EMIS 2017: European MSM Internet Survey
HOT NEWS: For World AIDS Day we have partnered with UNAIDS to present some key findings from EMIS and LAMIS as interactive maps on their website for key populations. Findings are presented as interactive maps with downloadable country-specific factsheets that include various sexual health indicatiors for gay men, bisexual men and other MSM. For each country we include percentages on: (1) who received targeted information on HIV and STI; (2) who received free condoms; (3) who did condomless anal intercourse last year; (4) using pre-exposure prophylaxis (PrEP); (5) HIV testing; (6) diagnosed with HIV; (7) and disclosure in health care.
Available in 33 languages, the European MSM Survey 2017 (EMIS 2017) recruited 137,358 qualifying participants from 46 countries across Europe and Lebanon, Israel, Canada and the Philippines. The Latin American MSM Internet Survey (LAMIS) recruited 64,655 participants from 18 countries. EMIS was undertaken by researchers from Sigma Research at the London School for Hygiene and Tropical Medicine and the Robert Koch Institute as part of ESTICOM. LAMIS, using the same questionnaire, was implemented by researchers from the "Red Iberoamericana de Estudios en Hombres que tienen Sexo con Hombres y Personas Trans" (www.estudiolamis.org) a coalition of researchers from Latin America, Portugal, Spain and the Netherlands, with support from the EMIS team. Both projects required a great deal of international cooperation and relied on the support of national stakeholders to aid local recruitment. Through this cooperation comparable data are now available for the first time for 64 countries across 4 continents.
Our first Community Report, targeted at EMIS respondents and MSM in general, and launched in English during AIDS2018 in Amsterdam, has been published in 31 languages (October 2018). We thank our network partners for their contributions and translations, and particularly the German NGO Deutsche AIDS-Hilfe for leading the process, and the Swiss AIDS Federation for financial support.
Background: Sigma @ LSHTM and a range of partners has been funded as part of the European Commission Health Programme 2014-2020 to deliver evidence about the sexual health of gay men, bisexual men and other MSM across Europe. Called ESTICOM (European Surveys and Trainings to Improve MSM Community Health) the partnership will deliver on three inter-linked projects over three years from August 2016 to August 2019.
The 3 main projects are:
- A pan-European online survey of MSM that will be known as EMIS 2017.
- A pan-European online survey about knowledge, attitudes, practices and training needs of community health workers (CHW) who provide health-related services and support for MSM in EU countries (European Community Health Worker Online Survey – ECHOES).
- Development and piloting of a training programme for MSM-focused community health workers intended to be adaptable for all EU countries.
The overall aim of EMIS 2017 is to generate data useful for the planning of HIV and STI prevention and care programmes and the monitoring of national progress in this area (by comparing with the results of previous surveys). The survey seeks to describe the level and distribution of HIV transmission risk and precautionary behaviours; related HIV prevention needs; and to assess self-reported STI testing behaviours, testing performance and STI diagnoses, including viral hepatitis. At a country level, the survey will generate data for understanding the needs of populations and directing prevention programmes. At the international level, patterns of policy, service and cultural responses can be examined for their impact on epidemic spread and containment, providing knowledge beyond the grasp of any one country.
EMIS 2017 was live and collecting data from gay, bisexual, and other MSM in 50 countries between 18 October 2017 and 31 January 2018. The online questionnaire was available simultaneously in 33 languages - PDFs of all the language-versions of the questionnaire are available here. About 137,000 MSM in our 50 target countries took part and submitted their answers including 100,000 in the European Union, more than 6,000 in EFTA countries, and about 7,000 in countries in the EU Enlargement Area or the European Neighbourhood Policy. We also recruited 6,000 MSM in Russia, 6,000 in Canada and on behalf of WHO (Western Pacific Region), 3,500 in the Philippines.
We have already merged and cleaned the whole dataset and prepared an EMIS 2017 Variable Manual, and an analysis plan for the main European Report. The analysis to establish priority areas for reporting will take account of the ESTICOM MSM review of the current European situation. First data feedback occurred at an expert workshop in late April 2018 in Berlin, where we sought input from partners, funders and other experts on the ideal structure for our final report. We are currently working on the first draft of the main report to the funders and distributing National data-sets back to our partners.
EMIS 2017 is undertaken by Sigma Research at the London School of Hygiene and Tropical Medicine (LSHTM) in association with the Robert Koch Institute (RKI) in Berlin. EMIS core team: Ford Hickson, David Reid, Axel J. Schmidt and Peter Weatherburn @ LSHTM and Uli Marcus and Susanne B. Schink @ RKI.
Primary Funding: EU Health Programme 2014-2020 for Europe.
Other international financial contributions: Swedish Ministry of Health for recruitment in the Nordic Countries; The Arctic University of Norway and University Hospital of North Norway for Russia; Israel Ministry of Health for Israel; Public Health Agency of Canada for Canada; WHO Western Pacific Region for the Philippines.
Acknowledgements: We begin by thanking all of the men who took part in EMIS 2017 and our partners who recruited 17% of all respondents through activities on Facebook and other social media and by placing EMIS banners on their websites. We thank all our partners for being part of something huge!
The following list acknowledges all partners in EMIS by country. Individual names are mentioned if a freelancer was the main contact and/or translator or where input on the questionnaire development came from a person not formally representing an organisation. The order is: main NGO partner, other NGO partners, academic partners, governmental partners, individuals.
