Pride and prejudice: serostatus identity and HIV-related stigma among men who have sex with men in a national online study in Australia
D. Murphy1,2, J. de Wit2,3, S. Donohoe1, P. Adam2,4
1Australian Federation of AIDS Organisations, Sydney, Australia, 2University of New South Wales, National Centre in HIV Social Research, Sydney, Australia, 3Utrecht University, Dept. of Social and Organizational Psychology, Utrecht, Netherlands, 4Institute for Prevention and Social Research, Utrecht, Netherlands
Background: HIV prevention to some extent must capitalise on the desire of seronegative men who have sex with men (MSM) to remain uninfected. However, what consequences does this valuing of seronegative status have for these men’s attitudes towards people living with HIV (PLWHIV)?
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 four items related to the perception of serostatus as a key aspect of self and identity, 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 .84-.94); responses were given on 5-point scales.
Results: Overall MSM placed moderate importance on their serostatus identity (M=3.0). However, importance of serostatus identity was significantly higher for HIV-negative men (M=3.1) than seropositive or status unknown men; there were no differences between seropositive men and men of unknown serostatus (both M=2.8). Among seronegative men, those who placed greater importance on their own serostatus identity were more likely to exhibit stigmatising attitudes towards people living with HIV in all domains (stigma-related attributions, negative feelings, social distancing and sexual exclusion).
Conclusions: This study found an association between seronegative status identity among MSM and stigmatising attitudes towards PLWHIV. In particular there was a strong association between the value placed on one’s own seronegative status and avoiding seropositive MSM as potential sexual or romantic partners. These findings suggest that HIV prevention that seeks to enhance such an identity may have detrimental effects, not only affect seropositive MSM directly through feelings of shame and blame, but also indirectly through social distancing and sexual exclusion by seronegative MSM.