Targeted Violence as a Risk Factor for Posttraumatic Stress Disorder Among Cisgender Gay, Bisexual, and Other Men Who have Sex with Men in the United States

Abstract

Gay, bisexual, and other men who have sex with men (GBMSM) in the United States (US) are disproportionately exposed to interpersonal violence, which carries a high conditional risk for developing posttraumatic stress disorder (PTSD) and which is often motivated by sexual prejudice. We determined PTSD prevalence by violence attribution (motivated by sexual prejudice or not) and measured PTSD–attribution associations. Using a 2020 nationwide cross-sectional survey of 2,886 GBMSM who reported ever experiencing interpersonal violence, we performed multivariable modified Poisson regressions with robust variance estimators to examine differences in prevalence of current PTSD by how participants attributed the violence (occurring due to one’s same-sex practices, not occurring due to one’s same-sex practices, or being unsure if it occurred due to one’s same-sex practices). Model results are reported as adjusted prevalence ratios (aPR) with 95% confidence intervals (CI). Median age was 27 years; 78.8% of participants identified as gay, and 62.2% were non-Hispanic White. Violence was attributed to same-sex practices by 45.8% of participants; 46.3% did not make this attribution, and 7.0% were unsure (0.9% preferred not to answer). Overall, 23.0% screened positive for PTSD, and PTSD prevalence was greater for those who attributed violence to same-sex practices (25.9% [342/1,321]; aPR = 1.55, 95% CI [1.34, 1.79]) and those who were unsure (33.5% [68/203]; aPR = 1.80, 95% CI [1.44, 2.25]) compared to those who did not make the attribution (18.1% [242/1,335]). Age modified this association, with participants 15 to 19 years old who made the attribution being significantly more likely to have PTSD relative to 20+ participants who also made the attribution. In addition to violence-prevention and stigma-mitigation efforts, interventions targeting attribution styles may be useful for violence-exposed GBMSM, especially teenagers.

Sexual behavior stigma among cisgender gay, bisexual, and other men who have sex with men in nine NHBS cities across the United States: Burden and associations with PrEP continuum and HIV care continuum outcomes.

“…The connection between social stigma enacted in other or nonspecific contexts (as with our subscale) and reduced HIV care engagement (i.e., ART use) is less clear, though decreased social support and increased mental health concerns have been posited as potential mechanisms (K. Quinn et al, 2018;Sayles et al, 2009;Turan et al, 2017). Prejudice-motivated violence and other traumas like those assessed in our subscale could lead to posttraumatic stress symptoms (Wiginton et al, 2023), which may constrain positive health behaviors such as ART use (Whetten et al, 2008), or decrease social engagement and support, leading to reduced motivation to engage in HIV care (K. Quinn et al, 2018). These are areas for future research with longitudinal designs.…”

“…Quinn et al, 2018; Sayles et al, 2009; Turan et al, 2017). Prejudice-motivated violence and other traumas like those assessed in our subscale could lead to posttraumatic stress symptoms (Wiginton et al, 2023), which may constrain positive health behaviors such as ART use (Whetten et al, 2008), or decrease social engagement and support, leading to reduced motivation to engage in HIV care (K. Quinn et al, 2018).…”

Revisiting the Harm of Hate: A Quasi-Experimental Approach Using the National Crime Victimization Survey

“…Paying particular attention to later experienced emotional trauma, these effects experienced by hate crime victims in this sample again mirror symptoms of PTSD. Much work coming from scholars of trauma and violence have long documented that identity-based victimization is linked with PTSD among various populations but has been especially studied among LGBTQIA+ victims whose victimization was motivated by bias against their perceived identity (Cramer et al, 2012;Szymanski & Balsam, 2011;Wiginton et al, 2023). It is perhaps not surprising, then, that these results emphasize the increased risk of emotional harm for crimes motivated by bias against gender non-conformity and sexuality.…”