Associations between HIV testing and multilevel stigmas among gay men and other men who have sex with men in nine urban centers across the United States
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Le résumé fourni par la source
BACKGROUND: Complex manifestation of stigma across personal, community, and structural levels and their effect on HIV outcomes are less understood than effects in isolation. Yet, multilevel approaches that jointly assesses HIV criminalization and personal sexual behavior stigma in relation to HIV testing have not been widely employed or have only focused on specific subpopulations. The current study assesses the association of three types of MSM-related sexual behavior-related stigma (family, healthcare, general social stigma) measured at both individual and site levels and the presence/absence of laws criminalizing HIV transmission with HIV testing behaviors to inform HIV surveillance and prevention efforts among HIV-negative MSM in a holistic and integrated way. METHODS: We included nine National HIV Behavioral Surveillance (NHBS) 2017 sites: Baltimore, MD; Denver, CO; Detroit, MI; Houston, TX; Long Island/Nassau-Suffolk, NY; Los Angeles, CA; Portland, OR; San Diego, CA; and Virginia Beach and Norfolk, VA. Multivariable generalized hierarchical linear modeling was used to examine how sexual behavior stigmas (stigma from family, anticipated healthcare stigma, general social stigma) measured at the individual and site levels and state HIV criminalization legislation (no, HIV-specific, or sentence-enhancement laws) were associated with past-year HIV testing behaviors across sites (n = 3,278). RESULTS: The majority of MSM across sites were tested for HIV in the past two years (n = 2,909, 95.4%) with the average number of times tested ranging from 1.79 (SD = 3.11) in Portland, OR to 4.95 (SD = 4.35) in Los Angeles, CA. In unadjusted models, there was a significant positive relationship between stigma from family and being tested for HIV in the past two years. Site-level HIV-specific criminalization laws were associated with an approximate 5% reduction in the prevalence of receiving any HIV test in the past two years after individual level stigma and sociodemographic covariate adjustments (PR = 0.94, 95% CI, 0.90-0.99). CONCLUSIONS: Structural barriers faced by MSM persist and ending the HIV epidemic in the US requires a supportive legal environment to ensure effective engagement in HIV services among MSM. Home-based solutions, such as self-testing, used to deliver HIV testing may be particularly important in punitive settings while legal change is advocated for on the community and state levels.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Associations between HIV testing and multilevel stigmas among gay men and other men who have sex with men in nine urban centers across the United States
- Date Crossref
- 20/09/2022
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Johns Hopkins University pays non établi dans la noticeUniversité ou école supérieure
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Denver Public Health pays non établi dans la noticeOrganisme public
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Los Angeles County Department of Public Health pays non établi dans la noticeOrganisme public
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Maryland Department of Health pays non établi dans la noticeOrganisme public
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Michigan Department of Health and Human Services pays non établi dans la noticeOrganisme public
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New York State Department of Health pays non établi dans la noticeOrganisme public
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Oregon Health Authority HIV Data and Analysis Program pays non établi dans la noticeOrganisme public
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Portland State University Regional Research Institute pays non établi dans la noticeUniversité ou école supérieure
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University of Washington pays non établi dans la noticeUniversité ou école supérieure
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Seattle University pays non établi dans la noticeUniversité ou école supérieure
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California Health and Human Services Agency pays non établi dans la noticeOrganisme public
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University of Texas Health Science Center at Dallas pays non établi dans la noticeUniversité ou école supérieure
Johns Hopkins University, Denver Public Health et Los Angeles County Department of Public Health, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.