Campaigns and Hubs South Asian sexual health and wellbeing RESULTS: Sex, life, love and health: what matters to South Asian gay and bi men LGBT HERO recently consulted 77 gay, bisexual and trans men of South Asian heritage to ask about their sexual health, mental health and wellbeing needs. Often, South Asian, particularly GBTMSM (gay, bi and trans men who have sex with men), people can face harsher health inequalities when it comes to accessing sexual health and wellbeing. The results showed us some of the reasons for this and gave an insight into how people of South Asian heritage feel about their sex lives, relationships and their place in the LGBTQ+ community. Here’s what we found... SEXUAL HEALTH AND SEXUAL WELLBEING WE ASKED: Would you say that you feel comfortable talking about your sex and sexual health? Yes – 70% No – 17% I’m not sure – 13% Who do you feel comfortable talking to about sex and your sexual health? Friends - 77% A sexual health Clinic - 62% Partner - 49% Hook-ups/sex buddies - 44% A GP/doctor - 42% Colleagues - 15% Helplines - 13% No one – 10% Family – 8% Social media - 5% “It’s encouraging that the survey indicates 77% people have someone to talk to,” says Dan Singh, LGBT HERO’s Group Facilitator for South Asian and 50+ HangOuts. “Often talking to a trusted friend will alleviate feelings of shame and guilt which often stem from childhood traumas that are informed by not fitting into our own South Asian culture, religion, faith and the various interpretations of this. Attending, for example, social and support groups where topics around sexual wellbeing can be discussed in a safe way can also be a safe starting space. “It’s also encouraging that 62% of South Asian GBTMSM feel comfortable to talk to someone at a sexual health clinic. This is key, as once they are there, they can access other useful information around sexual health and wellbeing; such as finding out more about PrEP, STIs and HIV. This also give us a chance to ask questions perhaps we are too embarrassed to ask or myth bust information that may not be accurate. “I was interesting to see around 40% of men who took this survey felt comfortable to talk a hook-up/sex buddy which is still helpful in terms of nuanced knowledge. This along with confirming findings with up-to-date information can only help. “My concerns are that around 10% of people feel they have no one to talk to. This shows how important it is that we have a South Asian hub for sexual health and wellbeing at LGBT HERO and development of this for the future. Perhaps more online campaigns are needed in other more common languages such as a Urdu, Punjabi, Hindi etc. Also, using slang/language appropriate to the campaign would help too.” WE ASKED: How often do you test for STIs? Every 3 months – 50% If I have a symptom – 25% I’ve never tested for STIs – 25% What was the last STI you tested positive for? Chlamydia – 25% Syphilis – 25% Hepatitis A – 25% Hepatitis C – 25% I’ve never had an STI – 25% “It’s great people are testing every three months. Regular testing means we can deal with any symptoms and diagnose quicker,” says Dan. “For me regular testing, often leads to less anxiety around sex allowing us to confidently have the sex we want. “Also, this result might show a gap in knowledge. Not all STIs will give us symptoms. So again, regular testing is important, as is the getting into the habit of doing this. “ It’s recommended that people with an active sex life test for HIV and STIs every three to six months, depending on the kind of sex you are having. Testing for HIV and STIs is easier than it has ever been. You can test in the privacy of your own home or you can test discreetly in a clinic. Choose the way that’s best for you. Find out how and where to access testing at lgbthero.org.uk/hometest. HIV AND PREVENTION WE ASKED: What is your HIV status? HIV-negative – 90% HIV-positive / HIV-undetectable – 5% I’m not sure – 5% How often do you test for HIV? Every 3 months – 20% Every 3-6 months – 22% 6-12 months – 15% Once a year – 9% Once every few years – 15% I haven’t tested for HIV for years – 5% I’ve never tested for HIV – 15% How do you usually test for HIV? At a sexual health clinic – 70% Standard home testing kit – 21% At a pop-up testing site – 6% Home testing kit with instant results – 6% GP – 2% You can find out how to access free home testing at lgbthero.org.uk/hometest. We also wanted to find out about knowledge around prevention methods and how people were preventing HIV. WE ASKED: PrEP is a pill you can take that prevents HIV. It can be taken daily or on-demand if you are planning to have sex. Do you take PrEP? Yes I take it daily – 16% Yes I take it on-demand – 16% I used to take PrEP – 7% I don’t take PrEP – 56% I’ve never heard of PrEP – 4% “I use event-based PrEP, but I don’t have regular sex sufficiently often to require daily PrEP,” explains an anonymous respondent. “It’s safe and I have researched about PrEP’s prevention of HIV infection,” says Hub. Some respondents preferred other prevention methods to PrEP. Zeeshan explains, “I’m just so comfortable using condoms, the thought of taking PrEP pills and having unprotected sex is not my cup of tea.” A thought echoed by Ameet, “I don’t feel the need to take PrEP, I use