title: Unhealthy environments, unhealthy consequences: Experienced homonegativity and HIV infection risk among young men who have sex with men.
abstract: Unfavourable social environments can negatively affect the health of gay, bisexual, and other men who have sex with men (MSM). We described how experienced homonegativity - negative perceptions and treatment that MSM encounter due to their sexual orientations - can increase HIV vulnerability among young MSM. Participants (n = 44) were young MSM diagnosed with HIV infection during January 2006-June 2009. All participants completed questionnaires that assessed experienced homonegativity and related factors (e.g. internalised homonegativity). We focus this analysis on qualitative interviews in which a subset of participants (n = 28) described factors that they perceived to have placed them at risk for HIV infection. Inductive content analysis identified themes within qualitative interviews, and we determined the prevalence of homonegativity and related factors using questionnaires. In qualitative interviews, participants reported that young MSM commonly experienced homonegativity. They described how homonegativity generated internalised homonegativity, HIV stigma, silence around homosexuality, and forced housing displacement. These factors could promote HIV risk. Homonegative experiences were more common among young Black (vs. non-Black) MSM who completed questionnaires. Results illustrate multiple pathways through which experienced homonegativity may increase HIV vulnerability among young MSM. Interventions that target homonegativity might help to reduce the burden of HIV within this population.
authors.affiliation: a Division of HIV/AIDS Prevention , National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta , GA , USA.|b Epidemic Intelligence Service, Division of Scientific Education and Professional Development , Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: William L
authors.initials: WL
authors.lastname: Jeffries
authors.affiliation: a Division of HIV/AIDS Prevention , National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Gelaude
authors.affiliation: b Epidemic Intelligence Service, Division of Scientific Education and Professional Development , Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention , Atlanta , GA , USA.|c Division of STD Prevention , National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Torrone
authors.affiliation: d Division of Public Health , Wisconsin Department of Health Services , Madison , WI , USA.
authors.forename: Mari
authors.initials: M
authors.lastname: Gasiorowicz
authors.affiliation: a Division of HIV/AIDS Prevention , National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Oster
authors.affiliation: a Division of HIV/AIDS Prevention , National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Pilgrim S
authors.initials: PS
authors.lastname: Spikes
authors.affiliation: a Division of HIV/AIDS Prevention , National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Donna Hubbard
authors.initials: DH
authors.lastname: McCree
authors.affiliation: a Division of HIV/AIDS Prevention , National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Bertolli
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology; D030881:Disclosure; D005195:Family Relations; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission; D054625:Healthcare Disparities; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data; D063509:Homophobia / Q000523:psychology* / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D016013:Likelihood Functions; D008297:Male; D010465:Perception; D036301:Qualitative Research; D012071:Religion and Sex; D012307:Risk Factors; D012649:Self Concept; D012931:Social Environment; D057545:Social Stigma; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology; D014922:Wisconsin; D055815:Young Adult
keywords: HIV; Homonegativity; men who have sex with men