Social and structural risks for HIV among migrant and immigrant men who have sex with men in Moscow, Russia: Implications for prevention

Abstract

Moscow has a large population of immigrants and migrants from across the Former Soviet Union. Little is studied about men who have sex with men (MSM) within these groups. Qualitative research methods were used to explore identities, practices, and factors affecting HIV prevention and risks among immigrant/migrant MSM in Moscow. Nine interviews and three focus group discussions were conducted between April–June 2010 with immigrant/migrant MSM, analyzed as a subset of a larger population of MSM who participated in qualitative research (n=121). Participants were purposively selected men who reported same sex practices (last 12 months). Migrants were men residing in Moscow but from other Russian regions and immigrants from countries outside of Russia. A socioecological framework was used to describe distal to proximal factors that influenced risks for HIV acquisition. MSM ranged from heterosexual to gay-identified. Stigma and violence related to homophobia in homelands and concerns about xenophobia and distrust of migrants in Moscow were emerged as key themes. Participants reported greater sexual freedom in Moscow but feared relatives in homelands would learn of behaviors in Moscow, often avoiding members of their own ethnicity in Moscow. Internalized homophobia was prevalent and linked to traditional sexual views. Sexual risks included sex work, high numbers of partners, and inconsistent condom use. Avoidance of HIV testing or purchasing false results was related to reporting requirements in Russia, which may bar entry or expel those testing positive. HIV prevention for MSM should consider immigrant/migrant populations, the range of sexual identities, and risk factors among these men. The willingness of some men to socialize with immigrants/migrants of other countries may provide opportunities for peer-based prevention approaches. Immigrants/migrants comprised important proportions of the MSM population, yet are rarely acknowledged in research. Understanding their risks and how to reach them may improve the overall impact of prevention for MSM and adults in Russia.

Keywords:

• men who have sex with men
• migrant
• immigrant
• HIV risk
• stigma
• Russia

Acknowledgements

We wish to thank SANAM clinic and Tatiana Bonderenko for insight, support, and use of the SANAM clinic for conduct of qualitative research and the Be Safe study. We thank Irina Deobald for her contribution to the development and planning of the Be Safe study. We extend our appreciation to Ronald Stall of the Center for LGBT Health Research at University of Pittsburgh for his contribution into the study measures. We are deeply thankful to the participants who contributed their time and personal experiences to this study.

Funding for this study came from the National Institute of Mental Health (NIMH R01 MH085574-01A2) “High Risk Men: Identity, Health Risks, HIV and Stigma” funded from 2009–2014.

Supplemental Material

All Supplementary Material is available alongside this article on www.tandfonline.com – go to http://dx.doi.org/10.1080/09540121.2013.819407