Sources of knowledge and truth related to anabolic/androgenic steroid use among two-spirit, gay, bisexual, queer, and other men who have sex with men.

OBJECTIVES: This study sought to explore how two-spirit, gay, bisexual, and queer cisgender and transgender (2SGBQ+) men engage with information related to non-prescribed anabolic/androgenic steroid (AAS) use, and how discourses of risk surrounding AASs influence their AAS use practices. Two objectives were achieved: (1) Sources of information that 2SGBQ+ men consulted when considering using AASs were identified and (2) the ways in which discourses of risk shaped 2SGBQ+ men's experiences of using AASs were revealed. METHODS: Participants were recruited for semi-structured interviews online and through word of mouth. A critical poststructural methodology and theories of risk discourse and biopolitics were used to identify themes and interpret data. RESULTS: Seventeen interviews were conducted with adult 2SGBQ+ cis and trans men. Three themes emerged: (1) Unauthoritative sources of knowledge and truth sought by current and prospective AAS users were inconsistent and difficult to evaluate; (2) Authoritative sources, including health care providers, reacted inconsistently; and (3) 2SGBQ+ men generated and shared lay knowledges as a form of community-led harm reduction. CONCLUSION: The complexities of seeking and evaluating information highlight the privileged nature of trustworthy, accurate information on the topic. Risk-as a discursive regime-places 2SGBQ+ male AAS users in the position to produce lay knowledge and cultivate their own "truths" on the topic, which can lead to preventable harm. Public health needs to address these biopolitical effects by considering these lay forms of knowledge as an untapped resource and design accessible and judgement-free AAS use harm reduction programs for 2SGBQ+ AAS users.

RéSUMé: OBJECTIFS: Cette étude visait à explorer le rapport des hommes gais, bisexuels, queer, trans, bispirituels et autres hommes cisgenres et transgenres qui aiment les hommes (GBTQ2+) avec les informations sur l'utilisation des stéroïdes anabolisants/androgéniques (SAA) vendus sans ordonnance, et en quoi le discours sur le risque posé par les SAA influence leurs pratiques d'utilisation des SAA. L'étude avait deux objectifs : 1) trouver les sources d'informations consultées par les hommes GBTQ2+ qui songent à utiliser des SAA; et 2) révéler comment le discours du risque modifie l'expérience d'utilisation des SAA par les hommes GBTQ2+. MéTHODE: Les participants ont été recrutés en ligne et de bouche à oreille pour se prêter à des entretiens semi-directifs. Une méthode critique poststructurale et les théories du discours du risque et de la biopolitique ont servi à repérer les thématiques et à interpréter les données. RéSULTATS: En tout, 17 entretiens ont été menés auprès d'hommes adultes GBTQ2+ cisgenres et transgenres. Trois thèmes en sont ressortis : 1) Les sources de savoir et de vérité non autorisées consultées par les utilisateurs actuels et éventuels des SAA se contredisaient et étaient difficiles à évaluer; 2) Les sources autorisées, dont les professionnels de santé, réagissaient contradictoirement; et 3) Les hommes GBTQ2+ produisaient et partageaient des savoirs non professionnels ­ une forme de réduction des méfaits d'inspiration communautaire. CONCLUSION: La complexité des tâches de recherche et d'évaluation des informations fait ressortir la nature privilégiée des informations fiables et exactes à ce sujet. Le discours du risque met les hommes GBTQ2+ qui font usage de SAA dans la position de devoir produire des savoirs non professionnels et cultiver leurs propres « vérités ¼ à ce sujet, ce qui peut causer des méfaits évitables. La santé publique doit se pencher sur ces effets biopolitiques en considérant ces formes de savoirs non professionnelles comme une ressource non exploitée et en concevant des programmes de réduction des méfaits accessibles et sans jugements pour les personnes GBTQ2+ qui utilisent des SAA.

Relationship between sociodemographics, loss of income, and mental health among two-spirit, gay, bisexual, and queer men in Manitoba during the COVID-19 pandemic.

This study examined the relationship between loss of income due to the COVID-19 pandemic and worsening mental health among a sample of 366 Two-Spirit, gay, bisexual, queer (2SGBQ+) men in Manitoba. Data were drawn from a cross-sectional online survey among 2SGBQ+ men in Manitoba. Logistic regression assessed the relationship between sociodemographics, loss of income due to COVID-19 (independent variable) and worsening of mental health (analytic outcome). Among all respondents in the sample (N = 366), 55% indicated worsening of their mental health. In logistic regression, compared to participants who did not experience any loss of income, those who experienced loss of income due to the COVID-19 pandemic were significantly more likely to report worsening mental health (Adjusted Odds Ratio [AOR] = 8.32, 95% Confidence Interval[CI] = 3.54-19.54). Compared to participants who self-identified as gay, bisexual-identifying participants were less likely to report worsening mental health (AOR = .35, 95%CI = 0.13-0.96). Finally, as compared to participants who were married or partnered, participants who were dating (AOR = 3.14, 95%CI = 1.60-6.17), single (AOR = 4.08, 95%CI = 1.75-9.52), and separated/divorced/widowed (AOR = 15.08, 95%CI = 2.22-102.51) were all significantly more likely to report experiencing a worsening of mental health due to the COVID-19 pandemic. This study highlights the need to develop robust public strategies for sub-populations of 2SGBQ+ men (non-gay identified sexual minorities and 2SGBQ+ men who may be more socially isolated). Specific targeted and tailored public health interventions designed with the unique needs of 2SGBQ+ men in Manitoba may be required to increase their access to socio-economic and mental health supports.