condoms.” Others have decided to not take PrEP for other reasons. “I have no discreet place to hide it at home,” says Jamaal. “I don’t know how to get it,” J tells us. What other prevention methods do you use for your sexual health? Condoms and lube – 59% Regular HIV testing – 39% Regular STI testing – 35% Vaccinations – 35% I find out the sexual health status of a hook-up before I meet them – 28% I have a monogamous partner – 19% I don’t have anal sex (giving or receiving) – 17% I don’t have sex – 13% PEP – 6% Dan Singh of LGBT HERO talks about his experience of PrEP in South Asian communities: “During my research and from my lived experience, it’s clear a significant majority of South Asian GBTMSM are not yet taking PrEP. In this survey, 56% are not taking PrEP. This could be a lack of awareness of what it is, where to access it from, or simply an issue of not trusting systems of public health. It’s quite common that South Asian men, before the age of 30, are living with families and therefore may not have the privacy they need to keep their PrEP discreetly. Perhaps the way Covid pandemic and mpox was experienced by minoritised people of colour could have impact too, in terms of trusting the information and advice. “Perhaps building up the trust through online PrEP conversations and campaigns for South Asian men is another step forward. It may just mean there is a general trend of men that do not view themselves as being sufficiently at risk of HIV to warrant taking PrEP or is this more about perception of risk of HIV or any medical fears of taking PrEP. Taking any new medication has to be an informed choice based on accurate information. When used correctly PrEP is a an effective treatment.” PrEP is now available for free on the NHS. You can take PrEP daily or on-demand as and when you want to have sex. If you want more information and to find a way to access PrEP visit lgbthero.org.uk/prep or prepster.info. LIVING WITH HIV WE ASKED: Are you open about your HIV status? Yes – 25% Yes – Yes: only with some people – 75% Who are you open about your HIV status? Friends – 75% Family – 75% Partner(s) – 75% I tell people when/if I need to – 75% Colleagues – 25% We asked about some of the barriers they faced when disclosing their HIV status. Sam very succinctly told us: “Judgment.” “Internal stigma from the way others have treated me. Fear of disclosure to other people and being known as the person with HIV,” Sakib explains. We asked people living with HIV whether they have faced stigma because of their HIV status and a 100% of respondents told us yes. “I’ve experienced it in the work environment and when dating,” says Sakib. “I’ve faced it from boyfriends,” Richard tells us. “I’ve lost a group of friends,” says Sam. Stigma had a very personal impact for Prashant. “I was drawn into unbalanced life, depression and still having the same stigma. I got into drugs and stuff to forget the pain. I’m trying to be sober now and having balanced life but life and thoughts are uncertain.” Someone who is living with HIV and on effective medication is HIV-undetectable. This means they cannot pass on HIV through sex. Undetectable = unstransmittable. Find out more at lgbthero.org.uk/hiv-undetectable. MPOX (MONKEYPOX) WE ASKED: Have you ever had mpox (monkeypox)? Yes – 12% No – 85% I’m not sure – 2% I’ve never heard of mpox (monkeypox) – 2% 100% of respondents who have had mpox said it was within the last 12 months and no one experiences any symptoms. Those who have had mpox said they had experienced some stigma because of it. Some experienced racism, judgement by friends and family or were sex shamed by others. WE ASKED: Have you had the Mpox vaccine? Yes, I’ve had one vaccination – 15% Yes, I had two vaccinations – 25% I haven’t been vaccinated – 60% If you aren’t vaccinated, please tell us why: I’m waiting for the vaccine to become available – 26% I don’t want the vaccine – 22% I’m not eligible to get the vaccine at the moment – 7% I didn’t know there was a vaccine – 7% I’ve booked my vaccine – 4% I don’t know how to get the vaccine – 4% The vaccine isn’t available in my area – 4% There is a smallpox vaccine called Imvanex which is being used as a vaccine for mpox (monkeypox). This is because it’s a similar virus to smallpox. The vaccine reduces the likelihood of symptomatic infection and severe symptoms. Anyone who could be in close contact to mpox. Men who have sex with men (MSM) are being prioritised for the vaccine at the moment as it’s spreading faster in the gay and bisexual community. The mpox (monkeypox) vaccine is usually administered at the top of your arm with a shallow injection. Due to the availability of the vaccine, only one dose is being administered at this time, however it is thought a top up dose will be offered as the vaccine becomes more available. Fractional dosing using intradermal vaccination is currently being trailed to maximise the current supply. This method uses 1/5 of the dose and uses a smaller needle and syringe. The injection should produce a small blister known as a ‘bleb’ that disappears within a minute. Find out where you can get your vaccine and more information at lgbthero.org.uk/monkeypox. SEX LIFE WE ASKED: Would you say that you are satisfied with your sex life? Yes – 47% No – 33% I’m not sure – 20% Where do you currently meet people for sex? Dating Apps - 58% Sex apps - 39% Gay bars/clubs – 36% Saunas - 27% Sex in the venue premises (e.g. sex clubs, cruise bars) - 24% Social Media – 17% Cruising areas (e.g. parks, designated cruising spaces etc) – 14% Prefer not to say – 8% Chill outs/sex parties – 5% Gym/fitness premises – 5% Sex Workers - 3% Cottaging – 2% Which gay dating/sex apps do you prefer using? Grindr - 63% Tinder - 21% Hinge - 21% Scruff - 21% Growlr - 11% Fab Swingers - 7% Bumble - 5% Squirt - 5% Recon - 5% Gaydar - 4% Jack’d – 2% Romeo – 2%# Dudesnude – 2% “As a recently single man, I’m struggling to find reliable people to explore my sexuality with,” confides Baloo. “I would like to be more sexually active as am currently single. I go through periods where I feel want to have more sex and times where I don’t, but it does play on my mind often,” says Mohammed. “I have a gastrointestinal health issue (IBS) that has caused a chronic anal fissure for many years, so I cannot bottom unfortunately, and I’d like to,” says an anonymous respondent. J explains, “There is a lot of stigma and racism when it comes to being LGBT and from a South Asian background. It hurts when people say ‘it’s nothing to do with you personally, I just don’t sleep with Indians’.” “Sometimes I feel fulfilled, but I recognise that I could explore a lot deeper into my sexuality if I was less afraid,” divulges Adam. “I am having regular sex with somebody I am comfortable with,” Ash tells us. “With racism in general and on gay sex and dating apps it affects the lives of South Asian GBTMSM men,” says Dan Singh of LGBT HERO. “I wonder how different it would be if the preference section or ethnicity was not available on these apps because then people would not block or delete people based on their ethnicity, colour, or cast immediately before a conversation can be had. Or perhaps statements like “…I don’t sleep with Indians or brown men” should simply be reported. To me this leads to the rise of colour fascism. Colour, body shaming, ageism and ethnicity are just some of the offences that affects mental health and wellbeing and affects our sex lives. “Some men that feel excluded may try to find that intimacy in situations or places when alcohol and drugs present and ultimately a need to be desired will exists in gay saunas, chillouts and other spaces where one can be more anonymous. But this is not exclusive to online dating and sex apps; this is happening still on the gay scene. Questions like …” So where are you really from?” do not help. Also, the exoticisation and comment on heritage, the clothes we may wear, skin colour or hair also does not help restore confidence but makes this unnecessary desire alienate some of us further away. “So, it is about how we reclaim our sex positiveness and where are the spaces we can talk about racism and sex.” LIFE AND WELLBEING WE ASKED: How happy are you with your sexual identity? Very happy - 39% Happy – 41% Not happy – 12% I’m not sure – 8% Suraj tells us: “I am less unhappy about being gay now, but sometimes I wish I wasn’t gay.” Haaris who told us he was not happy explains, “I was ostracised from my community and estranged for being gay.” “I’m mostly know where I stand with it, though I’m curious about experimenting but I mostly feel a little shy. I have intermittent peaks of confidence,” says Mohammed. Many respondents told us that their family doesn’t know about their sexuality, such as Shahan, “Aside from keeping it a secret from my parents, I just feel comfortable with myself.” “I am happy but it can be an awkward thing around family, as there are some backwards views,” says J. “I enjoy the gay fetish scene. I can explore more as a gay man,” an anonymous respondent told us. LGBT HERO’s Dan Singh explains his view: “Our South Asian heritage is important to us all. Depending on our lived experience, it is likely we may reject the whole or part of our religion, culture and faith as we feel excluded and feel like we do not fit in; but our heritage is South Asian, and we can be proud of that, and parts that work for us beyond masculine, political and heteronormative attitudes further imposed on to the fabric of South Asians from colonial power and the slow decolonisation of this. But we are now in 2023, attitudes towards sex, same sex marriages, trans rights and many more intersectionality as well as cast and colour are now positively activated with the speed of news on social media and direct action by protests in South Asian countries and in the UK. From recent discussions at South Asian HangOuts social and support group, there is an othering or rather a shame associated with sex as it is never spoken about when we are younger or no positive celebratory images of intimacy. So when are still struggling to assert our sexuality or gender without the complexities of coming out and being excluded by heritage values we can feel excluded. This invariably leads to social and health inequalities for us, low self-esteem and not having the sex we would like without shame. “Having said that, the above 80% of men who completed this survey are very happy or happy with their sex life. So, I guess this is an encouraging statistic.” WE ASKED: