Stigma, discrimination, and sexual risk behavior among gay and bisexual men in the US military

Background: Stigma and discrimination are common topics for investigation in research on gay and bisexual men's (GBM) sexual behavior. However, there is limited evidence about the role of these factors in driving sexual behavior among GBM in the military, particularly when considering the unique role of discrimination within the military. Methods: We recruited an internet-based sample of current and former LGBT members of the US military. A sample of 77 HIV-negative/unknown GBM reported being sexually active with casual male partners within the prior three months and completed measures of sexual behavior, internalized homophobia (IH), and sexual orientation-based discrimination within and outside of the military. Results: We found no demographic differences in the two discrimination scales; single men and those who had served actively within the past year reported higher levels of IH. The two measures of discrimination were significantly correlated (r=0.69), but both were uncorrelated with IH. We fit a series of models predicting sexual risk (number of casual partners, number of unprotected anal acts, and proportion of anal acts that were unprotected) adjusting for relationship status and whether or not participants were recently active duty. Military-based discrimination emerged as the only predictor of increased sexual risk across models (p=.005, p=.05, p=.09, respectively). Conclusions: The sexual risk of GBM in the military may be directly impacted by overt acts of discrimination experienced within the military. This discrimination may be well-targeted by structural interventions that may have a significant impact on reducing HIV risk among this unique population of GBM.