TY - JOUR
T1 - Sexual Behavior Stigma Among Cisgender Gay, Bisexual, and Other Men Who Have Sex With Men in Nine NHBS Cities Across the United States
T2 - Burden and Associations With PrEP Continuum and HIV Care Continuum Outcomes
AU - Wiginton, John Mark
AU - Murray, Sarah M.
AU - Anderson, Bridget J.
AU - Sey, Kwa
AU - Ma, Yingbo
AU - Flynn, Colin P.
AU - German, Danielle
AU - Higgins, Emily
AU - Menza, Timothy W.
AU - Orellana, E. Roberto
AU - Sanz, Stephanie
AU - Hasan, Nabeeh A.
AU - Al-Tayyib, Alia
AU - Kienzle, Jennifer
AU - Shields, Garrett
AU - Lopez, Zaida
AU - Wermuth, Paige
AU - Baral, Stefan D.
N1 - Publisher Copyright:
© 2024 American Psychological Association
PY - 2024
Y1 - 2024
N2 - In the United States, sexuality-based stigma continues to undermine HIV prevention and care efforts. We assessed sexual behavior stigma burden across family, health care, and social domains and determined associations with HIV-related outcomes among cisgender gay, bisexual, and other men who have sex with men (MSM) in nine United States metropolitan statistical areas. MSM (N = 4,086) recruited at places of MSM social congregation via venue-based, time-sampling procedures completed a survey on sexual behavior stigma, preexposure prophylaxis (PrEP) continuum and HIV care continuum outcomes, sociodemographic characteristics, and other measures. We calculated prevalence and overall mean stigma subscale scores (range: 0.00–1.00) and used logistic and mixed-effects logistic regression to determine stigma-HIV outcome associations. Most participants identified as gay, were employed, and were from West Coast cities; roughly 40% were non-Hispanic White, aged 25–34 years, and had completed some college. One in five were living with HIV. Family stigma (prevalence = 47.5%; M = 0.36) was associated with greater odds of health care engagement, PrEP awareness, and PrEP use among HIV-negative MSM. Anticipated health care stigma (prevalence = 14.5%; M = 0.11) was associated with lower odds of health care engagement, current antiretroviral treatment (ART) use, and viral load undetectability among MSM living with HIV. General social stigma (prevalence = 49.9%; M = 0.20) was associated with greater odds of PrEP awareness and use among HIV-negative MSM and lower odds of current ART use among MSM living with HIV. Targeted stigma-mitigation in family, health care, and other social contexts remains paramount to ending the HIV epidemic in the United States.
AB - In the United States, sexuality-based stigma continues to undermine HIV prevention and care efforts. We assessed sexual behavior stigma burden across family, health care, and social domains and determined associations with HIV-related outcomes among cisgender gay, bisexual, and other men who have sex with men (MSM) in nine United States metropolitan statistical areas. MSM (N = 4,086) recruited at places of MSM social congregation via venue-based, time-sampling procedures completed a survey on sexual behavior stigma, preexposure prophylaxis (PrEP) continuum and HIV care continuum outcomes, sociodemographic characteristics, and other measures. We calculated prevalence and overall mean stigma subscale scores (range: 0.00–1.00) and used logistic and mixed-effects logistic regression to determine stigma-HIV outcome associations. Most participants identified as gay, were employed, and were from West Coast cities; roughly 40% were non-Hispanic White, aged 25–34 years, and had completed some college. One in five were living with HIV. Family stigma (prevalence = 47.5%; M = 0.36) was associated with greater odds of health care engagement, PrEP awareness, and PrEP use among HIV-negative MSM. Anticipated health care stigma (prevalence = 14.5%; M = 0.11) was associated with lower odds of health care engagement, current antiretroviral treatment (ART) use, and viral load undetectability among MSM living with HIV. General social stigma (prevalence = 49.9%; M = 0.20) was associated with greater odds of PrEP awareness and use among HIV-negative MSM and lower odds of current ART use among MSM living with HIV. Targeted stigma-mitigation in family, health care, and other social contexts remains paramount to ending the HIV epidemic in the United States.
KW - HIV care continuum
KW - men who have sex with men
KW - preexposure prophylaxis continuum
KW - sexual behavior stigma
KW - stigma prevalence
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U2 - 10.1037/sah0000495
DO - 10.1037/sah0000495
M3 - Article
AN - SCOPUS:85183744271
SN - 2376-6972
JO - Stigma and Health
JF - Stigma and Health
ER -