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The ways gay men navigate socially constructed body tensions are explored through a post-structural lens. Nine self-identifying gay men in Canada used photovoice to create images that expressed their beliefs, values and practices about their bodies. Participants took part in semi-structured interviews to discuss the meanings of their images. Three discursive considerations were created from the analysis of both interviews and the photographs. Participants attempted to create bodies aligned with the dominant body ideals for gay men but, in doing so, often suffered from emotional harm that negatively shaped their health and well-being. Some participants, however, through the process of creating their bodies were able to find new connections and new understanding of their bodies. They were able to find new ways of being outside the rigid body ideals set before them. Through the post-structural lens of the research, participants’ bodies can be conceptualized as bodies becoming art.

The socio-politico-cultural context of sexual orientation often influences the attitudes, beliefs, and values produced in a given society. This study employed a qualitative methodology to explore the current attitudes, beliefs, and values of Canadian undergraduate students about sexual orientation. Students in a large human sexuality course at a Canadian university completed open-ended questions on the educational platform Top Hat. The data were analyzed using discourse analysis and four threads of discourse emerged: 1) The Nature of Sexual Orientation, 2) Gender Norms and Bisexuality, 3) Shared Connections, and 4) Foundations of Friendships. These findings contribute to the growing body of knowledge relating to changing attitudes, beliefs, and values about sexual orientation of Canadian university students.

Our purpose in writing this Perspective in Practice is to create awareness about the role of compassion within dietetic practice, particularly the role of compassion for body image tensions. Nine self-identifying gay men were recruited to a photovoice research study that explored their beliefs, values, and practices relating to food and their bodies. Compassion was found as one way to navigate body images tensions. It is not the intent of this article to review all aspects of this research study but to use it as an example to illustrate compassion in dietetics. We suggest that our findings reveal the strength of using compassionate practice within the dietetic profession. In doing so, we call upon dietitians to incorporate compassion into their clinical and client care practices to foster health and healing for all communities, especially among those who struggle with body image tensions.

The construction of masculinities is an important component of the bodies and lives of gay men. The role of gay culture on body standards, body dissatisfaction, and the health of gay men was explored using poststructuralism and queer theory within an arts-based framework. Nine gay men were recruited within the city of Halifax, Nova Scotia, Canada. Participants were asked to photograph their beliefs, values, and practices relating to their bodies and food. Semi-structured interviews were conducted, using the photographs as guides. Data were analyzed by critical discourse analysis and resulted in three overarching threads of discourse including: (1) Muscles: The Bigger the Better, (2) The Silence of Hegemonic Masculinity, and (3) Embracing a New Day. Participants believed that challenging hegemonic masculinity was a way to work through body image tension.

The sexual health of Indigenous Peoples in Canada has been identified as an important community and public health concern; however, there is a lack of research on the sexual health needs of Indigenous boys and men. This article shares results from interviews conducted with six stakeholders to explore pathways for sexual health promotion and considers the impacts of colonialism and other socio-political contextual factors on Indigenous boys’ and men’s sexual health. The study employed thematic analysis, and the findings indicate the following three pathways for sexual health promotion of Indigenous boys and men: (1) developing healthy relationships and highlighting role models, (2) providing access to comprehensive sexual health information, and (3) fostering open communication among Indigenous boys and men. Sexual health promotion with Indigenous boys and men in Atlantic Canada should include addressing the impacts of colonization and their unique socio-cultural contexts.

The identities and communities of gay, bisexual, and other men who have sex with men (GBMSM) are undergoing reconfiguration through two technologies: the digital spaces of social networking and hoo...

