Clinics as spaces of costly disclosure: HIV/STI testing and anticipated stigma among gay, bisexual and queer men

Tan, Rayner Kay Jin; Kaur, Nashwinder; Kumar, Pratap; Tay, Evonne; Leong, Amanda; Chen, Mark; Wong, Chen Seong

doi:10.1080/13691058.2019.1596313

Cited by 31 publications

(23 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While we sought to mitigate this by recruiting participants based on their past HIV and other STI testing behaviours, perspectives among GBMSM who might be less comfortable disclosing their sexual orientation may not be reflected as well in the study, especially since heavy stigma towards GBMSM and HIV prevail in Singapore. 15 Furthermore, as participants largely comprised those aged below 30 years old, the findings around perspectives towards HIVST in this study may not typify those of older GBMSM, and should thus be interpreted with this bias in mind. Nonetheless, this study is the first published study on perspectives towards HIVST among GBMSM in Singapore and contributes to the understandings of how HIVST may in fact have negative implications for other STI testing without proper considerations around the existing pathways to testing.…”

Section: Discussionmentioning

confidence: 85%

“…9 Barriers and facilitators to HIV testing among GBMSM have been well established in the literature, including the anticipation of stigma, extent of sexual orientation disclosure, low-risk perceptions of HIV infection and fear of a positive HIV diagnosis; conversely, increasing age, educational attainment and a history of other STIs have been found to be positively associated with both ever and regular testing for HIV among GBMSM. [10][11][12][13][14][15][16] A relatively novel intervention that may enable individuals to overcome such barriers involves the introduction of rapid result HIV self-testing (HIVST). The introduction of self-sampling methods arrived with the advent of over-the-counter home collection kits where blood specimen, collected outside of clinic settings, are sent to laboratories for testing.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Potential interactions between the pathways to diagnosis of HIV and other STIs and HIV self-testing: insights from a qualitative study of gay, bisexual and other men who have sex with men in Singapore

et al. 2020

Self Cite

View full text Add to dashboard Cite

ObjectivesThis study draws on qualitative insights on the barriers and facilitators to HIV testing, as well as perceptions of HIV self-testing (HIVST), to propose a framework to understand not only the benefits but also potential knock-on implications of introducing HIVST in the context of other STI testing.MethodsWe conducted semistructured, in-depth interviews with 30 gay, bisexual and other men who have sex with men aged 18 and 39 years old in Singapore. Interview topics included barriers and facilitators to HIV and other STI testing, as well as perceptions of HIVST. Interviews were audio-recorded, transcribed, coded and analysed using thematic analysis.ResultsFor HIV testing, participants cited the perceived risk of acquiring, susceptibility to and symptoms of HIV as internal motivators, while social influence and accessibility of HIV testing services were external motivators. For STI testing, perceived symptoms and partner notification of STI were reported as internal and external motivators, respectively. Availability of bundle tests, starting a new relationship and instances of mandatory testing motivated both simultaneous HIV and other STI testing. The fear of a positive diagnosis and lack of confidentiality were cited as internal and external barriers to HIV testing, respectively, while low perceived severity of other STI and the cost of STI tests were cited as internal and external barriers to other STI testing, respectively. We identified pathways to HIV and other STI testing and discussed how the introduction of HIVST may reduce opportunities for other STI testing.ConclusionsThe findings of this study suggest that introducing HIVST might weaken linkages to other STI testing if alternative strategies of promoting other STI testing are not simultaneously implemented. We recommend that future interventions address both the risks of HIV and other STI simultaneously, and that structural interventions promoting HIV and other STI preventions be balanced accordingly.

show abstract

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Potential interactions between the pathways to diagnosis of HIV and other STIs and HIV self-testing: insights from a qualitative study of gay, bisexual and other men who have sex with men in Singapore

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…In countries such as China, 80% of GBQ men had not disclosed their sexual orientation to healthcare professionals [ 44 ]. Within the Singapore context that emphasises heteronormativity, clinics become costly spaces for disclosure of sexual orientation, leading to poorer testing behaviours and health outcomes [ 45 ]. Conversely, disclosure towards a non-LGBTQ family member is correlated with better testing behaviours and health outcomes [ 46 ].…”

Section: Introductionmentioning

confidence: 99%

Association between sexual orientation acceptance and suicidal ideation, substance use, and internalised homophobia amongst the pink carpet Y cohort study of young gay, bisexual, and queer men in Singapore

