Why so many questions?

Gay men do a lot of surveys, and if you’re one of them, you’ve probably wondered why you keep getting asked strings of questions.

Some surveys are from community organisations trying to find out what services are needed or how gay men feel about a particular issue.

Some are from health professionals trying to find out if gay men are listening to the right advice.

Some are from businesses trying to find out how they can get their hands on the fabled ‘pink dollar.’ Other surveys are created by students trying to complete their studies.

And some surveys are crafted by researchers like me, who are employed by hospitals or universities. Sometimes these surveys help educate us about our lives, and sometimes they are used to evaluate the need for resources, but mostly they are for the benefit of the community.

In some of our recent surveys I’ve noticed some issues come up over and over again from the men completing the surveys. But because our surveys are usually anonymous we can’t answer them directly, so I thought I would answer them in this article.

“Why are you asking so many questions?”

It doesn’t matter if it’s a brief 10-minute survey or a one-hour interview — this question still comes up a lot. The short answer is “So we are sure we understand what you tell us”. The longer answer is that a survey is different from a poll, which may have been what you were expecting.

Increasingly we’re all getting used to answering snap polls online where we just answer one or two questions, make a quick comparison, or vote for a simple option. These sorts of polls are often just for entertainment, or used to collect a simple result for marketing purposes, and are almost useless in saying anything really useful because we don’t have the rest of the story — there’s no context.

Is the answer to the question affected by the person’s age? Their sex? Where they live? If so, the answer is meaningless without that information.

The issues we deal with in our community surveys are often quite complex, so we need to know more about you to give us the proper context. If we ask gay men about their sexual health knowledge, does the extent to which they participate in the gay community change their answers? How much do their sexual preferences matter when they make decisions about the kind of sex they have and with whom?

As you can see, context makes a big difference, and if we’re going to do the research at all, then we have to ask the correct number and correct kinds of questions. We always try to keep this down to as few as possible — after all, we don’t want you to give up and drop out!

“Why are you asking the same questions again?” Sometimes we are, and sometimes we’re not. We often have to ask questions about an issue from more than one angle. For example, if we ask about condom use during sex, the reality is that as gay men we often make very different choices about using condoms depending on who we are having sex with (a boyfriend, a fuck buddy, or an anonymous guy in a sauna.)

Condom use can also vary depending on what we know about that person’s HIV status, or a range of other factors.

If a researcher wants to understand the truth, we have to ask what appears to be virtually the same question several times but each time accounting for a slightly different scenario. So the questions may seem repetitive, but they are different, and it would be impossible to understand what gay men are doing and why they are doing it without them.

“But you asked me about this last year.” This is a variation of the question above, and the answer is, “Yes, we did”.

Many studies need to be able to monitor changes among gay men over some period of time, so we need to ask exactly the same questions each time you participate. If we didn’t, we couldn’t compare those answers to see what has changed.

Also, there are some things that have to be asked every time because they’re fundamental to how we all think about the issues (e.g. HIV status, relationships, sexuality, and whether we always use condoms or not). If we didn’t ask those questions in every survey then we wouldn’t be able to compare the answers in a meaningful way with other information we’ve gathered, or demonstrate that we asked the right questions of the right people for that issue.

“But you have to take into account that when I answer this question this way it’s only because of my personal/special/unique situation.” Sometimes someone says this because they’re in a monogamous relationship, or they have an agreement with their partner. Sometimes they’re saying that because they’re HIV-positive /HIV-negative they’ve made certain choices that apply specifically to them.

Whatever the reason, they’re usually saying it because they’re worried about how the answer they gave will be interpreted. Making sure we get that interpretation right is precisely why we have to ask a lot of other questions in each survey, so we can account for these sorts of things.

Proper, responsible research will never look at the answers on a single question, but at a range of factors and how they affect each other. This is why some of the questions that seem repetitive (like your HIV status or whether or not you’re in a relationship) are asked in each survey you might see — your answers are put into context using those types of questions.

“This is an issue that I disagree with, and you shouldn’t be asking about it!”

In a recent survey, we asked men about circumcision status. Some guys felt strongly that this was an issue that shouldn’t have been on the survey. They felt it would appear that maybe we were endorsing the practice, or that the issue was offensive or irrelevant and didn’t warrant the interest or attention it would get.

However, this attitude assumes that we all have the same information or opinion, when the reality is that if we don’t ask the questions and collect the information, it’s simply not possible to argue any side of the issue.

Our research is not about being on one side of an issue or another. We are looking for the facts, so we can understand the issue properly and decide what (if anything) can or needs to be done about it. Having clear evidence that most gay men are opposed to a particular issue is equally as important as finding out they agree with something. This brings us to the next question.

“Why do you want to research gay men specifically?”

In Australia, our response to HIV has been second to none. A key reason for this is that we’ve insisted on basing everything we do on good, solid evidence and particularly on research conducted in our community and by community members who understand the issues.

In spite of these efforts, the occasional piece of research by less qualified or ill-informed organisations can still occur, and these may not serve the interest of our community.

But how can you be sure the research opportunities you encounter are being conducted responsibly, and in ways that are useful and appropriate for our community? That’s simple: you can check to see who is sponsoring the research, or whether it’s being done in association with a community organisation you recognise and respect.

You can also check and see if ACON’s own Ethics Committee has reviewed the research project. Ethics approval for much of the community research passes through their hands, providing a valuable source of information for you.

In other countries the HIV response has often been based on simplistic and moralistic beliefs about sex and disease, but our response has always been reflective of what we’ve known to be the case among gay men.

How did we get this knowledge? By asking a lot of detailed, consistent, frequent, and issue-related questions in our research, along with demographic and other contextual information that gives us a clear picture we can use to inform our knowledge and action. In short, we get it from doing surveys!

Australia uses this approach to better effect than almost any other country. For example, the US emphasis on sexual abstinence and fidelity as an HIV prevention strategy was not taken up here because we knew it didn’t fit with most gay men’s beliefs and wasn’t actually relevant to HIV prevention.

Australian sexual health work among gay men has been of very high quality and has shown proven results. For this to continue to be the case we need to maintain our commitment to the accuracy of the information we collect, and see to it that we collect it within our own communities. Most Australian gay men have recognised this and participated generously in our research for over two decades.

In return, researchers such as myself do our best to ensure the surveys we conduct are as easy and efficient as possible and that any research we invite you to help us with will always be of direct benefit to the community.

Remember: if you have questions about any research project, or about a survey, or what benefit any of this has for us as a whole, just ask! Helping you find answers is what we do best.

– JACK BRADLEY

info: Jack Bradley is Projects Officer with the HIV Epidemiology and Prevention Program at the National Centre in HIV Epidemiology and Clinical Research.