Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
AIDS and Behavior
Published in: AIDS and Behavior 2/2015

01-02-2015 | Original Paper

Sexual Stigma, Criminalization, Investment, and Access to HIV Services Among Men Who Have Sex with Men Worldwide

Authors: Sonya Arreola, Glenn-Milo Santos, Jack Beck, Mohan Sundararaj, Patrick A. Wilson, Pato Hebert, Keletso Makofane, Tri D. Do, George Ayala

Published in: AIDS and Behavior | Issue 2/2015

Login to get access

Abstract

Globally, HIV disproportionately affects men who have sex with men (MSM). This study explored associations between access to HIV services and (1) individual-level perceived sexual stigma; (2) country-level criminalization of homosexuality; and (3) country-level investment in HIV services for MSM. 3,340 MSM completed an online survey assessing access to HIV services. MSM from over 115 countries were categorized according to criminalization of homosexuality policy and investment in HIV services targeting MSM. Lower access to condoms, lubricants, and HIV testing were each associated with greater perceived sexual stigma, existence of homosexuality criminalization policies, and less investment in HIV services. Lower access to HIV treatment was associated with greater perceived sexual stigma and criminalization. Criminalization of homosexuality and low investment in HIV services were both associated with greater perceived sexual stigma. Efforts to prevent and treat HIV among MSM should be coupled with structural interventions to reduce stigma, overturn homosexuality criminalization policies, and increase investment in MSM-specific HIV services.
Footnotes
1
UN Member States are committed to biennial reporting of a set of 25 United Nations General Assembly Special Session (UNGASS) indicators designed to measure progress in the overall AIDS response at the country level including the response among most-at-risk populations. UNGASS Indicator #1 (related to financing) includes a category to record spending on HIV servicesspecifically among MSM although only a subset of countries reported relevant data for this category in 2010.
 
