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“Living a life less ordinary”: Risk perspectives of men acquiring HIV while travelling and working overseas

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Presentation by John de Wit, from the National Centre in HIV Social Research, at the 2010 AFAO HIV Educators Conference.

Text of “Living a life less ordinary”: Risk perspectives of men acquiring HIV while travelling...

  • 1. Living a life less ordinary Risk perspectives of men acquiring HIV while travelling and working overseas
      • Dr Graham Brown
      • Dr Jeanne Ellard, A/Prof Garrett Prestage
      • Dr Julie Mooney-Somers,
  • 2. HIV Epidemiology Trends in WA 1993 - 2008 Total HIV Diagnoses By Exposure in WA
  • 3. HIV Epidemiology Trends in WA 1996 - 2008 Only those acquired overseas by exposure
  • 4. ABS,2007
  • 5. O/S Acquired HIV Social Research
    • Funding:
      • Sexual Health and BBV, WA Dept of Health
    • Collaboration of
      • WA Centre for Health Promotion Research, Curtin Health Innovation Research Institute
      • National Centre in HIV Social Research (UNSW)
      • National Centre in HIV Epidemiology and Clinical Research (UNSW)
      • Australian Research Centre in Sex, Health and Society (La Trobe)
  • 6. O/S Acquired HIV Social Research
    • Increase in men acquiring HIV while overseas
    • Only one aspect of the issue of HIV and mobility that WA is experiencing
    • Some insight into what , but little on why or what we could do to about it.
  • 7. O/S Acquired HIV Social Research
    • Qualitative in depth interviews about 2 hours each
    • About identifying the range of experiences and the common underlying themes rather than a representative sample of behaviour
  • 8. Who have we interviewed?
    • 14 Men (12 in WA, 2 in NT)
    • Sexuality identity
      • 9 heterosexual,
      • 5 gay
    • Believed location of transmission
      • 11 Asia (6 in Thailand)
      • 1 North America
      • 2 Africa
    • Age
      • 20+ 1
      • 30+ 3
      • 40+ 4
      • 50+ 3
      • 60+ 3
    • 1 born in Asia
    • 3 born in Europe
    • 10 born in Australia
  • 9. Role of networks
    • Friendship groups and networks were substantially other Australian or western expats or they were regular travellers who linked in with expat networks.
    • Some had strong friendship networks which included locals, but generally was mostly western
  • 10. Role of networks
    • Fly in Fly out mining context, spending most breaks in Thailand
    30+, Heterosexual, Asia Well theres a hotel in Phuket called the Expat Hotel and thats owned by a guy that used to work in the seismic industry, so youd always see guys there that youd worked with or knew But theres always people I knew up there and that sort of centred around that hotel. vast majority of any information like that I ever got was from workmates and guys that Id have a beer with in Thailand. Either at work, during a quiet period, or sitting around the bar somewhere in Thailand.
  • 11. Role of networks
    • There was a clear theme of mentoring and advising other westerners, and in particular fellow Australians, creating an experience of support and camaraderie between expats and longer term travellers.
    • In the context of bars advice would include which bars to go to and which bars treat the girls well, how to choose a nice girl, and how much to get involved.
    • Advice came from other guys in Australia who travelled frequently, or were based / living in the destination country.
  • 12. Role of networks
    • 50+, Heterosexual, Asia, Expat
    • A good friend of mine who had a marriage breakdown many years ago I had a phone call from him saying mate, come to Thailand, its paradise. Im married, I got a lovely little daughter. Book for a month, stay at my place, Ill show you the ropes and then your on your own When I get there for a holiday for a month it was fantastic like he said and when I got back I booked for another six months and.within 3 years I sold I was over there.He taught me right from wrong right from the word go. ..showed me, what to do, how to go about it, whats this, whos this Theres lady men, the men that have changed to ladies and all this, and how do you pick em. I tried to do that for guys who first come across when I was in the bar.
  • 13. Social norms and assumptions
    • The men saw themselves first and foremost as an expat or as a seasoned traveller, and not a short term or nave tourist
    • Active distancing themselves from a tourist identity
    • None of the men saw themselves going overseas exclusively for sex (including those involved in bar girl/sex work contexts).
    • Their understanding of the situation, context and culture seemed to be more driven by interactions with other foreigners than with locals
  • 14. Experience and Perspective Typology
    • The men and their experiences could be grouped into four groups which helps to understand their perspectives about risk
      • Going nativebut not local
      • Escaping and Finding
      • Fantasy realised
      • Living a life less ordinary
    • Still working on the labels
  • 15. Going native, but not a local
    • Felt they had found a place with which they had more connection with than Australia
    • Preferred to, planned to or had already decided to live permanently in their new country.
      • could come back to Australia if things went wrong and their Australian citizenship was maintained.
      • However this was not always the case - some descriptions of changes to religion and (prior to HIV diagnosis) had investigated changing citizenship.
    • Considered themselves to be actively and confidently engaging in local language and customs.
    • There was a sense of becoming local but not a local - there was still an underlying sense of difference.
  • 16. Going native, but not a Local
    • (R2, 30+, Heterosexual, Asia, FIFO).
    • It was more the people and just the place and just the whole attitude of the place is nice, you sort of, you know you go native a bit, I think, is the expression. you start picking up some more language and when you just walk down the street, if youve been there for a couple of years, youll see people you know, like locals and that. So its more like home I always used to feel as though I had a lot more freedom up there to do what I felt like doing, basically. I was happier being up there, basically, than down here. Although youre definitely separate, you know?... you sort of feel like youre at home or its getting that way, but youre also an outsider to them, mostly.
  • 17. Going native, but not a Local
    • (G1, 50+, Heterosexual, Asia, Expat).
    • It's like people say, how come you know so much about Indonesia? I said I studied the Koran for two years, if I can understand the Koran I can understand what the people are doing and I need to know what the people are doing because I'm a (profession) and I'm in the villages and I gotta know my danger areas you know. Which there isnt really any, so it doesnt matter, but at least if you can say some Islamic phrases, you'll get more fried rice you know. Or you know if you can say a go