Policy and practice recommendations

• Author: Ford Hickson - Axel J. Schmidt - David S. Reid - Peter Weatherburn - Ulrich Marcus - Susanne B. Schink
• Pages: 157-161

TECHNICAL REPORT EMIS-2017 – The European Men-W ho-Have-Sex-With-Men Internet Surv ey

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10. Policy and practice recommendations

EMIS-2017 was based on the fun damental principles of EU law. Its design and execution u pheld the founding

principles of the Union, namely respect for human dignity, democracy, equality, solidarity, the rule of law and

human rights. We expect that all the subsequent uses o f the data should do th e same.

In this chapter, we consider the po ssible implications of th e findings of EMIS-2017 for poli cies and practices in

relation to sexual health promotion among MSM in Europe. The importance of matching research questions to

research methods cannot be overstated. It is vital t hat we only ask questio ns of the data that our method (a large-

scale, self-complete, cross-section al survey) can address. We therefore begin by outlining some of the limitations.

10.1 Limitations of EMIS-2017

Anonymous, low-access threshold, self-completion, online, cross-sectional surveys have a number of resear ch

limitations. We therefore expressly asked researc h questions that this method is better at ad dressing, especially for

a marginalised population such as MSM. Nevertheless, the limitations of th e method for these question s must be

acknowledged.

There are limitations in t he demographic data we were able to collect. We have appr oximated migration

background, income, socio-ec onomic status, ethnic minority status and education. Some of the reasons that these

data were difficult to co llect include the len gth of the survey, the diversity of collabo rators and, most importantly,

difficulties related to co llecting data across a l arge number of different co untries and societies. There are also the

limitations inherent in self-reported data (recall bias, social desirabili ty bias), and these also ap ply to EMIS.

Like most studies among MS M, the large sample is a convenience sample, and is th erefore very unlikely to be

representative of all MSM in Europe. The sample was m ainly recruited through gay dating sites on th e internet. It

will largely exclude men who do not have access to th e internet and/or do no t use gay dating sites. A comparison

of UK-based men in EMIS 2010 with a nationally representative sample of MSM in the UK indicated that

convenience samples over-represent gay identified MSM and those who are more sexual ly active [9].

10.2 Strengths of EMIS-2017

EMIS-2017 brought together a wide range of stakeholders to map out and prioritis e an agenda for a large d ata

gathering exercise. This pro cess facilitated joint work ing and cooperation acro ss Europe and beyond. The strength

of the data generated is de pendent on the involvement of data users at all stag es of development.

We generated substantial MSM sex ual health needs assessme nt data sets for 43 cou ntries, many of which do no t

have the resources to implem ent a comparable national su rvey. These data can facilitate sexual h ealth promotion

planning processes at int ernational, national, r egional and organisation al levels, providing eviden ce of need and

information to direct resour ces where they can have most impact. The data may al so assist in the developm ent of

national health policies, as well as the integration of MSM health concerns, including HIV, viral hepatitis, other STIs,

and possibly drug and m ental health issues, in the wider policy environmen t pertaining to Europe.

In many countries EMIS offers the largest available national MSM samples. Analysing reg ional (sub-national)

distributions of responden ts can help with the calculation of estimates of local MSM populations, with implications

for prevention planning and the commissioning of health services [39].

These data sets are comparabl e. Comparing national MS M surveys carried out by different teams has been

challenging due to different recruitment procedures an d different measures. EMIS-2 017 provides an internat ional

data set which can be an alysed to reveal knowledge that one country alone could not provide. As an example, in

summer 2018, all EU Member States, all non-EU EEA countri es and Switzerland have been provided with a set of

EMIS-derived indicators for th e Dublin Declaration Moni toring (DDM) process.

Additionally, in collaboration with UNAIDS and the editorial board of the Latin American MS M Internet Survey

(LAMIS), a section on the UNAIDS key population website38 has been created w hich displays selected key

indicators, by country, for EMIS and LAMIS countries.

38 http://www.aidsinfoonline.org/kpatlas/#/home