Prevalence and correlates of sexual identity stigma among black and white men who have sex with men, Atlanta, GA

Background: A growing body of research suggests sexual identity stigma contributes to inequitable patterns of HIV risk among men who have sex with men (MSM). Despite substantial racial disparities in HIV infection among MSM, few studies have examined racial differences in the prevalence of and factors associated with sexual identity stigma.

Methods: Data come from a cohort of 454 black MSM and 349 white MSM recruited in Atlanta between July 2010 and December 2012. Sexual identity stigma was measured as the sum score from a seven-item Likert scale (range: 7-35). We used multiple linear regression models to understand the relationship between stigma and participant characteristics and neighborhood perceptions within separate black and white subgroups and among the total sample. 

Results: Black MSM reported significantly higher sexual identity stigma than white MSM (mean: 18.6 vs. 16.8, p<0.01). Among both white MSM and the total unstratified sample, lower perceived neighborhood quality (p<0.03), less connectedness to the gay community (p<0.01), and increased racial stigma (p<0.01) were associated with increased sexual identity stigma. Among black MSM, younger age (p=0.02), non-gay sexual identity (p=0.03), less connectedness to the gay community (p<0.01), and increased racial stigma (p<0.01) were associated with increased sexual identity stigma.

Conclusions: MSM with multiple minority statuses (e.g., non-gay-identified black MSM) may experience an increased burden of sexual identity stigma. Interventions designed to reduce stigma or address its effects among MSM should acknowledge the potential for disparate experiences related to sexual identity stigma, racism, and neighborhood perceptions among diverse MSM subgroups.