The impact of sexual stigma and gender non-conformity stigma on depression, coping and life satisfaction for men who have sex with men in South India

Published: July 21, 2010

C. Logie1, P.A. Newman1, V. Chakrapani2

1University of Toronto, Faculty of Social Work, Toronto, Canada, 2Indian Network for People Living with HIV/AIDS (INP+), Chennai, India

Background: Qualitative research with men who have sex with men (MSM) in India highlights experiences of discrimination and stigmatization within social, legal, and health systems. Yet empirical research with MSM in India has predominately focused on quantifying individual level risk behaviour. This study examines the impact of sexual stigma and gender-non conformity stigma on sexual risk behaviour, depression, and life satisfaction among MSM in South India.
Methods: A quantitative investigation was designed and implemented in partnership between the University of Toronto and community based organizations in Tamil Nadu, India. A cross-sectional survey was administered to MSM in urban and semi-urban locations in Tamil Nadu. Bivariate correlations and multiple linear regression (MLR) analyses were conducted to measure associations between independent (sexual stigma, gender non-conformity stigma) and dependent (life satisfaction, sexual risk behaviour, depression) variables.
Results: Participants (n=200, mean age=30.9) reported experiences of sexual stigma (perceived: 89%; enacted: 92%) and gender non-conformity stigma (perceived: 86.5%; enacted: 75.5%). The majority of participants had moderate/severe depression scores (n=116, 58%). Most participants exchanged sex for money in the past 3 months (n=129, 64.5%) and reported high levels of inconsistent condom use with paid partners (n=95, 73.6%). Sexual stigma and gender non-conformity scales had high reliability (Cronbach’s alpha >0.80). Gender non-conformity stigma and sexual stigma were significantly correlated with sexual risk behaviour, depression, and lower life satisfaction. In MLR analyses, gender non-conformity stigma predicted higher depression and lower life satisfaction, and sexual stigma predicted higher sexual risk behaviour.
Conclusions: Results highlight the associations between discriminatory social processes (e.g. gender non-conformity stigma) and inequitable health outcomes (e.g. increased depression), contributing evidence to the health and human rights dialogue. Understanding the impact of sexual/gender-non conformity stigma on health and risk behaviour can inform:
a) mental health interventions,
b) HIV risk reduction strategies, particularly for male sex workers, and
c) multi-level stigma interventions.

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