Levels and Correlates of Internalized Homophobia Among Men Who Have Sex with Men in Pretoria, South Africa

Abstract

This study examines levels and correlates of internalized homophobia among men who have sex with men (MSM) in Pretoria, South Africa. Using respondent-driven sampling, we recruited 324 MSM from February to August 2009. Results were adjusted using RDSAT analysis to yield population-based estimates. High levels of internalized homophobia exist among South African MSM: 10-15% reported "often/very often" and over 20% reported "sometimes" having feelings of internalized homophobia. A greater level of internalized homophobia was significantly associated with a lower level of education [Adjusted Odds Ratio = 2.2; 95% CI = 1.1-4.9], a higher level of HIV misinformation [AOR = 2.7; 95% CI: 1.3-5.3], bisexual identity (vs. homosexual) [AOR = 5.5; 95% CI: 2.5-12.0], and HIV-related conspiracy beliefs [AOR = 2.4; 95% CI: 1.02-5.8]. These findings contribute valuable information to our understanding of internalized homophobia in South Africa, highlighting the need to empower the gay community, promote self-acceptance of homosexual identity, and address conspiracy beliefs among MSM to reduce internalized homophobia and increase access to HIV prevention interventions.

The Relationship of Internalized Homonegativity to Sexual Health and Well-Being Among Men in 38 European Countries Who Have Sex With Men

“…In fact, there was a higher likelihood of men with greater IH to have been diagnosed with an STI in the past year, which may be related to not only knowledge, but the previously discussed results about the ability to refuse unwanted sex and feelings of loneliness. Lastly, we mention that contrary to other studies Vu et al, 2012), we found that IH was higher in MSM with higher education. There is no obvious explanation for this finding but it may be an artefact, it may be because higher educated men believe they have more to lose by being "outed," and it may be related to awareness of cultural heterosexism.…”

“…Consistent with our hypothesis and prior work (Franssens, 2010;Kuyper & Fokkema, 2011;Vu et al, 2012), IH was higher in nongay identified MSM compared with those who identified as gay (or homosexual). It is possible that self-identification as gay indicates a higher degree of self-acceptance.…”

“…Thus, we merely mention that a likely explanation for this relationship is that MSM who experience selfstigma and social isolation from gay communities have less access to safer sex information and resources. Other researchers have reported that higher levels of IH was related to higher levels of HIV misinformation (Vu et al, 2012) and lower awareness of HIV prevention programming (Huebner et al, 2002). It seems likely that stigma affects MSM's learning about HIV, in effect, making self-stigma a barrier to HIV prevention efforts.…”

“…This is suggested by findings showing that IH is negatively related to the degree of involvement in an LGB group, to the number of LGB friends one has, and to the amount of social time spent with other sexual minorities (Cox, van den Berghe, Dewaele, & Vincke, 2010;Mayfield, 2001;Ross & Rosser, 1996;Szymanski & Chung, 2001). IH has also been found to be higher in MSM who are younger (Cox et al, 2010), bisexual (Shoptaw et al, 2009;Vu, Tun, Sheehy, & Nel, 2012), closeted about their attraction to men (Ross, Rosser, Neumaier, & the Positive Connections Team, 2008), human immunodeficiency virus (HIV) negative (Shoptaw et al, 2009), and those with a high school education or less Vu et al, 2012).…”

“…Meta-analyses have confirmed that the presence of bacterial and viral STIs increase an individual's risk of both the acquisition and transmission of HIV infection (Ward & Rönn, 2010). Notwithstanding the fact that HIV and STIs are a considerable sexual health problem faced by many MSM, there are indications that many MSM have high levels of HIV misinformation, which is linked with high levels of IH (Vu et al, 2012). Further, IH has been found to be negatively related to awareness of HIV prevention programming (Huebner, Davis, Nemeroff, & Aiken, 2002) and substance use (DiPlacido, 1998;Shoptaw et al, 2009).…”