Ong

Tan

et al. 2021

BMC Public Health

Self Cite

View full text Add to dashboard Cite

Background Gay, bisexual and queer (GBQ) men are frequently subjected to minority stressors that have negative impacts on their health. Milestones that include the acceptance and disclosure of sexual identity amongst GBQ men are hence key instruments in understanding the prevalence of internalised homophobia and predicting health outcomes. As such, this work takes a novel approach to deduce the correlates of delayed acceptance of sexual orientation in young GBQ men as a measure of internalised homophobia through retrospective self-reporting and age-based analysis. Methods Participants were recruited as part of a cohort study exploring the syndemic risks associated with HIV acquisition among young GBQ men in Singapore. We examined their levels of internalised, perceived, experienced homophobia, as well as their health behaviours and suicidal tendencies. Two separate variables were also self-reported by the participants – the age of questioning of sexual orientation and the age of acceptance of sexual orientation. We subsequently recoded a new variable, delayed acceptance of sexual orientation, by taking the difference between these two variables, regressing it as an independent and dependent variable to deduce its psychosocial correlates, as well as its association with other measured instruments of health. Results As a dependent variable, delayed acceptance of sexual orientation is positively associated with an increase of age and internalised homophobia, while being negatively associated with reporting as being gay, compared to being bisexual or queer. As an independent variable, delayed acceptance of sexual orientation was associated with a delayed age of coming out to siblings and parents, suicide ideation, historical use of substances including smoking tobacco cigarettes and consuming marijuana, as well as reporting higher levels of experienced, internalised and perceived homophobia. Conclusion Greater levels of early intervention and efforts are required to reduce the heightened experience of minority stress resulting from communal and institutional hostilities. Areas of improvement may include community-based counselling and psychological support for GBQ men, while not forsaking greater education of the social and healthcare sectors. Most importantly, disrupting the stigma narrative of a GBQ ‘lifestyle’ is paramount in establishing an accepting social environment that reduces the health disparity faced by GBQ men.

show abstract

“…23 Social stigma in Singapore toward sexual minority individuals has a negative impact on sexual health-related behavior among gay, bisexual, queer, and other MSM in Singapore. [24][25][26] The aims of this study are twofold. First, it attempts to fill the gap in our knowledge of how experienced homophobia impacts the mental health of young gay, bisexual, transgender, and queer (GBTQ) men in Singapore, and thus allow for the development of appropriate interventions.…”

Section: Introductionmentioning

confidence: 99%

Experienced Homophobia and Suicide Among Young Gay, Bisexual, Transgender, and Queer Men in Singapore: Exploring the Mediating Role of Depression Severity, Self-Esteem, and Outness in the Pink Carpet Y Cohort Study

Tan

Low

Le³

et al. 2021

LGBT Health

Self Cite

View full text Add to dashboard Cite

Purpose: No prior study has been published on suicide-related behaviors among gay, bisexual, transgender, and queer (GBTQ) men in Singapore, where sexual relations between men are criminalized. This study explores the association and mediational pathways between experienced homophobia and suicidal ideation or suicide attempts among young GBTQ men in Singapore. Methods: Results of this study were derived from baseline data of the Pink Carpet Y Cohort Study, Singapore's first prospective cohort study among young GBTQ men. The sample comprised 570 young GBTQ men 18 to 25 years of age who were HIV negative or unsure of their HIV status. Statistical analyses were conducted through descriptive statistics, multivariable logistic regression, and structural equation modeling techniques. Results: Of 570 participants, 58.9% (n = 308) reported ever contemplating suicide, whereas 14.2% (n = 76) had ever attempted suicide. Controlling for key demographic variables, multivariable logistic regression revealed that experienced homophobia and depression severity were positively associated with a history of suicidal ideation, whereas depression severity and outness were positively associated with a history of suicide attempts. Mediation analyses revealed that depression severity and self-esteem partially accounted for the relationship between experienced homophobia and suicidal ideation, whereas depression severity and outness partially accounted for the relationship with suicide attempts. Conclusions: The prevalence of suicidal ideation and past suicide attempts was found to be high in a sample of young GBTQ men in Singapore. Interventions to address experienced homophobia and discrimination among young GBTQ men are needed urgently in Singapore.

show abstract

Clinics as spaces of costly disclosure: HIV/STI testing and anticipated stigma among gay, bisexual and queer men

Cited by 31 publications

References 20 publications

Potential interactions between the pathways to diagnosis of HIV and other STIs and HIV self-testing: insights from a qualitative study of gay, bisexual and other men who have sex with men in Singapore

Potential interactions between the pathways to diagnosis of HIV and other STIs and HIV self-testing: insights from a qualitative study of gay, bisexual and other men who have sex with men in Singapore

Association between sexual orientation acceptance and suicidal ideation, substance use, and internalised homophobia amongst the pink carpet Y cohort study of young gay, bisexual, and queer men in Singapore

Experienced Homophobia and Suicide Among Young Gay, Bisexual, Transgender, and Queer Men in Singapore: Exploring the Mediating Role of Depression Severity, Self-Esteem, and Outness in the Pink Carpet Y Cohort Study

Contact Info

Product

Resources

About