title: The Relationship Between Sexual Minority Stigma and Sexual Health Risk Behaviors Among HIV-Positive Older Gay and Bisexual Men.
abstract: This study investigates how internalized sexual minority stigma and enacted sexual minority stigma in health care settings are associated with sexual health risk behaviors (SRBs) and the mediating role of infrequent routine health care and perceived stress among older gay and bisexual (G/B) men living with HIV disease. Survey responses from 135 sexually active older G/B men living with HIV were analyzed using hierarchical linear regression models. Results indicate that one fifth of G/B older adult men living with HIV are engaged in multiple SRBs. Internalized sexual minority stigma and enacted sexual minority stigma in health care settings are significantly associated with SRBs. The relationship between internalized sexual minority stigma and SRBs are mediated by infrequent routine health care and elevated levels of perceived stress. Improved primary and secondary prevention strategies are needed for the growing number of sexually active older G/B men.
authors.affiliation: 1 University of Washington Tacoma, WA, USA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Emlet
authors.affiliation: 2 University of Washington, Seattle, WA, USA.
authors.forename: Karen I
authors.initials: KI
authors.lastname: Fredriksen-Goldsen
authors.affiliation: 2 University of Washington, Seattle, WA, USA.
authors.forename: Hun-Jun
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: 2 University of Washington, Seattle, WA, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Hoy-Ellis
mesh_terms: D000368:Aged; D006679:HIV Seropositivity / Q000523:psychology*; D000073599:Health Risk Behaviors; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010342:Patient Acceptance of Health Care; D000072339:Sexual and Gender Minorities / Q000523:psychology*; D057545:Social Stigma; D013315:Stress, Psychological
keywords: HIV disease; health care utilization; older adults; sexual identity; sexual risk