Evaluation of the Make Your Position Clear campaign
In 2010, Lisa McDaid and colleagues at Glasgow Caledonian University (Paul Flowers and Christina Knussen) initiated an evaluation of the Make Your Position Clear (MYPC) campaign’s impact on gay and bisexual men’s sexual health and behaviour in the West of Scotland.
This work was commissioned by NHS Greater Glasgow & Clyde, NHS Lanarkshire and NHS Ayrshire & Arran and aimed to:
- assess the association of exposure to and engagement with the MYPC campaign with gay and bisexual men’s sexual health behaviours;
- examine how measures of exposure to and engagement with the campaign are related to measures of sexual health behaviours when controlled for historical trends and a range of other factors;
- examine the attitudes, norms and other factors associated with contemporary HIV and STI testing, condom use and sexual behavior and to explore the extent to which these have changed over time.
As part of the evaluation of the MYPC campaign, questionnaires were completed by 822 gay and bisexual men (62.6% response rate) during a cross-sectional survey of gay bars in Glasgow in July 2010. The mean age of this sample was around 33 years (range 18-68 years), and the vast majority lived in areas with a Glasgow postcode. Two further papers on the role of social norms in men’s safer sex behaviour are forthcoming and will be available in 2015.
In our survey, 34.8% of the sample had heard of MYPC, and 34.1% recognised the logo. Of those who indicated that they had seen the MYPC images in the previous 12 months (57.1 %), 79.9% reported seeing the images on the gay scene, and 63.1% had seen the images in other places. 10.1% had picked up MYPC leaflets and 3.7% had talked to an outreach worker about the MYPC campaign. Men with mid or high campaign exposure were more likely to have been tested for HIV in the previous six months, but were not more likely to be tested for STIs. When adjusted for previous HIV testing, those with mid or high campaign exposure were not more likely to intend to be tested for HIV in the following six months. Overall, the campaign had demonstrable reach and our analysis showed partial support for the role of mass media campaigns in improving sexual health outcomes.
The survey has also further contributed to our understanding of HIV and STI testing among gay and bisexual men in Glasgow. We have shown that despite a 30.6% increase in recent HIV testing between 2000 and 2010 and increases in the perceived benefits of testing and HIV testing norms, fear of a positive test result remained a key barrier to testing. We have also found that, when compared with those tested within the previous year, those tested over one year previously and those never tested had greater fear of a positive-HIV test result, a weaker norm for HIV testing, and were more likely to have had no anal sex partners at all within the previous year. Those tested over one year previously were significantly older than both other groups (who were more likely to be under 25 years of age). Unprotected anal intercourse (UAI) did not discriminate among the HIV testing groups. As would be expected, there was a strong association between STI and HIV testing (91.3% of men who had had an STI test in the previous 12 months had had an HIV test in the previous 12 months). While STI testing rates were relatively high (37.4% had tested in the previous 6 months), they are still well below the minimum recommended for MSM at high risk and more likely among men with 6+ sexual partners, younger men and those who reported greater knowledge and engagement with sexual health support services. Our results highlight the need for targeted promotion of HIV and STI testing in Scotland and will contribute to intervention development in this area.
Knussen C, Flowers P, McDaid L. Factors associated with recency of HIV testing amongst men residing in Scotland who have sex with men. AIDS Care 2014;26:297-303pubmed
Flowers P, Knussen C, McDaid L. Has testing been normalized? An analysis of changes in barriers to HIV testing among men who have sex with men between 2000 and 2010 in Scotland, UK. HIV Medicine 2013;14:92-8pubmed open access
Flowers P, McDaid LM, Knussen C. Exposure and impact of a mass media campaign targeting sexual health amongst Scottish men who have sex with men: an outcome evaluation. BMC Public Health 2013;13:737open access
McDaid LM, Li J, Knussen C, Flowers P. Sexually transmitted infection testing and self-reported diagnoses among a community sample of men who have sex with men in Scotland. Sexually Transmitted Infections 2013;89:223-230open access
Flowers P, Knussen C, Li J, McDaid L M. Make Your Position Clear: report 2. Glasgow, 2012
Flowers P, Knussen C, McDaid L. The impact of Make Your Position Clear (MYPC) campaign on gay and bisexual men’s sexual health and behaviour in the West of Scotland: a scene-based outcome evaluation. Glasgow, 2011