Article

The influence of stigma on HIV risk behavior among men who have sex with men in Chennai, India

a Tuberculosis Research Centre , Indian Council of Medical Research , Chennai , India.
AIDS Care (Impact Factor: 1.6). 04/2012; 24(11). DOI: 10.1080/09540121.2012.672717
Source: PubMed

ABSTRACT

Abstract Stigma has been shown to increase vulnerability to HIV acquisition in many settings around the world. However, limited research has been conducted examining its role among men who have sex with men (MSM) in India, whose HIV prevalence is far greater than the general population. In 2009, 210 MSM in Chennai completed an interviewer-administered assessment, including questions about stigma, sexual risk, demographics, and psychosocial variables. More than one fifth of the MSM reported unprotected anal sex (UAS) in the past three months. Logistic regression procedures were used to examine correlates of having experienced stigma. The 11-item stigma scale had high internal consistency reliability (Cronbach's alpha=0.99). Almost 2/5 (39%) reported a high-level of experienced stigma (≥12 mean scale-score) in their lifetime, and the mean stigma scale score was 12 (SD=2.0). Significant correlates of having experienced prior stigma, after adjusting for age and educational attainment, included the following: identifying as a kothi (feminine acting/appearing and predominantly receptive in anal sex) compared to a panthi (masculine appearing, predominantly insertive) (AOR=63.23; 95% CI: 15.92-251.14; p<0.0001); being "out" about one's MSM behavior (AOR=5.63; 95% CI: 1.46-21.73; p=0.01); having clinically significant depressive symptoms (AOR=2.68; 95% CI: 1.40-5.12; p=0.003); and engaging in sex work in the prior three months (AOR=4.89; 95% CI: 2.51-9.51; p<0.0001). These findings underscore the need to address psychosocial issues of Indian MSM. Unless issues such as stigma are addressed, effective HIV prevention interventions for this hidden population remain a challenge.

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Available from: Beena Thomas, Jan 06, 2015
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    • "The framework recognizes, for example, that the endorsements of stereotypes (related to HIV or sexual minority status) may impact health outcomes. Greater incidence of enacted stigma has been associated with increased SRB and psychological distress among Latino gay men (Díaz, Ayala, & Bein, 2004), among gender non-conforming Indian MSM (Thomas et al., 2012), "
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    ABSTRACT: This study investigates how internalized sexual minority stigma and enacted sexual minority stigma in health care settings are associated with sexual health risk behaviors (SRBs) and the mediating role of infrequent routine health care and perceived stress among older gay and bisexual (G/B) men living with HIV disease. Survey responses from 135 sexually active older G/B men living with HIV were analyzed using hierarchical linear regression models. Results indicate that one fifth of G/B older adult men living with HIV are engaged in multiple SRBs. Internalized sexual minority stigma and enacted sexual minority stigma in health care settings are significantly associated with SRBs. The relationship between internalized sexual minority stigma and SRBs are mediated by infrequent routine health care and elevated levels of perceived stress. Improved primary and secondary prevention strategies are needed for the growing number of sexually active older G/B men. © The Author(s) 2015.
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    • "The framework recognizes, for example, that the endorsements of stereotypes (related to HIV or sexual minority status) may impact health outcomes. Greater incidence of enacted stigma has been associated with increased SRB and psychological distress among Latino gay men (Díaz, Ayala, & Bein, 2004), among gender non-conforming Indian MSM (Thomas et al., 2012), "
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    • "RESEARCH IN NURSING & HEALTH Struthers, McIntyre, & Lane, 2013; Fay et al., 2011; Thomas et al., 2012). Stigma is a major issue complicating HIV prevention and treatment efforts in Ghana, and given the very limited research evidence on the degree of perceived stigma among MSM or their impact on health outcomes (Ulasi et al., 2009), the findings from this study add substantially to the emerging literature on HIV stigma among MSM in sub-Saharan Africa. "
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