Structural and environmental factors are associated with internalised homonegativity in men who have sex with men: Findings from the European MSM Internet Survey (EMIS) in 38 countries

Abstract

Internalised homonegativity refers to a gay person's negative feelings about homosexuality and is believed to stem from negative societal stereotypes and attitudes towards homosexuality. Surprisingly, little research has centred on this link. In this research, we aimed to examine the associations between internalised homonegativity and structural forces, cultural influence, and access to sexual health promotion measures among a sample of 144,177 men who have sex with men (MSM) in 38 European countries. Participants were recruited as part of the European MSM Internet Survey (EMIS) during 2010. It was a self-completion, multilingual Internet-based survey for men living in Europe who have sex with men and/or feel attracted to men. Assumed causal relations were tested through multiple regression models. Variables at the structure of rule-systems (macro-level) that were significantly and negatively associated with internalised homonegativity were the presence of laws recognising same-sex relationships and same-sex adoption. In the meso-level model, greater proportions of the population expressing that they would not like to have homosexuals as neighbours predicted higher internalised homonegativity. In the last model, five variables were significantly and negatively associated with internalised homonegativity: being exposed to HIV/STI information for MSM, access to HIV testing, access to STI testing, access to condoms, and experience of gay-related hostility. In turn, men who had tested for HIV in the past year evidenced lower internalised homonegativity. This is the largest and certainly most geographically diverse study to date to examine structural and environmental predictors of internalised homonegativity among MSM. Our results show that one insidious consequence of society's stigma towards homosexuals is the internalisation of that stigma by gay and bisexual men themselves, thus, drawing attention to the importance of promoting social equity for self-acceptance around gay identity in building a positive sense of self.

The GAy MEn Sex StudieS: Design of an Online Registration of Sexual Behaviour of Men Having Sex with Men and Preliminary Results (GAMESSS-study)

“…Once this preparatory phase is over, however, the data collection runs very fast and can be easily analyzed. This methodology was already used for the European MSM Internet Survey (EMIS) in 2010 and other HIV surveillance studies (17)(18)(19).…”

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

“…[4][5][6][7][8] In Romania, negative attitudes toward gender and sexual minorities are among the highest in Europe, 9,10 leading many LGBT individuals to conceal their identities from healthcare providers and avoid seeking healthcare, which is widely recognized as being unresponsive to LGBT health concerns. [10][11][12] Stigma-related barriers to healthcare exacerbate sexual orientation-based health disparities, including increasing HIV and sexually transmitted infection (STI) incidence. [4][5][6][7]10,13 Two international sexual health surveys indicate that HIV prevalence among Romanian men who have sex with men (MSM) was 5% in 2008 14 and 18% in 2014, 15 suggesting a potential recent increase in HIV infection.…”

“…However, Romanian LGBT individuals' physical and mental healthcare are compromised by discrimination and lack of psychosocial support, which have been associated with sexual risk, substance use, and depressive symptoms. 11,12,[22][23][24][25][26][27][28][29] Furthermore, previous findings indicate that mental health disorders, alcohol use, and sexual risk increase with a lack of protective laws (i.e., same-sex marriage, nondiscriminatory housing and employment) for LGB individuals. 30 While mental healthcare is provided through both the national healthcare system and privately, utilization of mental health services remains stigmatized.…”

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

“…It has been defined as "negative feelings about one's homosexuality" (Herek, 2004, p. 19). The negative sentiments that lesbian, gay, and bisexual (LGB) individuals hold about their own sexuality is thought to stem from structural and environmental stigma toward homosexuals that to varying extents exists in the majority society and are absorbed from one's culture (Shidlo, 1994;Berg, Ross, Weatherburn, & Schmidt, 2013). In an early Swedish-Australian study, Ross (1985) noted that it is important to measure the internalized component of social gay stigma.…”