunities for young gay men to explore masculinity in relation to their sexuality and highlights the ways in which schools support and reinforce binaries of heterosexuality/homosexuality in terms of normality and abnormality. The paper raises important implications for gender identity and equity in schooling. [ABSTRACT FROM AUTHOR]

Sex workers have their perspective on HIV transmission, claiming that in general they are more similar than different from other people in HIV status and the practice of safe sex. Such an assertion of similarity goes against public and professional opinion that prostitution is a major vector in the spread of AIDS. Taking the sex workers' similarity claim seriously, this paper considers the conditions under which it would be valid. We focus on those factors that make a population more or less vulnerable to HIV and how they affect its spread into the sex work population. Data from New Zealand comparing men sex workers and other men who have sex with men is used to evaluate these ideas. Data partially support the hypothesis in that these two groups of men are similar with regard to their HIV status. We do find the sex workers to be different, however, in their being less likely to engage in safe sex practices. We provide an explanation for why this has not lead to their having a higher rate of seropositivity. [ABSTRACT FROM AUTHOR]

This article examines the circulation of heterosexist positions within several recent New Zealand media texts. It argues that a recent form of discourse engages liberal language and assumptions in ways that support the privileged position of heterosexuality and the marginalization of homosexuality. The examples given highlight not only the tenor of some recent representations of homosexuality, but also some problems within liberalism. Most notable of these are liberalism's individualism and its failure to recognize the systemic nature of hierarchical power relationships and the constituting of lesbian and gay subjectivities within these relationships. These problems allow liberalism to play an active part in processes of domination and subordination. [ABSTRACT FROM AUTHOR]

The article examines the discursive processes involved in passing the 1986 Homosexual Law Reform Bill and the 1993 Human Rights Amendment in New Zealand. It discusses parliamentary debates and political tactics of parliamentarians for their influence, meaning and outcome of the legislations. It is inferred that iconography reflecting gay men was used in political strategies by both the supporters and opponents of gay rights in their arguments over HIV prevention. The author inferred that the 1993 legislation's focus on the moral aspect, rather than physical health, reflected a diminished sense of urgency about AIDS and public acceptance of the effects of a decriminalised homosexuality.

Introduction and Aims: Data are lacking on drug use among gay and bisexual men (GBM) in New Zealand. We establish a baseline estimate of drug use and investigate associations with sexual health and HIV risk.Design and Methods: A cross-sectional survey of GBM was conducted in gay community settings and online. Participants were asked their frequency of using nine drugs (poppers, cannabis, ecstasy, methamphetamine, amphetamine, cocaine, LSD, gamma hydroxybutyrate and ketamine) in the previous 6 months. We examined associations between selected drugs and number of recent partners, unprotected anal intercourse with a casual partner and sexually transmitted infections using adjusted odds ratios (AOR).Results: Overall, 3211 participants provided information of whom 55.8% reported any drug use, and 37.9% cannabis, 36.7% poppers, 16.5% ecstasy, 10.5% amphetamine, 7.4% methamphetamine, 6.6% LSD, 6.1% cocaine, 5.3% gamma hydroxybutyrate and 4.4% ketamine use. A quarter of all respondents (25.6%) reported using one drug, 22.8% two to four and 7.4% five or more drugs (polydrugs). Methamphetamine and polydrug use was independently predictive of reporting >20 recent partners (AOR 1.6 and 7.0, respectively), unprotected anal intercourse with a casual partner (AOR 1.8 and 3.2, respectively) and a sexually transmitted infection (AOR 1.6 and 4.3, respectively).Discussion and Conclusions: Drug use was common in this sample of GBM. Polydrug and methamphetamine users had especially high sexual health needs, but risks remained elevated among GBM consuming other drugs. Drug harm reduction programs and HIV prevention should target GBM with problematic drug use. Limitations include an inability to attribute causation. [Saxton P, Newcombe D, Ahmed A, Dickson N, Hughes A. Illicit drug use among New Zealand gay and bisexual men: Prevalence and association with sexual health behaviours. Drug Alcohol Rev 2017;00:000-000]. [ABSTRACT FROM AUTHOR]

Objectives: To determine the incidence of self-reported sexually transmitted infections (STIs) and sexual health checks in community and internet samples of New Zealand gay, bisexual and other men who have sex with men (MSM) and factors associated with these., Methods: We analysed anonymous self-completed data from 3138 MSM who participated in the location-based Gay Auckland Periodic Sex Survey (GAPSS) and the internet-based Gay Online Sex Survey (GOSS) undertaken in February 2011., Results: Overall 8.2% of the participants reported at least one STI in the previous 12 months, which did not differ significantly by demographic factors or HIV status. While having anal sex and more partners were associated with more STI, after adjustment for the number of partners, the type of partner (regular or casual) was not. Medium and low condom users reported STIs more than high condom users, regardless of partner type. Overall 40% had a sexual health check-up without an STI diagnosed in the past year, with similar numbers attending general practice and sexual health clinics. Having a check-up was lower among Pacific and Asian men, those identifying as bisexual and recruited online. While those with more partners, having anal intercourse and diagnosed with HIV were more likely to go for a check-up, those using condoms less often were not., Conclusions: STIs are commonly reported in this community sample of MSM but will underestimate the true incidence due to asymptomatic infection. Screening for STIs outside sexual health clinics should be normalised for MSM and made accessible, safe and relevant., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Understanding how people in any given population think about and experience their sexuality is fundamental to developing and implementing good health policy, research, and practice. Yet despite several decades of focus on sexual identity and HIV risk within health research, gay men as a category are often treated in an uncomplicated way. This article reports on focus group discussions held with 45 gay and other men who have sex with men in New Zealand to identify how they talked about issues of gay identity and gay community/ies. The men negotiated and renegotiated their gay identity and being gay was reported as just one part of most men's lives. Many men did not like to be labeled as gay and downplayed aspects of their gay identity. Only a few men proclaimed being gay. Men reported very mixed experiences with the gay community/ies. Understanding how men experience being gay, provides information vital to enhancing policy, research and practice responses to gay men's health issues. A major challenge for health service provision to appropriately engage with men who have sex with other men but resist being labeled as gay was identified., (© The Author(s) 2014.)