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Anticipated HIV Stigma and Delays in Regular HIV Testing Behaviors Among Sexually-Active Young Gay, Bisexual, and Other Men Who Have Sex with Men and Transgender Women

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Abstract

Young gay, bisexual and other men who have sex with men (YGBMSM) and young transgender women are disproportionately affected by HIV/AIDS. The success of biomedical prevention strategies is predicated on regular HIV testing; however, there has been limited uptake of testing among YGBMSM and young transgender women. Anticipated HIV stigma—expecting rejection as a result of seroconversion- may serve as a significant barrier to testing. A cross-sectional sample of YGBMSM (n = 719, 95.5%) and young transgender women (n = 33, 4.4%) ages 15–24 were recruited to participate in a one-time survey. Approximately one-third of youth had not tested within the last 6 months. In a multivariable model, anticipated HIV stigma and reporting a non-gay identity were associated with an increased odds of delaying regular HIV testing. Future research and interventions are warranted to address HIV stigma, in order to increase regular HIV testing among YGBMSM and transgender women.

Resumen

Los hombres jóvenes homosexuales, bisexuales o que tienen sexo con hombres (YGBMSM) y las mujeres jóvenes transgénero, son afectados desproporcionalmente por el VIH/SIDA. El éxito de las estrategias de prevención biomédicas se basa en pruebas de VIH frecuentes; sin embargo, entre los YGBMSM y las mujeres jóvenes transgéneros ha habido una aceptación limitada a hacerse la prueba de VIH. Esperar el rechazo como resultado de seroconversión a VIH es un estigma anticipado que puede servir como una barrera significativa para realizarse la prueba. Una muestra transversal de hombres YGBMSM (n = 719, 95.5%) y de mujeres jóvenes transgéneros (n = 33, 4.4%), entre las edades de 15 a 24 años, fueron reclutados para participar en una encuesta transversal. Aproximadamente un tercio no se habían realizado la prueba durante los pasados seis meses. En un modelo multivariado, el estigma anticipado de VIH y la identidad no-homosexual estuvieron asociados con un incremento en la probabilidad de posponer la prueba regular de VIH. Futuras investigaciones e intervenciones se necesitan para aumentar la frecuencia de la prueba de VIH entre los hombres YGBMSM y las mujeres transgéneros.

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Acknowledgements

This work was supported by The Adolescent Trials Network for HIV/AIDS Interventions (ATN) from the National Institutes of Health [U01 HD 040533 and U01 HD 040474] through the National Institute of Child Health and Human Development (B. Kapogiannis), with supplemental funding from the National Institutes on Drug Abuse (S. Kahana) and Mental Health (P. Brouwers, S. Allison). The study was scientifically reviewed by the ATN’s Community Prevention Leadership Group. Network, scientific and logistical support was provided by the ATN Coordinating Center (C. Wilson, C. Partlow) at The University of Alabama at Birmingham. Network operations and analytic support was provided by the ATN Data and Operations Center at Westat, Inc. (B. Harris, B. Driver). Support was also provided to the first author by the Providence/Boston Center for AIDS Research (P30AI042853, PI: Cu-Uvin) and the second author was supported by Career Development Grant (K23MH109346, PI: Nelson). The comments and views of the authors do not necessarily represent the views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. We acknowledge the contribution of the investigators and staff at the following sites that participated in this study: University of South Florida, Tampa (Emmanuel, Straub, Walker), Children’s Hospital of Los Angeles (Belzer, Smith), Children’s National Medical Center (D’Angelo, Trexler, Sinkfield), Children’s Hospital of Philadelphia (Douglas, Tanney), John H. Stroger Jr. Hospital of Cook County and the Ruth M. Rothstein CORE Center (Martinez, Henry-Reid, Holliman), Montefiore Medical Center (Futterman, Hinkson), Tulane University Health Sciences Center (Abdalian, Hayden, Jeanjacques), University of Miami School of Medicine (Friedman, Sanchez), St. Jude’s Children’s Research Hospital (Flynn, Stubbs), Baylor College of Medicine, Texas Children’s Hospital (Paul, Lopez); Wayne State University (Secord, Outlaw, Djalaj); Johns Hopkins University School of Medicine (Agwu, Sanders, Terreforte); The Fenway Institute (Mayer, Salomon); and University of Colorado (Reirden, Munoz). The investigators are grateful to the members of the local youth Community Advisory Boards for their insight and counsel and are indebted to the youth who participated in this study.

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Authors and Affiliations

  1. Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA

    Kristi E. Gamarel & Rob Stephenson

  2. The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA

    Kristi E. Gamarel & Rob Stephenson

  3. Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA

    Kristi E. Gamarel & Kimberly M. Nelson

  4. Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Providence, RI, USA

    Kimberly M. Nelson

  5. Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA

    Kimberly M. Nelson

  6. Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA

    Rob Stephenson

  7. Department of Psychology, Michigan State University, East Lansing, MI, USA

    Olga J. Santiago Rivera, Danielle Chiaramonte & Robin Lin Miller

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  1. Kristi E. Gamarel
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  2. Kimberly M. Nelson
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the Adolescent Medicine Trials Network for HIV/AIDS Interventions

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Correspondence to Kristi E. Gamarel.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Gamarel, K.E., Nelson, K.M., Stephenson, R. et al. Anticipated HIV Stigma and Delays in Regular HIV Testing Behaviors Among Sexually-Active Young Gay, Bisexual, and Other Men Who Have Sex with Men and Transgender Women. AIDS Behav 22, 522–530 (2018). https://doi.org/10.1007/s10461-017-2005-1

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