Have you experienced any racism, stigma, hate incidents, hate crime in places you socialise in? Yes – 57% No – 35% I’m not sure – 8% Where did this hate incident or hate crime take place? In a gay bar/club – 55% Gay Dating Apps – 50% Social Media – 31% On public transport – 21% In the workplace – 14% From family – 12% In a ‘straight’ bar – 7% From friends – 7% “I was once called a ‘paki’ in a club I just couldn’t find who called me that. I also don’t know what I’d do if it happened again,” Baloo tells us. Haaris confided, I was physically attacked by family for coming out. I’ve also experienced stigma from the LGBT community for trying to be both Muslim and gay. Nobody likes me from either side of the community it feels sometimes.” “They aren’t necessarily hate-crimes, but I experience racial micro-aggressions on an almost daily basis. Especially on dating apps,” says J. “People say no hairy or brown people when they speak to me. I get weird looks sometimes when I go to gay clubs. I don’t see a point in reporting,” Raj tells us. “I’ve experienced mostly verbal abuse that uses racial slurs on the apps. From my family it is psychological, playing on guilt and shame,” Adam says. WE ASKED: Do you know how to report a hate crime or incident? Yes – 63% No – 33% I’m not sure – 4% Dan Singh says, “Where can we report hate incidences and crime? Who is going to listen? Well, we can report online racism, give feedback to the sex and dating apps, or in terms of racism on the scene we can report online lgbthero.org.uk/pages/category/hatecrime. “Finally, try not to be silent – do talk to someone who will listen as a first step. Most bar people at gay venues will listen to you – they are there to help too and protect your safety. But how do we report those unwanted looks, or a clear intention of not want to socially mix with you. This othering continues.” There are a few different ways to report a hate crime to the police: Online - The police have developed an online portal for reporting hate crime called True Vision. The online form is easy to understand and asks for details about the incident (where, motivation, how many people etc). Once the form has been submitted it is processed by your local police force, and an officer will aim to contact you within 48 hours. Visit report-it.org.uk. Calling 101 - This is the national non-emergency number for the police. You can report a hate crime by calling and asking for the Community Safety Unit. They also provide help and advice about your situation. This is also available for the deaf or hard of hearing via a textphone service on 18001 101. In person - It’s also possible to report a hate crime at your local police station. This allows you to speak to an officer face to face. Through a third party - Galop.org.uk, the LGBTQ+ anti-violence charity, can report an incident on your behalf, and offer you support after an incident. If you’re reporting by phone or in person, you’ll be speaking with an officer or someone working in a police call centre. It’s important to let them know what has happened, highlighting the type of hate crime (transphobic, homophobic) as once they are given this information they are bound by the rules to record it this way. If you’re nervous or anxious then that’s perfectly normal, just try as best you can to tell the officer what happened as clearly as you can manage. Whoever you’re dealing with should provide you with a crime reference number. Be sure to note this down in case you need to talk to someone else about your incident. Galop - the LGBT+ anti violence charity, offers robust support to people who have experienced homophobia, biphobia and transphobia. Whether you’re looking for advice, or just want to talk, Galop is there to give you options. It’s more than just a helpline too, it can advocate for you with organisations like the police, your landlord, or the local council. Here’s a little excerpt from their website: “Galop can give you a space to talk, help you get what you want from the police, negotiate with your housing provider or find you legal advice. If you want the police to know, we can make a report for you and liaise with the police on your behalf. If you prefer, you can make a report anonymously.” Here’s a complete list of Galop’s services: Support and advice for people who have experienced hate crime, domestic abuse or sexual violenceSpecialist advocacy and support Help in reporting or getting what you need from police and other agencies Advice on the law and how the police work Applying for financial compensation for victims of crime Police complaints. HELP AND ADVICE LGBT HERO have put together a South Asian sexual health and wellbeing hub where you can find help and advice about STIs and HIV, testing, mpox and support around your mental health and wellbeing. You can find out more at lgbthero.org.uk/south-asian-wellbeing. Find out more about sexual wellbeing by visiting LGBT HERO’s sexual wellbeing hub at www.lgbthero.org.uk/sexual-wellbeing. Talk to other people like you on the LGBT HERO Forums. Visit the forums at www.lgbthero.org.uk/forums. For more sex tips and advice and for information about better sex, STIs, HIV and testing, visit LGBT HERO’s sexual health pages at lgbthero.org.uk/Pages/Category/sex.