Literature
1.
Baral S, Sifakis F, Cleghorn F, Beyrer C. Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries 2000–2006: a systematic review. PLoS Med. 2007;4(12):e339.CrossRefPubMedCentralPubMed
2.
Sullivan PS, Hamouda O, Delpech V, Geduld JE, Prejean J, Semaille C, et al. Reemergence of the HIV epidemic among men who have sex with men in North America, Western Europe, and Australia, 1996–2005. Ann Epidemiol. 2009;19(6):423–31.CrossRefPubMed
3.
Beyrer C, Baral SD, van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380(9839):367–77.CrossRefPubMedCentralPubMed
4.
Beyrer C, Sullivan PS, Sanchez J, Dowdy D, Altman D, Trapence G, et al. A call to action for comprehensive HIV services for men who have sex with men. Lancet. 2012;380(9839):424–38.CrossRefPubMedCentralPubMed
5.
Saavedra J, Izazola-Licea JA, Beyrer C. Sex between men in the context of HIV: The AIDS 2008 Jonathan Mann Memorial Lecture in health and human rights. J Int AIDS Soc. 2008;11(1):9.CrossRefPubMedCentralPubMed
6.
amfAR. MSM, HIV, and the Road to Universal Access—How Far Have We Come? New York, NY: amfAR, 2008.
7.
Beyrer C. Global prevention of HIV infection for neglected populations: men who have sex with men. Clin Infect Dis. 2010;50(Suppl 3):S108–13.CrossRefPubMed
8.
Ayala G, Herbert P, Keatley J, Sundararaj M. An analysis of major HIV donor investments targeting mem who have sex with men and transgender people. Oakland: The Global Forum on MSM & HIV (MSMGF); 2011.
9.
Beyrer C, Sullivan P, Sanchez J, Baral SD, Collins C, Wirtz AL, et al. The increase in global HIV epidemics in MSM. AIDS. 2013;27:2665–78.
10.
Kippax S, Stephenson N. Beyond the distinction between biomedical and social dimensions of HIV prevention through the lens of a social public health. Am J Public Health. 2012;102(5):789–99.CrossRefPubMedCentralPubMed
11.
12.
13.
Brown JL, Vanable PA. Cognitive-behavioral stress management interventions for persons living with HIV: a review and critique of the literature. Ann Behav Med. 2008;35(1):26–40.CrossRefPubMedCentralPubMed
14.
15.
Johnson WD, Diaz RM, Flanders WD, Goodman M, Hill AN, Holtgrave D, et al. Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. Cochrane Database Syst Rev. 2008;16(3):CD001230.
16.
Beyrer C. HIV epidemiological update and transmission factors: risks and risk contexts–16th international AIDS conference epidemiology plenary. Clin Infect Dis. 2007;44:981–7.CrossRefPubMed
17.
Herek GM. Beyond “homophobia”: thinking about sexual prejudice and stigma in the twenty-first century. Sex Res Soc Policy A J NSRC. 2004;1(2):6–24.CrossRef
18.
Wilson P, Santos GM, Hebert P, Ayala G. Access to HIV prevention services and attitudes about emerging strategies: a global survey of men who have sex with men (MSM) and their health care providers. Oakland, CA: The Global Forum on MSM and HIV (MSMGF), 2011 July, 2011. Report No.
19.
Kessler RC, Mickelson KD, Williams DR. The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. J Health Soc Behav. 1999;40(3):208–30.CrossRefPubMed
20.
Herek GM, Glunt EK. Identity and community among gay and bisexual men in the AIDS era: preliminary findings from the Sacramento Men’s Health Study. In: Herek GM, Greene B, editors. AIDS, identity, and community: the HIV epidemic and lesbians and gay men. Thousand Oaks: Sage Publications; 1995. p. 55–84.CrossRef
21.
22.
23.
Funders for LGBTQ Issues. A global gaze: LGBTI grant making in the global south and east 2010. 2011.
24.
25.
Friedman MS, Marshal MP, Stall R, Cheong J, Wright ER. Gay-related development, early abuse and adult health outcomes among gay males. AIDS Behav. 2008;12(6):891–902.CrossRefPubMedCentralPubMed
26.
Stall R, Mills TC, Williamson J, Hart T, Greenwood G, Paul J, et al. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J Public Health. 2003;93(6):939–42.CrossRefPubMedCentralPubMed
27.
Carballo-Dieguez A, Dolezal C. Association between history of childhood sexual abuse and adult HIV-risk sexual behavior in Puerto Rican men who have sex with men. Child Abuse Negl. 1995;19(5):595–605.CrossRefPubMed
28.
Jinich S, Paul JP, Stall R, Acree M, Kegeles SM, Hoff C, et al. Childhood sexual abuse and HIV risk-taking behavior among gay and bisexual men. AIDS Behav. 1998;2(1):41–51.CrossRef
29.
Arreola S, Neilands T, Pollack L, Paul J, Catania J. Childhood sexual experiences and adult health sequelae among gay and bisexual men: defining childhood sexual abuse. J Sex Res. 2008;45(3):246–52.CrossRefPubMed
30.
Arreola SG, Neilands TB, Diaz R. Childhood sexual abuse and the sociocultural context of sexual risk among adult latino gay and bisexual men. Am J Public Health. 2009;99(Suppl 2):S432–8.
