Homophobia is Associated with Sexual Behavior that Increases Risk of Acquiring and Transmitting HIV Infection Among Black Men Who Have Sex with Men

Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, 1600 Clifton Road MS E-37, Atlanta, GA, 30333, USA, .
AIDS and Behavior (Impact Factor: 3.49). 05/2012; 17(4). DOI: 10.1007/s10461-012-0189-y
Source: PubMed


We investigated whether the experience of homophobic events increases the odds of engaging in unprotected anal intercourse (UAI) among black men who have sex with men (MSM) and whether social integration level buffered the association. Participants (N = 1,154) reported homophobic events experienced in the past 12 months. Social integration measures included social support, closeness with family members and friends, attachment to the black gay community, openness about sexuality within religious communities, and MSM social network size. Logistic regression analyses indicated that experiencing homophobia was associated with (1) UAI among men not previously diagnosed with HIV and (2) sexual HIV transmission risk behavior among men who knew they were HIV-infected. None of the social integration measures buffered these associations. Homophobia may promote acquisition and transmission of HIV infection among black MSM. Interventions are needed to reduce homophobia experienced by black MSM.

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Available from: Gregorio Millett
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    • "These entities are those that are both familiar to young MSM and those that young MSM might ordinarily expect to provide them care and support. In this regard, experienced homonegativity may attack the core of young MSM's sense of personhood (Jeffries et al., 2013). Such an assault is likely amplified for young Black MSM, who reported increased levels of experienced homonegativity across all study measures. "
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    ABSTRACT: Unfavourable social environments can negatively affect the health of gay, bisexual, and other men who have sex with men (MSM). We described how experienced homonegativity - negative perceptions and treatment that MSM encounter due to their sexual orientations - can increase HIV vulnerability among young MSM. Participants (n = 44) were young MSM diagnosed with HIV infection during January 2006-June 2009. All participants completed questionnaires that assessed experienced homonegativity and related factors (e.g. internalised homonegativity). We focus this analysis on qualitative interviews in which a subset of participants (n = 28) described factors that they perceived to have placed them at risk for HIV infection. Inductive content analysis identified themes within qualitative interviews, and we determined the prevalence of homonegativity and related factors using questionnaires. In qualitative interviews, participants reported that young MSM commonly experienced homonegativity. They described how homonegativity generated internalised homonegativity, HIV stigma, silence around homosexuality, and forced housing displacement. These factors could promote HIV risk. Homonegative experiences were more common among young Black (vs. non-Black) MSM who completed questionnaires. Results illustrate multiple pathways through which experienced homonegativity may increase HIV vulnerability among young MSM. Interventions that target homonegativity might help to reduce the burden of HIV within this population.
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    ABSTRACT: Men who have sex with men (MSM) have been disproportionately affected by HIV since the onset of the epidemic. Public health discourse about prevention has traditionally focused on individual risk behavior and less on the socio-structural factors that place MSM at increased risk of infection. Anti-gay bias and stigma are key structural drivers of HIV and must therefore be treated as a public health threat. Community-based prevention intervention programs that affirm the healthy formation of gay and transgender identities are strongly needed. Gay affirming school-based interventions and resiliency-focused social marketing campaigns have shown positive impact on health outcomes and should be implemented on a broader scale to challenge anti-gay stigma.Journal of Public Health Policy advance online publication, 15 November 2012; doi:10.1057/jphp.2012.59.
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