Social context, individual trajectories and risk for HIV/AIDS in homosexuals men in Mexico City
Background: Different studies documenting the importance of social context in controlling HIV-AIDS, have stressed that conditions such as poverty and discrimination are conducive to its transmission, impeding prevention and delay access to medical care. The purpose of this study was to identify and describe the influence of homophobia in vulnerability to HIV-AIDS with gay men.
Methods: We rebuilt the experience of homophobia and its connection with the exercise of sexuality of young homosexuals from a qualitative approach. Were applied in-depth interviews to seventeen gay residents of Mexico City between 2005 and 2007. The information obtained was analyzed based on the grounded theory through Atlas.ti 5.0 software. The individual trajectories of informants were related to their contexts of primary and secondary socialization; we sought associations between the internalized homophobia and sexual practices. We identified three groups of regularities discursive categories: homophobia (rejection, ridicule or assault), internalized homophobia (sadness, fear, suicide, self-devaluation, self-esteem) and sexual practices (oral penetration, anal intercourse, condom, location, sex partner and drug use).
Results: There were several levels of homophobia in social contexts, which identified the individual trajectories, mainly suffering psychological, characteristic of internalized homophobia: self-denial, depression, anxiety and suicidal behaviour. These data were associated with sexual practices and risk situations characterized by: concealment of sexual orientation, anonymity, secrecy and scarce negotiating condom use, feelings of coercion, emotional dependence and idealizations about the exclusivity of the couple.
Conclusions: The psychological suffering caused by homophobia represents mediation between homophobia and risk situations in which respondents exercised their sexual practices. This link helps in explaining the increased vulnerability to HIV-AIDS with homosexuals. Homophobia represents a fundamental social determinant in the incidence and prevalence of HIV-AIDS. Designing public actions to combat it helps in controlling the pandemic.
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