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Stigma reduces HIV prevention, knowledge, diagnosis among MSM
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Men who have sex with men living in countries with cultural stigmas against homosexuality may be less likely to use HIV-preventive services, according to recently published data.
“Our findings suggest that rather than primarily being the result of personal failure, HIV risk is largely determined by national laws, policies and attitudes toward homosexuality,” John E. Pachankis, PhD, of the Yale School of Public Health, said in a press release. “This study shows that gay and bisexual men in homophobic countries are denied the resources, including psychological resources like open self-expression, that are necessary to stay healthy.”
Pachankis and colleagues examined respondent data from the European MSM Internet Survey, which was distributed across 38 European countries between June 2010 and August 2010, to determine MSM behaviors amid country-level stigmatization. Eligible survey participants were European males above the age of homosexual consent in their country who self-identified as being only or mostly attracted to men, resulting in a final analytic sample of 157,211 MSM.
Survey respondents answered questions pertaining to concealment, HIV status, number of male sex partners in the past year, testing, and their knowledge and use of HIV-preventive services. Country-level stigma was assessed using a combination of national legislation and general population attitudes.
Survey respondents living in countries with higher levels of stigma were more likely to conceal their sexual attraction (P < .001) and less likely to be diagnosed with HIV (adjusted OR = 0.68; 95% CI, 0.57-0.82). In addition, they were more likely to have inadequate knowledge of the infection (aOR = 1.43; 95% CI, 1.27-1.62); not test themselves for HIV (aOR = 1.14; 95% CI, 1.05-1.24) or sexually transmitted diseases (aOR = 1.21; 95% CI, 1.07-1.36) in the last 12 months; not have used a condom during their last nonsteady sexual intercourse (aOR = 1.3; 95% CI, 1.1-1.54); and not discuss their sexual behaviors during HIV testing (aOR = 1.52; 95% CI, 1.29-1.8).
“Concealment mediated the relationship between country-level stigma and HIV diagnosis and preventive outcomes,” the researchers wrote. “These findings suggest that, by keeping MSM relatively invisible, even from each other, stigma suppresses opportunities for HIV transmission while also limiting MSM’s easy access to HIV prevention services, knowledge and precautionary behaviors.” – by Dave Muoio
Disclosure: The researchers report no relevant financial disclosures.
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