Want to help improve queer men’s health, end the blood ban, and earn $10? Well, now you can! This year at Pride, the Edmonton Men’s Health Collective (EMHC), in partnership with the Community Based Research Centre for Gay Men’s Health (CBRC), is delivering the Sex Now Survey – Canada’s largest and longest-running queer men’s health survey. And this year, we’ve got our eyes set on the blood ban! Read our interview with Rob Higgins, Sex Now Manager, to learn more about how you can participate.
Over the past decade, the Sex Now Survey has become Canada’s largest queer men’s health survey. Can you tell us a little bit about why the Sex Now Survey was first established, how it’s evolved, and what the data is used for?
The Sex Now Survey was established in 2002 by the founders of the CBRC, Rick Marchand and Terry Trussler. They recognized that the needs of queer men were being ignored by policy makers because their experiences weren’t reflected in the data collected by government.
In the absence of government action, they launched Sex Now, so that they could demonstrate to funders and policymakers that the needs of queer men differed from those of the general population and required a unique response. In fact, over time some queer men began referring to the Sex Now as the unofficial “gay census.”
In its initial years, the survey was paper-based and delivered in-person by a few volunteers at pride festivals. Since then, it has shifted online and has become the largest and longest-running health survey of queer men in Canada.
The data from Sex Now is used in a variety of ways such as advocating for more funding for queer men’s health programming, working with public health partners to make their services more inclusive, and advocating for policy change – just like we are doing this year with our focus on changing the one-year ban on blood donation by men who have sex with men.
This year, Sex Now is unique. In addition to being available online, it is also being delivered in-person at Pride Festivals across the country. Additionally, there is a new component which includes participants providing a dried blood spot sample by having their finger pricked. Can you explain the changes to Sex Now this year?
While we’ll still be offering the online version of the survey in the fall, this year we’re returning to our roots by delivering the Sex Now in-person at Pride Festivals across the country. This allows us to engage with queer guys directly, face-to-face, to learn firsthand about the issues that affect them most.
And yes, the new component involves a (nearly) painless finger prick, which allows us to collect a few drops of blood to be tested – anonymously – for HIV and Hepatitis C. The data from these “dried blood spots” will be combined with data from the Sex Now Survey to help us better understand how viruses like HIV and Hepatitis C impact our community and how we can work to decrease their transmission – in addition to informing changes to the current Canadian policy which bans blood donation by men who have had sex with men in the last twelve months.
On that note, what is the current rationale provided by CBS for why they ban blood donation from men who’ve had sex with men in the last year?
So, this is a complicated question. Canadian Blood Services is regulated by Health Canada. So, really, this is a Health Canada policy. That said, CBS can, and should in my opinion, apply to health Canada to have the policy changed.
Currently, their rationale for defending the policy is that men who have sex with men are more likely to have HIV than those who do not. However, that reasoning makes it appear as though all men who have sex with men experience the same risk of HIV infection, which we know is not the case. For example, we know that guys who consistently use prevention options like condoms and PrEP, or who are in monogamous relationships, experience a lower risk of HIV infection.
So, there are definitely nuances which the current policy ignores. And we have seen other regions throughout the world respond to these nuances by changing their blood donor screening policies. For example, in 2001, Italy shifted to an individual risk assessment based on someone’s personal sexual behaviours as opposed to a blanket ban on all sexually active men who have sex with men.
That’s interesting to hear, especially since we noticed that Canadian Blood Services is actually funding part of Sex Now this year. Can you tell us a little more about their involvement, why they’re demonstrating a willingness to address this issue, and what commitment they’ve made to review the study’s results and make potential changes to their policy?
When the federal Liberals were elected, they announced $3,000,000 in funding to investigate potential changes to this policy. Those funds were given to Canadian Blood Services to conduct the research necessary to inform these changes. Of course, CBS recognized that they didn’t have the partnerships in the community needed to meaningfully engage with queer men. So, they put out a call for research proposals from other organizations – and we were fortunate enough to be successful.
As for their willingness to make changes to the current policy, I’ve had the chance to speak with their Chief Scientist, Dr. Dana Devine, and I do get the sense that she wants to see this policy changed. However, for organizations like Health Canada and Canadian Blood Services to make policy changes as significant as this, they need evidence. Our hope is that the evidence we collect will demonstrate that changes can be made to this policy without resulting in risk to the blood supply.
