Sexual Minority Stress, Identity and Condom Use Among Sexual Minority Men in a Small Metropolitan Southern Region
This study sought to assess the associations between sexual minority stress, sexual identity, and HIV risk behavior in sexual minority men from a small metropolitan region of the south. A total of 189 sexual minority men (65% White, 83% gay-identified, Mage = 36) from the Central Savannah River Area (CSRA) of Georgia and South Carolina participated in the study. Participants completed a series of surveys assessing demographics, sexual minority stressors of lifetime experiences of gay-based discrimination, perceived safety of the LGBTQ community in the CSRA, and internalized homophobia, as well as positive identity factors of outness comfort (i.e., comfort living as an “out” sexual minority), positive internalized identity, and sense of community, and the primary outcome, barrier use during anal intercourse. Bivariate correlational analyses revealed a significant association between perceived lifetime experiences of discrimination and barrier protection use (r = -.19, p < .05). In a multiple regression model controlling for the effects of demographic covariates, perceived lifetime discrimination independently predicted decreased barrier protection use (β = -.215, p < .05, 95% CI = -.545 – -.040). Post hoc analyses revealed a potential moderating role of HIV status. Stratifying the sample by HIV status, a moderate correlation was found between lifetime discrimination and condom use in the small sample of HIV-positive men ( n = 17; r = -.46, p < .05), where the relationship between lifetime discrimination condom use in the HIV-negative sample was not significant. In a multiple regression analysis, perceived lifetime discrimination independently predicted decreased barrier protection use in HIV-positive men (β = -.215, p < .05, 95% CI = -.545 – -.040). No other sexual minority stress or identity variable was associated with barrier protection use in the full sample or any subsample. The results of this study provide support for the influence of discriminatory experiences on engagement in risky sexual behavior, particularly among sexual minority men living with HIV in the CSRA. Efforts to decrease stigma and discrimination, increase community visibility, and allocate greater resources to prevention efforts are greatly needed in order to address ongoing, critical health disparities endured by this community.
Griffin, James A, "Sexual Minority Stress, Identity and Condom Use Among Sexual Minority Men in a Small Metropolitan Southern Region" (2017). ETD Collection for Fordham University. AAI10282577.