We often talk about inequalities and the protected characteristics like age, gender, sexual orientation, but it’s not often that we focus on how individuals with multiple minority identities can potentially experience compound discrimination.
A white gay man, for example, may experience worse health outcomes than a white heterosexual man, but a black gay man’s experiences are potentially even worse, and even further from those of their heterosexual counterparts.
Evidence shows that there are a range of areas where the health of ethnic minority gay and bisexual men is much worse than that of the general population. These include:
- Black MSM are 15 times more likely to be HIV positive compared with general population.
- Just 7% of black gay and bisexual men have tested for any sexually transmitted infection compared to 26% of white gay and bisexual men.
- A third of Asian men and mixed ethnicity men have experienced domestic abuse since the age of 16 compared to one in five of white gay and bisexual men.
- This group also has significantly higher rates of suicide, self-harm and mental illness
Over recent decades we have seen a collection of organisations focusing their attention on the health and wellbeing needs of BME MSM. Organisations like The Black Gay Men’s Advisory Group which wound down around 2009, and The Black Connexion, which closed in March 2014, have all worked hard to raise awareness of this important inequality issue.
But very few of these initiatives survive. The legacy of those that have gone is sadly dispersed and the learning has often been lost and not passed on to younger generations. However the burden of ill health continues.
In October this year PHE held a conference to explore the inequalities experienced by black and minority ethnic gay, bisexual and other men who have sex with men (BME MSM), and launched a new programme of work supported by the MAC AIDS Foundation to address the issue.
The BME MSM project aims to reinvigorate action working with the ethnic minority sector, lesbian, gay and bisexual community sector and the faith community. The ambition is to move us forward over the next year towards a society which enables all BME MSM to experience healthy, safe and fulfilling sexual and social relationships and work towards their potential in life.
PHEs event report on ‘The health and wellbeing of black and minority ethnic gay, bisexual and other men who have sex with men’ was launched last week. Over the course of the next year we will be working with partners across the public health system to address these issues, focusing on three specific areas where there is greatest need: sexual health and HIV, mental health and wellbeing and drugs, alcohol and tobacco use.
Project components include:
- Three structured and interconnected learning sets to increase understanding of BME MSM identity, health and social care needs and access issues among BME, LGBT and faith third sector organisations and leaders. These will then be evaluated and a framework will be produced.
- An E-learning module for health professionals developed by the Royal College of General Practice – to increase understanding of sexual orientation and minority identity among healthcare professionals.
- Redevelopment of the BME MSM image bank for use by NHS and PHE.
- Pilot intervention models for BME MSM focused on group behaviour change interventions, group behaviour change interventions for newly diagnosed BME MSM, individual behaviour change interventions and online engagement with BME MSM
This project is a great opportunity to address inequalities affecting a specific minority community. De Montford University will lead the evaluation of the learning sets and interventions pilots and we have established an external advisory board to ensure the project is informed by the community it aims to reach.
Working with the National LGBT Strategic Partnership, Race Equality Foundation, Faith Action and agencies like NAZ, Metro, Yorkshire Mesmac, Afiya Trust, and GMFA, we hope this work will reach a broad selection of organisations across England.
1 comment
Comment by Bren posted on
Hello Justin,
A really great blog and thank you.
The multiple inequalities is really important, and understanding the person's needs is always crucial.
I wondered if it was worth looking back at the NIC guidance on HIV on MSM and Black Africans and, I do believe a lot is around what the environment is like for the person and the community. is it safe, etc.
It will be good to look at action research and evaluation too. I think it might also be worth looking at evidence bases that tells us what is already known too.
Thanks again for a great blog and a really important area within the whole inequalities area of much needed work.
Best wishes,
Bren.