Europe: PlanetRomeo, European AIDS Treatment Group (EATG), Eurasian Coalition on Male Health (ECOM), European Centre for Disease Prevention and Control (ECDC), European Monitoring Centre for Drugs & Drug Addiction (EMCDDA), European Commission (DG SANTE). We would like to highlight the individual contributions of Caoimhe Cawley (ESTICOM consortium coordinator from October 2016 to May 2018), and Teymur Noori for continuous support for EMIS since the first version of the project in 2010.
AL: Arian Boci. AT: Aids Hilfe Wien, Dr Frank M. Amort. BA: lgbti.ba, Masha Durkalić. BE: SENSOA, exaequo, Observatoire du SIDA et des sexualités. BG: HUGE, GLAS Foundation, Dr Emilia Naseva, Petar Tsintsarski. BY: Vstrecha. CA: Health Initiative for Men, Rézo, Gay Men’s Sexual Health Alliance of Ontario, CATIE, Université du Quebec & Montréal, University of Toronto, Ryerson University, University of Windsor, University of Victoria, Public Health Agency of Canada, Rob Gair. CH: Swiss AIDS Federation, Cantonal Hospital St. Gallen, Centre Hospitalier Universitaire Vaudois, University Hospital Zurich, Swiss Federal Office of Public Health. CY: AIDS Solidarity Movement. CZ: AIDS pomoc, National Institute of Public Health, Tereza Zvolska, Dr Michał Pitonak. DE: Deutsche AIDS-Hilfe, Robert Koch Institute, BZgA, Dr Michael Bochow, Dr Richard Lemke. DK: AIDS-Fondet, Statens Serum Institut, François Pinchon, Jakob Haff. EE: Eesti LGBT, VEK LGBT, Estonia National Institute for Health Development, Dr Kristi Rüütel. ES: Stop Sida, CEEISCAT, Ministerio de Sanidad. FI: Positiiviset, Hivpoint, SeksiPertti, Trasek. FR: AIDES, Coalition PLUS, SexoSafe, Santé Publique France, INSERM. GR: Ath Checkpoint, Thess Checkpoint; Positive Voice. HR: Iskorak, gay.hr, Zoran Dominković, Vjeko Vacek. HU: Háttér, Tamás Bereczky. IE: Gay Health Network, Man2Man, HIV Ireland, Outhouse, GOSHH, Sexual Health Centre Cork, AIDSWEST, Gay Community News, Health Service Executive, Gay Men's Health Service, Sexual Health and Crisis Pregnancy Programme, Health Protection Surveillance Centre. IL: Israel AIDS Task Force, Israel Ministry of Health, Dr Zohar Mor. IS: Samtökin '78. IT: Arcigay, Fondazione LILA Milano ONLUS, University of Verona, Dr Raffaele Lelleri. LB: SIDC, Dr Ismaël Maatouk. LT: demetra, LGL, Gayline. LV: Testpunkts, Baltic HIV Association, Dr Antons Mozalevskis, Indra Linina. MD: GENDERDOC-M. ME: Juventas. MK: Subversive Front, Dr Kristefer Stojanovski. MT: Malta LGBTIQ Rights Movement, Allied Rainbow Communities, Infectious Disease Prevention and Control Unit (Malta), Silvan Agius, Russel Sammut. NL: Results in Health, Maastricht University, Amsterdam Pink Panel, Soa Aids Nederland, Rutgers, Dr Wim Vanden Berghe. NO: Helseutvalget, Folkehelseinstituttet, Dr Rigmor C. Berg. PH: Bisdak Pride-Cebu, Cebu Plus, HASH, Pinoy Plus, UP Babaylanes, YPEER, TLF, Natasha Montevirgen, Mikael N. Navarro. PL: Spoleczny Komitet ds AIDS, Kampania Przeciw Homofobii, Lambda Warszawa, Dr Łukasz Henszel. PT: GAT Portugal, CheckpointLX, Associação ABRAÇO, rede ex aequo, SexED, dezanove, ILGA Portugal, Trombeta Bath, ISPUP. RO: PSI Romania, ARAS Romania, Tudor Kovacs. RS: Association Duga, Association Red Line, Omladina JAZAS-a Novi Sad, Institute of Public Health of Serbia, Sladjana Baros, Dr Marija Pantelic. RU: LaSky. SE: RFSL, University of Gothenburg, Folkhålsomyndigheten. SI: ŠKUC, Legebitra, LJUDMILA. SK: PRIDE Košice, Light-House Slovakia, Trnavská univerzita, Slovenská zdravotnícka univerzita, Dr Zuzana Klocháňová. TR: Pozitif Yaşam, Sami Sarper Yazıcılaroğlu. UA: Alliance for Public Health, alliance.global, msmua.org, Oleksii Shestakovskyi. UK: Terrence Higgins Trust, NAM, PrEPster, Antidote, Horizon Drugs and Alcohol Support, LGBT Foundation, Yorkshire MESMAC, MESMAC Newcastle, Derbyshire LGBT+, Trade Sexual Health, London Friend, GMFA, Spectra, International HIV Partnerships, International Planned Parenthood Federation, Bristol University, University College London, Sigma Research, Raul Soriano. Other: Dr John Pachankis, Dr Mark Hatzenbühler, Dr Valeria Stuardo Ávila, Dr Michael W. Ross.
These acknowledgements and recruitment information can be found here as Powerpoint-Slides.
EMIS co-ordination: Axel J. Schmidt