Something that has emerged in local discussions around this study is the fact that CBS’s policy related to trans blood donors is also discriminatory – and could actually result in many trans women being banned from donating blood, based on the same criteria used to discriminate against men who have sex with men. Can you explain why trans women are not included in this specific study and why it’s limited to queer-masculine individuals?
First off, this is a great question; one that I think we could use an entire additional interview to cover; and one that demonstrates the value of a gender-blind screening policy (which we’re currently investigating and likely in support of).
Unfortunately, the way that CBS currently assesses gender (for screening purposes) is not based on someone’s gender identity but instead on anatomy (i.e. genitals). For example, if a trans woman hasn’t had bottom surgery, CBS would treat them (as it relates to screening criteria) like they would a cisgender man. This is a significant issue which negatively affects many members of the LGBTQ population – and one that needs to be addressed. That said, although this year’s Sex Now study does include a specific focus on the blood donation deferral policy for men who have sex with men, Sex Now has never been focused on just one issue. Instead, we focus on a variety of issues facing our community – and this year is no different.
So, like previous years, regardless of the additional blood deferral policy component, Sex Now remains focused on queer-masculine health. And unlike CBS, we base our understanding of someone’s gender on their gender identity, not their anatomy. So, if someone identifies as male/masculine or female/feminine, then that’s how we recognize them – period.
Therefore, to be an eligible participant for Sex Now (a queer men’s/masculine health study) participants must identify as the following:
- Be 15 years of age or older to complete the survey (or 18 or older for the finger prick
- Live in Canada
- And identify as a trans or cis man who identifies as gay, bi, queer, pan, or two spirit AND/OR a trans or cis man who has had sex with another man in the last five years.
Finally, we recognize that for many people, their experience of gender (and that of their partners) does not fit the gender binary. And in an effort to ensure that we are inclusive and that trans and non-binary people are more represented in research, we encourage anyone interested in discussing their eligibility to visit the booth and speak with one of our recruiters. At the end of the day, if you read the eligibility criteria and feel that it describes you, you are welcome to participate – no questions asked.
As mentioned earlier, Sex Now isn’t just about the blood ban. What kind of information can we expect to learn from Sex Now, how can we expect it to be shared locally, and what kinds of changes to programming and policy might we expect to come out of it? Can you provide examples of how Sex Now data has been used to create change in the past?
Although the special policy issue we’re focused on this year is related to the blood “ban,” as always, Sex Now asks a variety of questions about sexual practices, substance use, mental health, and social connectedness. In turn, Sex Now data has influenced a range of programs, services, and advocacy initiatives across the country. For example, most recently, our data was used in the BC Public Health Officer’s report on HIV Stigma and Society to highlight how stigma acts as a driver of HIV infections amongst men who have sex with men, resulting in the development of six priority health interventions (i.e. programs and services) that the province is currently implementing. Similarly, we think the data we get from this year’s Sex Now Survey can help push forward a range of important conversations related to queer men’s health.
For the individuals considering participating in Sex Now this year, what can they expect?
If someone is eligible, they will complete a short survey (about 15 minutes maximum) and (if they’re comfortable) receive a small finger prick so that they can provide a few small blood droplets for our dried blood spot collection. Participation is anonymous (and optional) so folks can stop at any time or skip any questions they don’t want to answer.
If someone wishes to receive their results from the dried blood spot HIV and Hepatitis C testing, it’ll take us a couple of months to get results from the lab. But if they’re interested, we can reach out via email, text, or phone to let them know if their results were different than expected (NO results are shared with public health). And as a thank-you for participating in the finger prick, participants will get a $10 bill!
Of course, if people are interested and want to learn more, they can follow us on our Sex Now Survey Facebook page for news about our findings or check our website for regular updates at www.cbrc.net/sexnow.
Is there anything else you’d like to share about Sex Now?
The big message I hope folks walk away with is, “Nothing About Us, Without Us.” Sex Now is a queer men’s health survey, designed by queer men, for queer men – which also gets the attention of the decision makers which determine what services, programming, and resources our community gets to receive! So, if you want to improve your health and the health of the people you care about– and earn $10 in the process – come visit us at Pride!
Are you interested in participating in Sex Now – and helping end the blood ban? Follow our event here and/or visit the EMHC booth at the Edmonton Pride Festival (in the Beer Gardens or the main exhibiting area). Look for the red balloons!