Jad Sinno,1,2 Nicole Doria,1 Nicholas Cochkanoff,1 Matthew Numer,1 Heather Neyedli,1 Darrell Tan2,3 1School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada; 2Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; 3Department of Medicine, St. Michael’s Hospital, Toronto, ON, CanadaCorrespondence: Jad SinnoSchool of Health and Human Performance, Dalhousie University, Stairs House, 6230 South Street, Halifax, NS, B3H 4R2, CanadaTel +1 (902) 402-9596Fax +1 (902) 494-5120Email jad.sinno@dal.caIntroduction: Pre-exposure prophylaxis (PrEP) is an effective HIV prevention tool that requires the ongoing support of physicians to be accessible. Recently, Nova Scotia experienced a 100% increase in HIV diagnoses. The purpose of this study is to explore the relationship between physicians’ support of PrEP, knowledge of PrEP, and PrEP prescribing history using the information-motivation-behavioral (IMB) skills model.Methods: An online survey was distributed to physicians in Nova Scotia, Canada, and eighty physicians participated. Two exploratory factor analyses were conducted with items from the Support of PrEP scale and Knowledge of PrEP scale. A mediation analysis was conducted to assess if knowledge of PrEP mediated the relationship between support of PrEP and whether physicians have prescribed PrEP in the past.Results: On average, physicians reported strong support for PrEP, and as support for PrEP increased so did knowledge of PrEP. Further, physicians who had prescribed PrEP demonstrated strong knowledge of PrEP and physicians who had not prescribed PrEP reported feeling neutral. The 95% bootstrap confidence interval indirect effect of Support for PrEP on prescription history did not include zero (B = 1.59, 95% BsCI [0.83, 3.57]) demonstrating that the effect of support for PrEP is mediated by knowledge of PrEP. The most commonly identified barrier to prescribing PrEP was the lack of drug coverage among patients.Conclusion: The results of the mediation analysis support the IMB skills model regarding support for PrEP, Knowledge of PrEP, and having prescribed PrEP in the past. Our findings suggest that to improve PrEP uptake in Nova Scotia, educational interventions for physicians and universal coverage of the drug would be necessary.Keywords: HIV pre-exposure prophylaxis, health care providers, attitudes, knowledge, barriers, accessibility, health care access, information-motivation-behavior skills model

Comics are an innovative way to translate health knowledge and research to service providers and communities. A theoretical framework intertwining poststructuralism and queer theory was used to exp...

The purpose of this article is to review the scope of the current literature on sexualized drug use (SDU) among gay, bisexual and other men who have sex with men (GBMSM), particularly in online spaces. Over the last decade, there has been a rapid emergence of online venues for GBMSM to interact for sexual purposes. These spaces have also been infused with various substances that influence or shape the sexual interactions among GBMSM. Employing a scoping review methodology, we explored the interplay between GBMSM, SDU, and online dating and hookup apps. This scoping review presents four themes emerging from the literature: the connection between social networking apps (SNAs) and SDU, the planning and coordination of sex parties, accessing drugs through SNAs, and the coded language that emerges on SNAs. These findings synthesize the important relationship between GBMSM and SDUs, and identify the implications for health promotion.

Evidence suggests that the use of educational technologies may promote positive learning environments and contribute to students’ success. The following mixed methods study examined the impact of T...

Sexualized drug use is a form of sexual practice that resists risk-based discourses (otherwise referred to as "radical sex practices") and is reportedly common among gay, bisexual and other men who have sex with men (GBMSM). With the growth of online technologies, the use of hookup apps has also increased. We refer to men's use of drugs, apps, and sex form as "wired sex" that forms what post-structuralist theorists Deleuze and Guattari described as an assemblage. Perspectives of the health and social service providers who work directly with GBMSM has not been explored. This research project involved a critical discourse analysis of 13 semi-structured interviews with service providers in Canada to understand their perspectives and interactions with wired sex assemblages. We identified several themes reflecting the social and political effects of wired sex assemblages and discuss the implications of these effects on services provision with GBMSM.

Chemicals have penetrated everyday lives of men who have sex with men as never before, along with new online and mobile technologies used to seek pleasures and connections. Poststructuralist (including queer) explorations of these new intensities show how bodies exist in the form of (political) surfaces able to connect with other bodies and with other objects where they may find/create a function (e.g., reproduce or disrupt hegemonies). This federally funded netnographic study explored how a variety of chemicals such as recreational drugs, pharmaceuticals and steroids are contributing to the construction of gay, bisexual and other men having sex with men (GBMSM) communities and their interactions with idealized masculinities in the age of increasing technology. Five major thematic categories emerged from our analysis: (1) assembling bodies and technologies, (2) becoming orgiastic, (3) experiencing stigma, (4) becoming machinic and (5) negotiating practices. Our analysis explores how and why GBMSM pursue excesses of pleasure and connection through the assemblages they make with sexualized drug use, online platforms and other men.

Social networking applications (SNAs), such as Grindr, are shaping the identities and sexual practices of gay, bisexual and other men who have sex with men (GBM). This qualitative study aim...

