Correlates of Internalized Homonegativity Among Black Men Who Have Sex With Men

Quinn, Katherine; Dickson‐Gómez, Julia; DiFranceisco, Wayne; Kelly, Jeffrey A.; Lawrence, Janet S. St.; Amirkhanian, Yuri A.; Broaddus, Michelle

doi:10.1521/aeap.2015.27.3.212

Cited by 51 publications

(42 citation statements)

References 56 publications

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“…Our finding that Black MSM experienced lower levels of certain types of sexual behavior stigma is in contrast to previous literature suggesting that stigma surrounding sexual orientation is more pervasive in the Black community [ 62 , 63 ]. However, much of this previous work assessed internalized homo-negativity among Black MSM, which we did not measure in this study [ 64 ]. In addition, there is potential selection bias in that Black MSM are underrepresented in AMIS-2015, and thus this finding should be further explored and confirmed using alternative sampling methods.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Sexual Behavior Stigma Affecting Gay Men and Other Men Who Have Sex with Men Across Sub-Saharan Africa and in the United States

Stahlman¹,

Sanchez²,

Sullivan³

et al. 2016

JMIR Public Health Surveill

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BackgroundThere has been increased attention for the need to reduce stigma related to sexual behaviors among gay men and other men who have sex with men (MSM) as part of comprehensive human immunodeficiency virus (HIV) prevention and treatment programming. However, most studies focused on measuring and mitigating stigma have been in high-income settings, challenging the ability to characterize the transferability of these findings because of lack of consistent metrics across settings.ObjectiveThe objective of these analyses is to describe the prevalence of sexual behavior stigma in the United States, and to compare the prevalence of sexual behavior stigma between MSM in Southern and Western Africa and in the United States using consistent metrics.MethodsThe same 13 sexual behavior stigma items were administered in face-to-face interviews to 4285 MSM recruited in multiple studies from 2013 to 2016 from 7 Sub-Saharan African countries and to 2590 MSM from the 2015 American Men’s Internet Survey (AMIS), an anonymous Web-based behavioral survey. We limited the study sample to men who reported anal sex with a man at least once in the past 12 months and men who were aged 18 years and older. Unadjusted and adjusted prevalence ratios were used to compare the prevalence of stigma between groups.ResultsWithin the United States, prevalence of sexual behavior stigma did not vary substantially by race/ethnicity or geographic region except in a few instances. Feeling afraid to seek health care, avoiding health care, feeling like police refused to protect, being blackmailed, and being raped were more commonly reported in rural versus urban settings in the United States (P<.05 for all). In the United States, West Africa, and Southern Africa, MSM reported verbal harassment as the most common form of stigma. Disclosure of same-sex practices to family members increased prevalence of reported stigma from family members within all geographic settings (P<.001 for all). After adjusting for potential confounders and nesting of participants within countries, AMIS-2015 participants reported a higher prevalence of family exclusion (P=.02) and poor health care treatment (P=.009) as compared with participants in West Africa. However, participants in both West Africa (P<.001) and Southern Africa (P<.001) reported a higher prevalence of blackmail. The prevalence of all other types of stigma was not found to be statistically significantly different across settings.ConclusionsThe prevalence of sexual behavior stigma among MSM in the United States appears to have a high absolute burden and similar pattern as the same forms of stigma reported by MSM in Sub-Saharan Africa, although results may be influenced by differences in sampling methodology across regions. The disproportionate burden of HIV is consistent among MSM across Sub-Saharan Africa and the United States, suggesting the need in all contexts for stigma mitigation interventions to optimize existing evidence-based and human-rights affirming HIV prevention and treatment interventions.

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Section: Discussionmentioning

confidence: 99%

The Prevalence of Sexual Behavior Stigma Affecting Gay Men and Other Men Who Have Sex with Men Across Sub-Saharan Africa and in the United States

Stahlman¹,

Sanchez²,

Sullivan³

et al. 2016

JMIR Public Health Surveill

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“…For example, lacking condom use self-efficacy can promote condomless anal sex by making BMSM feel doubtful about their abilities to use and discuss condoms with sexual partners [17]. Moreover, internalized homophobia, which is associated with decreased resilience levels [18], may promote condomless anal sex by diminishing BMSM’s perceived self-worth [19]. Internalized homophobia could also confound the association between resilience and condomless anal sex.…”

Section: Introductionmentioning

confidence: 99%

Resilience, condom use self-efficacy, internalized homophobia, and condomless anal sex among black men who have sex with men, New York City

et al. 2019

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Background Black men who have sex with men, who account for less than 1% of the U.S. population, account for approximately 25% of new HIV infections annually. Condomless anal sex contributes to HIV infection among black men who have sex with men. The capacity to recover quickly from difficulties (resilience) may be protective against condomless anal sex, but has been understudied among black men who have sex with men. Psychosocial factors related to resilience, i.e., condom use self-efficacy and internalized homophobia, may also affect condomless anal sex. We assessed the association between resilience, condom use self-efficacy, internalized homophobia and condomless anal sex among black men who have sex with men. Methods Data are from a 2010–2011 study examining condomless anal sex (past 60 days) among black men who have sex with men in New York City. Validated scales assessed resilience (theoretical range = 0–100), condom use self-efficacy (theoretical range = 27–135), and internalized homophobia (theoretical range = 9–36). We described continuous variables using median and interquartile range (IQR). Univariable and multivariable Poisson regression models assuming a robust variance estimator were used to compute unadjusted and adjusted prevalence ratios, respectively, and their corresponding 95% confidence intervals (CI). Adjusted prevalence ratios (aPR) examined the association of resilience, condom use self-efficacy, and internalized homophobia with condomless anal sex, while controlling for potential confounders (e.g., having >1 sex partner). Results The median resilience score within our sample (N = 228) was 75 (IQR = 66–83). Many black men who have sex with men reported condomless anal sex (55.7%) and >1 sex partner (58.8%). Decreased condomless anal sex was associated with increased levels of condom use self-efficacy (aPR: 0.94 per 10-point increase in condom use self-efficacy score; CI: 0.90–0.97; p -value: 0.001). Condomless anal sex was not associated with resilience or internalized homophobia. Conclusions Within this sample of black men who have sex with men, condomless anal sex was prevalent. Greater resilience was not protective against condomless anal sex. Interventions that support condom use are warranted for black men who have sex with men.

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“…IH has been known to adversely affect GBM (Emlet, Fredriksen-Goldsen, Kim, & Hoy-Ellis, 2017; Herrick et al, 2013), and may be even more pronounced in racial minority GBM (Balaji et al, 2012; Quinn et al, 2015). Research has linked IH to psychological (e.g., depression), physical (e.g., substance abuse), social (e.g., relation to lesbian, gay, bisexual, transgender, queer/questioning [LGBTQ] communities), and behavioral (e.g., high-risk sex) issues in GBM.…”

mentioning

confidence: 99%

Psychosocial and Behavioral Correlates of Internalized Homonegativity in Midlife and Older Gay and Bisexual Men

2019

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This study investigated psychosocial and demographic variables that might influence internalized homonegativity (IH) in midlife and older gay and bisexual men (GBM). Data were collected from 802 community-dwelling GBM aged 40 to 94 years ( M = 54.8) through an anonymous questionnaire that assessed levels of IH, coping self-efficacy, self-silencing, and other characteristics. Multivariate logistic regression analysis successfully explained 22% of the variance in predicting IH, which was significantly related to coping self-efficacy, self-silencing, gay community volunteering, partnership status, and race, F = 59.74, p < .001. IH scores were highest in participants who were single, had lower education levels, were non-White, were less involved in gay community volunteering, experienced less coping self-efficacy, and reported higher levels of self-silencing behaviors. These data underscore the need for more tailored programming approaches for midlife and older GBM, focusing on underlying factors contributing to IH that include skill-building to increase coping self-efficacy, community involvement, and decrease self-silencing behaviors in this overlooked population.

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Correlates of Internalized Homonegativity Among Black Men Who Have Sex With Men

Cited by 51 publications

References 56 publications

The Prevalence of Sexual Behavior Stigma Affecting Gay Men and Other Men Who Have Sex with Men Across Sub-Saharan Africa and in the United States

The Prevalence of Sexual Behavior Stigma Affecting Gay Men and Other Men Who Have Sex with Men Across Sub-Saharan Africa and in the United States

Resilience, condom use self-efficacy, internalized homophobia, and condomless anal sex among black men who have sex with men, New York City

Psychosocial and Behavioral Correlates of Internalized Homonegativity in Midlife and Older Gay and Bisexual Men

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