1. MSM and Access to Free Water-based Lubricants:
Results from a 2010 Global Survey
The Global Forum on MSM & HIV
Pato Hebert
Glenn-Milo Santos
Patrick Wilson
George Ayala

2. Methods Online survey for MSM and service providers
Administered from June to August of 2010
MSMGF networks, list serves, blasts, website
Chinese, English, French, Russian, Spanish
Measures adapted from validated scales
Assessments included items from recommendations by governmental agencies, and advocacy organizations
This survey was administered online for MSM and service providers from June to August of 2010.
I would like to note that this is during the time that the Caprisa Microbicide trial results were released, and 6 months before the iPrex PrEP trial was available
Recruitment for the study occurred within the MSM Global Forum networks, and list serves, blasts, and through the organization’s website.
It was available in Chinese, French, Russian, Spanish, English
The measures that were collected were adapted from a set of questions that have been shown to be reliable and accurate from previous studies.
The survey also assessed coverage of HIV prevention components recommended by governmental agencies and advocacy organizations
After data collection, data was analyze using the following procedures:
Analysis of Variance - to identify disparities among different regions, and age groups
We also created regression models to identify which variables and demographic characteristics are strongly associated with two outcomes: access to basic HIV prevention, and participation in basic HIV prevention. These regressions do not necessarily indicate an underlying causal relationships.

3. Access to Basic HIV prevention services
Prevention components
“This is easily accessible in my community”
Free HIV Testing
48%
HIV Counseling
51%
HIV Treatment
36%
Sexually Transmitted Diseases (STD)Testing
53%
STD Treatment
47%
Free Condoms
44%
Free Water-based Lubricants
29%
Sex Education Programs
25%
Now I am going to report some frequencies of some survey items that were collected for our construct measures.
The following table describes the levels of easy access for basic HIV prevention services reported by participants. Of note, levels of easy access was low to moderate for these measures.
For example,
Free HIV testing was only accessible to 48% of respondents
for HIV counseling this proportion was 51%
HIV treatment was 36%
Sexually transmitted disease (STD) testing was 53%
STD treatment was 47%
Free condoms was 44%
Condom-compatible lubricants was 29%

4. Access to Basic HIV prevention services (cont.)
Anti-homophobia campaigns were either not available (30%) or unheard of (20%)
Health facilities for MSM were not easily accessible—52% reported this was either not available (27%) or unheard of (25%)
We also observed that media campaigns to reduce homophobia were not widespread
and anti-homophobia campaigns were either not available (30%) or unheard of (20%)
Moreover, health facilities for MSM were not easily accessible
With 52% reporting this was either not available (27%) or unheard of (25%)
Also, access to services for substance use was also low
With 16% reporting easy access
And only 43% reporting any access to needle exchange programs

5. Please indicate how available the following are in your community.
Free water-based lubricants
This is easily accessible in my community.
This is available in my community, but it is somewhat hard to access.
This is available in my community, but close to impossible to access.
This is not available in my community.
I have never heard of this.

6. Access to Lubricants Globally%
Responses

7. Access to Lubricants Globally (cont.)%
Responses

8. MSM and Access to Free Water-based Lubricants
3,604 responses overall
Globally, only 29% reported that lubricants were “easily accessible”

9. Access to Lubricants by Age%
Age

10. Access to Lubricants by HIV Status%
HIV Status

11. Access to Lubricants by Number of Sexual Partners%
Number of Sexual Partners

12. Access to Lubricants by Region%
Region

13. Access to Lubricants by Language%
Language

14. Access to Lubricants by Living Situation%
Living Situation

15. Access to Lubricants by Income%
Income

16. Access to Lubricants, Providers vs. Non-Providers%
Non-Provider vs. Health Provider

17. Limitations Convenience sample Selection Bias for MSM who are:
Socially Connected
Accessing Web and
Motivated to participate
Bias likely to overestimate access and knowledge
Translation of Survey
Reliability of Constructs
Our study does have several limitations.
First, this is not a population based sample – we didn’t do random-digit dialing, time-location sampling, or respondent driven sampling
Convenience sample based on who was reached by the survey and decided to participate. This sample precludes use from generalizing findings for all MSM.
The nature of this online survey may be a source selection bias toward MSM who are:
Socially Connected, particularly with MSM global forums’ networks,
those who have Web and Access
Those motivated to participate
We hypothesize that bias likely to overestimate access and knowledge; underestimate homophobia measures and the true picture for MSM we did not reach is more bleak.
Translation of Survey may have introduced some information bias – could have misclassified some respondents
Reliability of Constructs – the internal consistency of scales were not equal across languages – for example lowest consistency in Russian for Internalized Homophobia and Self-esteem.

18. Strengths Sample size (n=3,604) Regional Diversity
Accessible in 5 languages
Robust and comprehensive measures

19. The Global Forum on MSM & HIV