Association Between Enacted Stigma and HIV-Related Risk Behavior Among MSM, National HIV Behavioral Surveillance System, 2011.
MSM bear a disproportionate burden of the HIV epidemic. Enacted stigma (overt negative actions) against sexual minorities may play an important role in increasing HIV risk among this population. Using data from the 2011 National HIV Behavioral Surveillance system, MSM cycle, we examined the independent associations between three measures of enacted stigma (verbal harassment, discrimination, physical assault) and engagement in each of four HIV-related risk behaviors as outcomes: condomless anal intercourse (CAI) at last sex with a male partner of HIV discordant or unknown status and, in the past 12 months, CAI with a male partner, ≥4 male sex partners, and exchange sex. Of 9819 MSM, 32% experienced verbal harassment in the past 12 months, 23% experienced discrimination, and 8% experienced physical assault. Discordant CAI at last sex with a male partner was associated with previous discrimination and physical assault. Past 12 month CAI with a male partner, ≥4 male sex partners, and exchange sex were each associated with verbal harassment, discrimination, and physical assault. These findings indicate that a sizable proportion of MSM report occurrences of past 12 month enacted stigma and suggest that these experiences may be associated with HIV-related risk behavior. Addressing stigma towards sexual minorities must involve an integrated, multi-faceted approach, including interventions at the individual, community, and societal level.
Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. MS E-46, Atlanta, GA, USA. dvi7@cdc.gov.
Alexandra B
AB
Balaji
Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. MS E-46, Atlanta, GA, USA.
Kristina E
KE
Bowles
Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. MS E-46, Atlanta, GA, USA.
Kristen L
KL
Hess
Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
Justin C
JC
Smith
Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. MS E-46, Atlanta, GA, USA.
Gabriela
G
Paz-Bailey
D000293:Adolescent; D000328:Adult; D001727:Bisexuality; D017280:Condoms / Q000706:statistics & numerical data; D015658:HIV Infections; D000073599:Health Risk Behaviors; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D000072339:Sexual and Gender Minorities; D057545:Social Stigma; D047568:Unsafe Sex; D055815:Young Adult
HIV-related risk behavior; MSM; National HIV Behavioral Surveillance System; Stigma