The LGBT Health & Development Program

Research Blog–Stigma & Status: Social Factors Leading to Lack of Healthcare Access for MSM of Color


Posted on April 28th, 2016 by Christian A. in Featured, Research Blog. No Comments

phlebotomist appearing to draw blood in a patient's arm in a medical labBeing recently diagnosed with HIV can be overwhelming to anyone. Navigating the healthcare field and managing the emotional and social aspects of the diagnosis each present a challenge, especially when stigma against HIV is present in one’s community. Young men who have sex with men (YMSM) are disproportionately affected by HIV. In 2013, the CDC estimated that 63% of all new HIV infections occurred in men who have sex with men (MSM), with 36% and 22% of total infections occurring in Black and Latino MSM, respectively [1]. Black and Latino MSM have also been shown to access HIV/AIDS care –medical, mental, and social- markedly less than White MSM [2]. MSM of color have been shown to have different structural barriers that affect access to HIV testing and care, particularly more stigma from their communities, compared to White MSM [2]. Additionally, it has been shown that HIV-positive YMSM of color do not actively seek out healthcare from providers, or regularly fall out of care [3].

Stigma and MSM of Color

Stigma in regards to HIV can be seen as the negative beliefs, feelings, and attitudes towards people living with HIV, as well as negative beliefs about groups that are frequently associated with people living with HIV including MSM [4]. MSM, particularly in racial/ethnic minority groups, face stigma on two fronts: stigma related to sexual orientation (or expression), and stigma related to HIV status. In one study, YMSM of African-American and Latino descent reported feeling unsafe in disclosing their sexuality due to such stigmas [3]. Similar stigma is present in these communities with regards to HIV-status; in Black and Latino communities, HIV-positive individuals experience higher rates of poor psychological status than HIV-negative members of the community [3]. Both sexual minority and HIV-positive stigma contribute to lack of disclosure in HIV-positive MSM of color individually, though the effect of the intersection of both of these stigmas must be examined. It has been shown that the presence of both of these stigmas in Black and Latino HIV-positive MSM leads to elevated rates of depression and lower levels of social support compared to both HIV-negative and heterosexual members of their respective communities [3].

Getting HIV-Positive YMSM of Color into Care

The stigma present in many communities of color cause stress to HIV-positive YMSM of color, particularly due to the inability to disclose multiple aspects of one’s life [2]. This persistent stigma prevents many of these individuals from seeking regular healthcare, due to a fear that seeking healthcare could out their HIV status or sexual orientation [2]. Perhaps by providing opportunities for these individuals to disclose anonymously and receive culturally appropriate support, these YMSM of color can get the support they need to overcome stigma and seek care.

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References:

[1] HIV Among Gay and Bisexual Men. (2015, September 29). Retrieved March 10, 2016, from http://www.cdc.gov/hiv/group/msm/
[2] Levy, M. E., Wilton, L., Phillips, G., Glick, S. N., Kuo, I., Brewer, R. A., … Magnus, M. (2014). Understanding Structural Barriers to Accessing HIV Testing and Prevention Services Among Black Men Who Have Sex with Men (BMSM) in the United States. AIDS Behav AIDS and Behavior, 18(5), 972-996. doi:10.1007/s10461-014-0719-x.

[3] Wohl, A. R., Galvan, F. H., Carlos, J., Myers, H. F., Garland, W., Witt, M. D., … George, S. (2012). A Comparison of MSM Stigma, HIV Stigma and Depression in HIV-Positive Latino and African American Men who have Sex with Men (MSM). AIDS Behav AIDS and Behavior, 17(4), 1454-1464. doi:10.1007/s10461-012-0385-9.

[4] UNAIDS. Reduction of HIV-related stigma and discrimination. (2014, May). Retrieved April 27, 2016, from http://www.unaids.org/sites/default/files/media_asset/2014unaidsguidancenote_stigma_en.pdf.





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