31.
Díaz RM, Ayala G, Bein E, Henne J, Marin BV. The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: findings from 3 US cities. Am J Public Health. 2001;91(6):927–32.CrossRefPubMedCentralPubMed
32.
Radcliffe J, Doty N, Hawkins LA, Gaskins CS, Beidas R, Rudy BJ. Stigma and sexual health risk in HIV-positive African American young men who have sex with men. AIDS Patient Care STDS. 2010;24(8):493–9.CrossRefPubMed
33.
Song Y, Li X, Zhang L, Fang X, Lin X, Liu Y, et al. HIV-testing behavior among young migrant men who have sex with men (MSM) in Beijing, China. AIDS Care. 2011;23(2):179–86.CrossRefPubMedCentralPubMed
34.
Jeffries WLT, Marks G, Lauby J, Murrill CS, Millett GA. Homophobia is associated with sexual behavior that increases risk of acquiring and transmitting HIV infection among black men who have sex with men. AIDS Behav. 2012.
35.
Mizuno Y, Borkowf C, Millett GA, Bingham T, Ayala G, Stueve A. Homophobia and racism experienced by Latino men who have sex with men in the United States: correlates of exposure and associations with HIV risk behaviors. AIDS Behav. 2012;16(3):724–35.CrossRefPubMed
36.
Yi H, Shidlo A, Sandfort T. Assessing maladaptive responses to the stress of being at risk of HIV Infection among HIV-negative gay men in New York City. J Sex Res. 2011;48(1):62–73.CrossRefPubMedCentralPubMed
37.
Shoptaw S, Weiss RE, Munjas B, Hucks-Ortiz C, Young SD, Larkins S, et al. Homonegativity, substance use, sexual risk behaviors, and HIV status in poor and ethnic men who have sex with men in Los Angeles. J Urban Health. 2009;86(Suppl 1):77–92.CrossRefPubMedCentralPubMed
38.
Wayal S, Llewellyn C, Smith H, Fisher M. Home sampling kits for sexually transmitted infections: preferences and concerns of men who have sex with men. Cult Health Sex. 2011;13(3):343–53.CrossRefPubMed
39.
Jeffries WL, Marks G, Lauby J, Murrill CS, Millett GA. Homophobia is associated with sexual behavior that increases risk of acquiring and transmitting HIV infection among black men who have sex with men. AIDS Behav. 2013;17(4):1442–53.CrossRefPubMed
40.
41.
Ayala G, Makofane K, Santos G-M, Beck J, Do TD, Hebert P, et al. Access to Basic HIV-related services and PrEP acceptability among men who have sex with men worldwide: barriers, facilitators, and implications for combination prevention. J Sex Trans Dis. 2013;2013:11. doi:10.​1155/​2013/​953123
42.
Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Soc Sci Med. 2003;57(1):13–24.CrossRefPubMed
43.
White RC, Carr R. Homosexuality and HIV/AIDS stigma in Jamaica. Cult Health Sex. 2005;7(4):347–59.CrossRefPubMed
44.
Baral S, Trapence G, Motimedi F, Umar E, Iipinge S, Dausab F, et al. HIV prevalence, risks for HIV infection, and human rights among men who have sex with men (MSM) in Malawi, Namibia, and Botswana. PLoS One. 2009;4(3):e4997.CrossRefPubMedCentralPubMed
45.
Fay H, Baral SD, Trapence G, Motimedi F, Umar E, Iipinge S, et al. Stigma, health care access, and HIV knowledge among men who have sex with men in Malawi, Namibia, and Botswana. AIDS Behav. 2011;15(6):1088–97.CrossRefPubMed
46.
47.
Metadata
Title
Sexual Stigma, Criminalization, Investment, and Access to HIV Services Among Men Who Have Sex with Men Worldwide
Authors
Sonya Arreola
Glenn-Milo Santos
Jack Beck
Mohan Sundararaj
Patrick A. Wilson
Pato Hebert
Keletso Makofane
Tri D. Do
George Ayala
Publication date
01-02-2015
Publisher
Springer US
Published in
AIDS and Behavior / Issue 2/2015
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-014-0869-x

Other articles of this Issue 2/2015

AIDS and Behavior 2/2015 Go to the issue

Original Paper

Improving Hospital-Based Quality of Care by Reducing HIV-Related Stigma: Evaluation Results from Vietnam

Original Paper

Using a 2-Stage Strategy with Respondent-Driven Sampling to Recruit a Hard-to-Reach Population for a Placebo Microbicide Gel Clinical Trial in Nellore, Andhra Pradesh (India)

Original Paper

Socioeconomic Gradients in Internalized Stigma Among 4,314 Persons with HIV in Sub-Saharan Africa

Original Paper

Disclosure of Their Status to Youth with Human Immunodeficiency Virus Infection in the Dominican Republic: A Mixed-Methods Study

Original Paper

Strategies for Recruiting Steady Male Partners of Female Sex Workers for HIV Research

Original Paper

Prevalence and Correlates of Knowledge of Male Partner HIV Testing and Serostatus Among African-American Women Living in High Poverty, High HIV Prevalence Communities (HPTN 064)

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits