Experiences of HIV-Related Stigma Among Young Men Who Have Sex with Men

Abstract

Young men who have sex with men (MSM) represent an increasing number of new HIV infections in many communities. Many individuals still hold beliefs that may lead to discrimination against HIV-positive individuals. HIV stigma is associated with negative health and psychosocial outcomes and may lead to greater challenges for this marginalized population. This study describes stigma experienced by HIV-positive young MSM, explores its relationship to psychosocial measures, and tests the hypothesis that stigma scores will be higher in those diagnosed less than 1 year ago versus more than 1 year. From August 2004 to September 2005 young MSM completed a questionnaire including demographic information and psychosocial measures. Descriptive and bivariate analyses of association were used to interpret data from the total stigma scale and four subscales: personalized stigma (PS), public attitudes (PA), negative self-image (NSI), and disclosure concerns (DC). Index scores were calculated by standardizing each subscale for direct comparisons. The 42 participants were: mean 21.3 years; 45% black, 24% Hispanic, 26% white; 14% transgender; and 50% diagnosed HIV-positive less than 1 year. Participants reported HIV-related stigma across all domains with mean index subscale scores: PS 0.57, PA 0.61, NSI 0.63, DC 0.75 indicating that disclosure concerns were prevalent in comparison to other forms of HIV-related stigma. Stigma scores correlated with depression, social support, self-esteem, and romantic loneliness. Stigma scores did not differ for those diagnosed less than 1 year ago versus more than 1 year ago. Providers should address HIV-related stigma concerns, particularly disclosure, throughout the trajectory of the illness when caring for HIV-positive young MSM as a factor affecting health outcomes and psychosocial functioning.

Stigma and Sexual Health Risk in HIV-Positive African American Young Men Who Have Sex with Men

“…This incidental finding stands in contrast to prior studies, which suggest that perceptions of HIV stigma may decrease over time following an initial HIV diagnosis. 11,36 Similarly, biologic markers of disease progression (i.e., CD4 count, viral load) did not relate to stigma variables in the current study, despite past research suggesting that HIV stigma may become exacerbated by increased disease progression and symptomatology. The current study was not designed to examine these linkages, and null findings may reflect power limitations of the small sample size.…”

“…9,10 The current study focuses on stigma, which is one factor thought to be particularly salient to African American MSM infected with HIV. [9][10][11] Emerging research suggests that young MSM infected with HIV may experience multiple forms of stigma related to both their sexuality and seropositive status. 12,13 HIV stigma may be particularly salient for young MSM who are African American, since research suggests that HIV-positive African Americans experience higher levels of HIV stigma than both Latinos and whites.…”

“…18 Theories of layered stigma suggest that when multiple forms of stigma are present, there will be additive, cumulative effects on individuals' well-being. Recently, Dowshen and colleagues 11 were among the first to examine HIV stigma and psychosocial correlates in an ethnically diverse sample of 42 HIV-positive young MSM. Participants reported experiencing multiple forms of HIV stigma, including personalized prejudice or discrimination, negative self-image, concerns about public attitudes toward HIV, and fears regarding disclosure of their HIV status.…”

Brief communication (Original). Challenges of providing treatment and care to men who have sex with men and with HIV/AIDS in Bangkok

“…One of the key informant interviewees also identified the negative attitudes of providers as a factor in deterring clients from returning to HIV clinics. This finding is consistent with another study conducted with MSM and transgender women in Thailand that reported high rates of perceived hostility from healthcare providers and being given less attention than other patients [13]. These results suggest that future interventions should include efforts to reduce discrimination in the healthcare system.…”

“…However, because many MSM may not report their sexual orientation to healthcare providers or HIV testing centers because of fear of stigma [8], prevalence of HIV/AIDS among MSM maybe under-reported [4]. HIV-positive MSM in Thailand experience stigma associated with being MSM and significant discrimination because of their HIV status [8], putting them at risk for poorer healthcare utilization and negative health outcomes [13].…”