Community engagement: does it protect against HIV-related stigma in gay and other men who have sex with men in Australia?

Published: July 21, 2010

Community engagement: does it protect against HIV-related stigma in gay and other men who have sex with men in Australia?

J. de Wit1,2, D. Murphy1,3, S. Donohoe3, P. Adam1,4

1University of New South Wales, National Centre in HIV Social Research, Sydney, Australia, 2Utrecht University, Dept. of Social and Organizational Psychology, Utrecht, Netherlands, 3Australian Federation of AIDS Organisations, Sydney, Australia, 4Institute for Prevention and Social Research, Utrecht, Netherlands

Background: Effective responses to HIV in gay and other men who have sex with men (MSM) benefit from strong community engagement. In addition to appropriate HIV prevention, a key aspect of the gay community response is to address HIV-related stigma. However, gay communities are changing and many men today rely mostly on the Internet to engage with their social and sexual networks. As a result, traditional channels to address HIV-related stigma amongst MSM may be eroding.

Methods: Between 1 December 2009 and 31 January 2010 we recruited over 1,350 respondents into an online survey of HIV-related stigma. The majority of respondents to the Barometer Survey were gay or other MSM and present analyses are restricted to these 1,260 respondents. The survey included three questions to assess men’s engagement with the gay community, three questions to assess engagement with people living with HIV (PLWHIV), and 22 questions regarding HIV-stigma-related attributions (e.g., blame, shame), negative feelings, social distancing, and sexual exclusion. Scales and subscales were highly reliable (alphas .76-.90); responses were given on 5-point scales.

Results: Gay community engagement and positive community engagement were highest in HIV-positive men (M=3.0, M=2.3), intermediate in HIV-negative men (M=2.8, M=1.5), and lowest in serostatus unknown men (M=2.4, M=1.3) (all differences are statistically significant). In HIV-negative and serostatus unknown men greater community engagement was significantly related to lower expressed stigma. In contrast, in HIV-positive men community engagement was unrelated to experienced stigma.

Conclusions: In this study community engagement was not associated with HIV-related stigma in HIV-positive MSM, but was associated with lower expressed stigma in HIV-negative MSM. Together these findings suggest that community efforts to fight stigma may be effective among many MSM, but efforts are needed to address stigma in the wider social context, including among increasing numbers of MSM who are less community engaged.

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