A preliminary evaluation of support and education groups for rural men who have sex with men (MSM)

Background: MSM living in rural states identify isolation, homophobia, lack of social support and fear of violence as contributors to health-demoting behaviors, including risky sex and substance abuse. Rural MSM face unique logistical and social obstacles to reducing these behaviors. The present study tested whether support and education groups for MSM in Montana impacted health behaviors.

Methods: Thirty-seven MSM participated in groups designed to provide social support and sexual health education in four Montana communities. Condom use, substance abuse and several factors influencing health behaviors (i.e., HIV transmission knowledge, attitudes towards condoms, sexual communication, social support, self-acceptance of sexuality, self-esteem and depression) were evaluated using a questionnaire tailored for the study. Questionnaire ratings were obtained during the first group meeting and after nine hours of participation. Pre- and posttest differences were examined with non-parametric and t-tests as appropriate.

Results: Relative to pre-test reports, at post-test, participants reported that they were more likely to wear a condom during sex and that it was easier to talk to partners about sexual health risks. Post-tests also evidenced reductions in binge drinking and drug use. Significant positive changes occurred in depression symptomatology (p=.00) and self-esteem (p=.00). Finally, post-test scores evidenced increases in HIV knowledge, self-acceptance of sexuality, social support and sexual communication.

Conclusion: These preliminary results suggest a positive impact for education/support groups on MSM's health behaviors. Although further study is needed, these groups may support health through the development of gay community, establishment of positive sexual norms, and reduction of social stigma.