Background Sexualized violence against women is a significant human rights problem worldwide. Safety apps have the capacity to provide women with resources to prevent or respond to experiences of sexualized violence. The aim of the following study was to review the scope of the literature on women’s experiences of safety apps related to sexualized violence and identify if there is a current gap in this literature. Methods This scoping review employed a systematic methodology guided by the Arksey and O’Malley framework. The search for this scoping review was conducted in January 2020 and four electronic databases were searched: Embase, MEDLINE, PsycINFO, and Scopus. Reference lists of systematic reviews, scoping reviews, and literature reviews that were found through the search of databases were also checked to ensure all relevant studies had been screened. Last, the table of contents for the last five years (2015–2020) were hand searched in four key journals (Journal of Technology in Human Services, Violence Against Women, BMC Public Health, and Health Promotion International) to identify any articles that may have been missed in the database search. Covidence was used to complete the screening. All data that met inclusion criteria was charted, extracted and synthesized. Results Across the four databases searched, a total of 389 studies were identified; 127 duplicates were removed, resulting in 262 studies screened. In total, 6 studies were included from the search of databases and 1 study was included from hand-searching, for a total of 7 included studies. Thematic analysis identified the following themes in the literature, which are summarized narratively: (1) security; (2) accessibility; and (3) knowledge. Recommendations and barriers found in relation to each theme are also presented. Conclusions This review confirms that the qualitative literature on women’s experiences of sexualized violence safety apps is scarce and exposes that a gap in the literature on this topic. The gaps in the literature were identified and implications and recommendations for future research are discussed.

Indigenous boys and men in Canada face adverse social and structural circumstances that affect their ability to achieve and maintain sexual health. Research about Indigenous sexual health, however, is largely limited to matters relating to women and statistics on sexually transmitted infections. A rapid review of research was conducted to determine what is currently known about Indigenous boys' and men's sexual health in Canada. Given the prevalence of research documenting quantitative disparities, the current review included qualitative research only. Thirteen included studies explored a wide range of topics relating to sexual health and an overarching intersection between social conditions and individual health outcomes was observed. The results of this review reveal significant gaps in the literature relating to the holistic sexual health of Indigenous boys and men and highlight important domains of sexual health to consider in future research. Findings suggest that sexual health programmes that promote traditional Indigenous knowledge and intergenerational relationships may be effective for promoting sexual health among Indigenous boys and men.

University can be a critical time for queer identifying youth as they attempt to navigate new relationships and heteronormative and, sometimes, hostile environments. Involvement in queer student groups is one strategy to develop protective mechanisms for these students. This research examines the effect of participation in a queer advocacy group at a local university in Halifax, Nova Scotia, Canada, using a qualitative photo elicitation method. Four themes—learning, safe environments, shared emotional connection, and personal fulfillment and growth—emerged concerning the effects of their involvement in the group. As a research method, photo elicitation was determined to be an effective tool for queer identifying youth, allowing for in-depth exploration of the data and self-reflection. Recommendations for queer student advocacy groups are given.

Modern digital technologies have and continue to transform the possibilities for encountering sex. This chapter examines how one mobile app contributes to the shaping of sexual subjectivities among gay men and other men who have sex with men (MSM), as well as to the modern conceptualization of the gay community. It analysis how Grindr, the most prominent mobile gay cruising app in Western culture, has impacted the understanding of community. The chapter illustrates how Grindr itself is a contested space from which to understand the male body. It focuses on the findings of a qualitative study on Grindr users. Digital technologies have transformed what constitutes public space and the gay men's community, revolutionizing the subjective experience of being gay. Poststructural scholarship offers a compelling approach to investigate how technology is woven into the sexual subjectivities of gay men and other MSM.

Introduction In response to the HIV/AIDS epidemic, many jurisdictions in North America (especially in the United States) have cracked down on most of the sex-on-thepremises venues such as gay bathhouses, parks, and adult theaters in order to “control” and “contain” the epidemic. This has prompted men who have sex with men (MSM) to find alternative venues for sex, especially group sex (Meunier, 2014). This chapter presents the results of ethnographic (excluding observation) fieldwork involving MSM who engage in group sex, which we define as any planned or unplanned event with three or more men who engage in sexual activities together. Our research included MSM who gathered together for group sex either at their own home(s), at another private location, or at gay hotels/resorts. Despite increasing research on MSM who are involved in group sex sessions (Grov et al., 2013; Meunier, 2014; Philipps II et al., 2013; Solomon et al., 2011), to date little has looked at risky sexual practices (including attendees’ definition of risk) specifically in a context that is gaining in popularity. The broad research objective was to understand the sexual practices of men who engage in group sex, where verbal communication is often minimal. Aligned with this main objective, we explored two research questions: (1) what are the representations of STI/ HIV risk among MSM who engage in group sex, and (2) what “risk reduction” strategies did group sex participants employ? We approached the study from a critical theoretical standpoint, and structured data analysis using poststructuralist scholarship.

