Based on the findings of the literature review and qualitative research, it was decided to conduct a baseline survey in 2002. The objective was to collect standard data on current health as well as health-related behaviors and attitudes. This data was meant to shed light on the most common health problems experienced by gay men so as to set priorities for proposed actions and awareness-raising among the health authorities. To the extent possible, the survey was also meant to allow for the findings to be compared against data from the general population in order to identify health-related specifics and inequalities.
The responses of gay and bisexual men in the Lake Geneva area to the project health questionnaires were compared with those given by men in the general population on the Swiss Health Survey. For the 2002 baseline survey, the respondents were matched up with one another. This means each participant in the gay survey was compared with a man of the same age, place of residence and nationality as in the Swiss Health Survey (ESS, its French acronym) in 2002. Some of the questions in our surveys were not asked in the Swiss Health Survey. For these questions, findings on the health of men in the general population of countries similar to Switzerland were used for comparison. The sources for comparison are systematically cited in the tables.
In order to compare our findings with the general population, we used the same questions as those on the Swiss Health Survey (ESS). When European Standardized Health Instruments for Health Surveys (EUROHIS) questions existed, we used those. Finally, we chose a number of questions from the Canadian National Health Survey which covers psycho-social aspects and the different areas of life rather well.
The baseline gay health survey questionnaire in 2002 included 550 questions, of which 95% came from existing standardized instruments. Completing the survey took between 1 and 1 ½ hours. It was designed to be self-administering by the respondents on-line or from their laptops. Given the duration of the survey, it was made up of two parts that could be answered all at once or on multiple occasions with a unique access code on an ad-hoc Internet site.
Representation is a major challenge when it comes to studying minorities and hard-to-reach populations. Men identifying as gay or bisexual or who had at least one sexual experience with a man and went to meeting places or cruising areas constituted the baseline population for the survey. We opted for the time-space sampling method developed by the USA’s Center for Disease Control and Prevention (CDC) for hard-to-reach populations. All meeting spaces for gay men in Geneva, whether commercial or non-commercial, real-life or virtual, were analyzed beforehand to understand the usage rate based on opening hours and to come up with a user profile. On this basis, an intervention plan was drawn up laying out the time of day to visit and how many people should be selected at random to participate in the questionnaire.
Number of participants and participation rate according to meeting place type
|Nb of participants||Participation rate|
|Gay groups and associations||69||86%|
|Parks, public toilets||41||38%|
|Gay Internet Sites||47||15%|
From October to December 2002, the recruitment team proposed the questionnaire to 1153 men who were eligible for the survey. 63% of them accepted to participate. In the end, 571 men (50%) actually filled out the survey. Participation was strongest in real-life meeting places (62%) and weakest in virtual meeting places on the Internet (15%).
The baseline survey findings were compared against the Swiss Health Survey (ESS) from 2002. This means each gay or bisexual man residing in Switzerland who participated in the baseline survey was compared with a man who participated in the ESS of the same age, region and nationality.