title: Stigma and suicide among gay and bisexual men living with HIV.
abstract: HIV positive gay and bisexual men (GBM) continue to struggle with the pervasiveness of HIV stigma, but little is known about the health effects of stigma. In this article, suicidal ideation and attempts are measured among GBM living with HIV, evaluating the extent to which these experiences are associated with stigma and suicide. Drawing from an online national survey of Canadian GBM completed by 7995 respondents, a sub-set of data provided by respondents self-reporting HIV-positive status was used for the current study. The associations between suicidal ideation (SI) and attempts (SA) and four measures of HIV stigma were measured: social exclusion, sexual rejection, verbal abuse and physical abuse. A total of 673 HIV-positive men completed the survey (8% of total sample). Among this group, 22% (n = 150) reported SI and 5% (n = 33) SA in the last 12 months. After adjusting for sociodemographic factors, SI and SA were associated with each of the four measures of HIV stigma: being excluded socially for being HIV positive (SI adjusted odds ratio, AOR 2.0 95% CI 1.4-3.1; SA AOR 3.8 95% CI 1.9-7.9), rejected as a sexual partner (SI AOR 1.6 95% CI 1.1-2.4; SA AOR 2.6 95% CI 1.1-6.0), verbally abused (SI AOR 2.9 95% CI 1.9-4.5; SA AOR 2.4 95% CI 1.1-5.1), and physically abused (SI AOR 4.5 95% CI 1.8-11.7; SA AOR 6.4 95% CI 2.0-20.1). Furthermore, experiencing multiple forms of stigma was associated with significantly increased risk of SI and SA. The authors conclude that HIV positive GBM experience significant levels of stigma that are associated with heightened risk for suicide. The findings affirm the need for targeted interventions to prevent suicide amid public health efforts to de-stigmatize HIV and mental illness.
authors.affiliation: a Men's Health Research program , University of British Columbia , Vancouver Canada.
authors.forename: Olivier
authors.initials: O
authors.lastname: Ferlatte
authors.affiliation: b Dalla Lana School of Public Health , University of Toronto , Toronto , Canada.
authors.forename: Travis
authors.identifier: 0000-0002-5699-5444
authors.initials: T
authors.lastname: Salway
authors.affiliation: a Men's Health Research program , University of British Columbia , Vancouver Canada.
authors.forename: John L
authors.initials: JL
authors.lastname: Oliffe
authors.affiliation: c Community-Based Research Centre for Gay Men's Health , Vancouver , Canada.
authors.forename: Terry
authors.initials: T
authors.lastname: Trussler
mesh_terms: D000328:Adult; D001727:Bisexuality / Q000523:psychology / Q000706:statistics & numerical data*; D002170:Canada; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072339:Sexual and Gender Minorities / Q000523:psychology / Q000706:statistics & numerical data*; D057545:Social Stigma; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: HIV stigma; Suicide; bisexual men; discrimination; gay men