This article presents a study of the social, emotional and physical health lifestyle behaviours of a socially marginalised segment of Canada's population: retired, widowed, immigrant mothers from a South Asian country. Using a narrative research process, we explore how present physical, emotional and social health leisure activities are influenced by behaviours from their childhood, with emphasis on migration to Canada, retirement and widowing as lifestyle behavioural change points. Our sample of immigrant women were living in Halifax, Nova Scotia, Canada during the time of the study. The study employed narrative inquiry, which is often used in migration studies. Our qualitative data analyses uncovered themes that linked present social health activities and early life behaviours and the influence on them of cultural constraints or stimulants. Three forms of sociocultural influences, gender segregation, patriarchal protection and early preparation for marriage, shaped adolescence and adult life as less physically active but more emotionally and socially healthy. Later life events, migration, retirement and widowing, enabled women to gain freedom to renegotiate and reconstruct late‐life styles to be more physically and socially active through ethno‐cultural social networks they had built after migration. The concluding discussion makes recommendations for health and social programme planning to draw attention to cultural realms that could help these women become physically active after migration without compromising traditional social behaviours.

Popular health discourses on obesity tend to highlight the negative impacts of excess weight. Obesity, however, also has the effect of ranking and stationing individuals in the neoliberal health paradigm as unhealthy, immoral, and undesirable. The effects of obesity discourses can be prominently observed in gay men’s culture where muscular, white, thin bodies are glorified. This paper employs a feminist poststructural framework to examine how desired bodies are constituted in gay culture, the effects this has on gay men’s experiences of food and exercise, and resistance within gay culture to dominant obesity discourses. A review of the literature on obesity, gay culture, gay men’s health, body image and eating practices was undertaken to inform this work. Various studies have shown that the views within gay culture on fat bodies result in feelings of body dissatisfaction, rejection, and isolation for many men, especially for those that fall outside the privileged version of male bodies or who are labelled as ‘obese’. A critical review of the literature will explore how these experiences are produced through the sexualized culture of gay men.

This article discusses feminist, post-structuralist and queer theories as a framework for masculinities research on sexual health promotion efforts targeting gay men, particularly in relation to HIV prevention. The theories discussed have the potential to challenge the social categories associated with gender, sex, sexual identity and sexual orientation which often determine identities and subjectivities. Recognizing masculinity as a gender “performance” rather than a fixed identity enables health researchers to more fully investigate gendered sexual behaviors which are imbued with social, political and economic meaning. A combined feminist, post-structuralist and queer theoretical framework provides a way to understand how concepts of masculinity organize social interactions and how these in turn shape and inform the sexual health behaviors of men. The purpose of this article is to offer an approach for use by gay men’s health researchers working on health promotion.

The medical community is giving increasing attention to issues of social class, gender, race, ethnicity, culture and other areas of difference in interprofessional education and patient care. The Changing Worlds: Diversity and Health Care Project, an interprofessional diversity education initiative, was designed with the aim of exploring social issues in the medical professions. This project brought together the Faculties of Medicine, Dentistry and Health Professions at Dalhousie University in an effort to address issues of difference related to multiplicities of races, ethnicities, cultures, languages, sexualities and religions. The findings of this paper include methods for the project implementation and future direction for education initiatives aimed at issues of social justice and equity in health care.

Objectives. We developed and validated a set of self-administered, multidimensional indicators of sexual health among Canadians aged 16–24 years. Methods. This study used a mixed-method qualitative and quantitative approach to develop and validate indicators of sexual health We used the four-stage Dillman method to identify, focus-test, pilot-test, and validate key metrics to measure sexual health We collected quantitative data to validate the measures through a computer-assisted self-interviewing program among a purposive sample of 1,158 people aged 16–24 years recruited from four Canadian provinces. Results. The survey contained 75 items measuring five dimensions of sexual health: (1) physical, mental, emotional, and social well-being in relation to sexuality; (2) approach to sexuality; (3) sexual relationships; (4) sexual experiences; and (5) discrimination, coercion, and violence. Principal components analysis for composite measures found seven components with eigenvalues ≥1. The factor structure was stable across gender, age, size of area of residence, and language in which the survey was completed. Cronbach's alpha coefficients ranged from 0.79 to 0.90. Indicators of condom use at last vaginal sex, protection self-efficacy, sexually transmitted infection/HIV testing self-efficacy, and sexual orientation also showed good construct validity. Conclusions. The indicators constituted a conceptually grounded survey that is easy for young adults to complete and contains valid, reliable, and psychometrically robust measures The survey instrument provides a tool for future research to collect population-level data to measure and monitor trends in the sexual health of young people in Canada.