Stakeholder Engagement Report - London Councils

4.1.2 diversity of needs
“Its gay men and many African communities who are most at risk and most likely
to be HIV positive in London. Meeting their needs, or at least trying to, should be of
the highest priority for Public Health and Local Authorities.”
Key issues
Stakeholders believed assumptions on the homogeneity of gay men, men who have
sex with men (MSM) and African communities were unhelpful, but there was consensus
that interventions and activities specifically targeted should remain a priority for future
commissioned prevention.
Migration into London poses particular challenges with stakeholders reporting new
cohorts of gay men migrating from across the globe, and within African communities,
new Francophone and Portuguese speaking communities. Many recent arrivals do not
appear to be in touch with services and some are too nervous to come forward because of
a range of other challenges happening within their individual lives such as finding work,
housing and, for some, their immigration status.
For MSM, the move away from traditional venues (pubs/clubs) identifies a major cultural
shift, and the ways in which gay men now actively seek sexual partners online challenges
the old models of outreach. Gay venues are no longer the predominant way in which
gay men socialise. Smartphone apps designed for men to meet for sex are increasingly
popular, with MSM able organise and access sex in the borough they live with ease.
“Gay men require non-judgemental support - we have to make sure it’s there.”
An emerging trend raised by some stakeholder organisations, particularly clinical,
HIV support and substance misuse services, was increasing numbers of MSM coming
forward with substance misuse problems, particularly crystal methamphetamine (meth),
mephedrone and GHB/GBL, primarily linked to sex and sex parties taking place across
London. Some stakeholders felt that new innovative ways of undertaking HIV prevention
need to be considered in addition to meet these new and challenging phenomena.
Although there were examples of excellent relationships with some gay businesses, major
concerns were expressed about the lack of partnership approaches with some, especially
those where ‘sex on the premises’ is happening with no accountability for robust HIV
prevention messages and resources. The issue of drug fuelled sex parties for MSM, with
little access to condoms, was raised several times as a major concern by both clinical and
non-clinical stakeholder; however solutions to address this are in their infancy.
African communities were seen to be complex. Stakeholders reported marked differences in
views, experiences and methods of communication, for example between first and second
generation migrants and African people of different social classes. Stigma and discrimination
affects many African communities, and fear of disclosure of HIV status is commonplace.
Many stakeholders believed the division between primary and secondary prevention work
to be unhelpful: an example given was on presentations on HIV prevention provided to
an African community or faith group which assumes the audience are all HIV negative.
However, with 30% of new infections in London being in African people, it is likely many
of the audience will be positive but undisclosed, so they miss out on getting vital sexual
health and HIV information.
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