Association Between Enacted Stigma and HIV-Related Risk Behavior Among MSM, National HIV Behavioral Surveillance System, 2011

Alexandra B. Balaji*, Kristina E. Bowles, Kristen L. Hess, Justin C. Smith, Gabriela Paz-Bailey, Jennifer Taussig, Robert Gern, Tamika Hoyte, Laura Salazar, Jianglan White, Jeff Todd, Greg Bautista, Colin Flynn, Frangiscos Sifakis, Danielle German, Debbie Isenberg, Maura Driscoll, Elizabeth Hurwitz, Miminos, Rose DohertyChris Wittke, Nikhil Prachand, Nanette Benbow, Sharon Melville, Praveen Pannala, Richard Yeager, Aaron Sayegh, Jim Dyer, Shane Sheu, Alicia Novoa, Mark Thrun, Alia Al-Tayyib, Ralph Wilmoth, Emily Higgins, Vivian Griffin, Eve Mokotoff, Karen MacMaster, Marcia Wolverton, Jan Risser, Hafeez Rehman, Paige Padgett, Trista Bingham, Ekow Kwa Sey, Marlene LaLota, Lisa Metsch, David Forrest, Dano Beck, Gabriel Cardenas, Chris Nemeth, Bridget J. Anderson, for the NHBS study group

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)227-237
Number of pages11
JournalAIDS and behavior
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2017

Keywords

  • HIV-related risk behavior
  • MSM
  • National HIV Behavioral Surveillance System
  • Stigma

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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