HIV-related stigma within communities of gay men: a literature review

Abstract

While stigma associated with HIV infection is well recognised, there is limited information on the impact of HIV-related stigma between men who have sex with men and within communities of gay men. The consequences of HIV-related stigma can be personal and community-wide, including impacts on mood and emotional well-being, prevention, testing behaviour, and mental and general health. This review of the literature reports a growing division between HIV-positive and HIV-negative gay men, and a fragmentation of gay communities based along lines of perceived or actual HIV status. The literature includes multiple references to HIV stigma and discrimination between gay men, men who have sex with men, and among and between many gay communities. This HIV stigma takes diverse forms and can incorporate aspects of social exclusion, ageism, discrimination based on physical appearance and health status, rejection and violence. By compiling the available information on this understudied form of HIV-related discrimination, we hope to better understand and target research and countermeasures aimed at reducing its impact at multiple levels.

Young Black Gay/Bisexual and Other Men Who Have Sex With Men: A Review and Content Analysis of Health-Focused Research Between 1988 and 2013

“…The HIV status of study participants was the most frequently addressed HIV subtopic in this review, which may indeed be reflective of the deepening concerns over increasing rates of HIV infection among Black YGBMSM. In contrast, HIV stigma was only explored in two articles, even though many researchers have suggested that stigma related to HIV may be a fundamental driving force behind the epidemic (Maulsby et al, 2014;Smit et al, 2012). Last, HIV treatment knowledge/awareness, linkage/retention in care, and ART use/viral loads/CD4 counts were all poorly represented in this review.…”

Epidemiology, Sexual Risk Behavior, and HIV Prevention Practices of Men who Have Sex with Men Using GRINDR in Los Angeles, California

“…Although the GRINDR sample did not acquire any biologic specimens for HIV or STI testing, self-reports of HIV-positive serostatus almost universally underestimate the true seroprevalence rate 16 attributable primarily to occult and undiagnosed HIV infection and secondarily to the persistent stigma associated with reporting an HIVpositive diagnosis among MSM. 17 Participants demonstrated a high rate of ongoing transmission-associated risk behavior, indicating that the sample is an excellent target for recruitment for and ultimate deployment of HIV prevention studies and interventions, respectively. In particular, although participants reported low rates of previous clinical trial participation, more than half of participants noted that they would be interested in participating in a future HIV prevention study, with an additional 25 % indicating that they might be interested in participating, depending on the details of the study, incentives, and various other parameters.…”

Condom Use, Disclosure, and Risk for Unprotected Sex in HIV-Negative Midlife and Older Men Who Have Sex With Men

“…It is acceptable in most gay communities to be openly sexual, to have multiple partners, to negotiate openly for sex, and to enjoy sex freely (Bronski, 2000;Crossley, 2004). Given this, there may be less permission for gay (Schope, 2005;Smit et al, 2012;Wierzalis, Barret, Pope, & Rankins, 2006), older MSM may experience a pressure to look attractive and often are expected to be able to follow through on any sexual opportunities that arise. It is also much more acceptable and possible in some gay subcultures to use sex as a way to deal with stress and feelings of isolation (Murray & Adam, 2001).…”