Stigma An Apparent Barrier in Achieving AIDS-free Generation

By Alvin Tran

Research presented this week at the 19th International AIDS Conference shows how homophobia may be a major barrier to achieving the "AIDS-free generation" -- the optimistic tagline underlying much of the conference.

A new survey of young men who have sex with men (MSM) shows that "experiencing homophobia" may put them at greater risk of contracting and spreading HIV, the virus that causes AIDS.

The study was conducted by Oakland's Global Forum on MSM and HIV (MSMGF). Researchers surveyed more than 5,000 MSM globally. Nearly 1,500 were age 30 or younger, with about two-thirds of these young men from Asia and six percent from North America. According to the study, young MSM who experienced homophobia more frequently said they had less access to a variety of services including free HIV testing and condoms. Experiencing higher levels of homophobia equated with less access to medical treatment for HIV-positive gay men.

“Our findings really underscore the importance of also addressing the larger structure and social factors that are associated with HIV infection especially among young men who have sex with men,” said Glenn-Milo Santos, an epidemiologist and MSMGF researcher.

In addition to highlighting the possible relationship between experiencing homophobia and having less access to HIV preventive services and care, Santos also presented results about respondents' overall experiences with homophobia.

More than 60 percent of young MSM interviewed said they believed that people in their respective countries felt that gay men and MSM could not be trusted. Seventy percent felt that others believed that they are dangerous. Additionally, the majority of those interviewed said they believed MSM are tolerated but not accepted.

What shocked many audience members attending Santo’s presentation, however, was the rate of internalized homophobia or the negative feelings people have about themselves based on their homosexuality.

Roughly 40 percent of the young MSM said they wished they weren’t gay or bisexual. More than 30 percent said they avoided personal or social involvement with other men who have sex with men. More than 20 percent said their sexual history was a "negative feature" of who they are.

Overall, young MSM had higher levels of this internalized homophobia than older MSM.

“It was really surprising ... that we found evidence of high internalized and external homophobia among young men who have sex with men,” Santos told me. “Each of these factors was independently associated with reduced access to HIV prevention services that are critical to reducing exposure to HIV.”

Santos thinks that future efforts aimed at preventing the spread of HIV should consider social factors such as homophobia in order to be effective among the younger MSM population.

"I don't think that we're going to achieve our goal of achieving zero new infections without addressing ... external homophobia and alleviating internalized homophobia among young men who have sex with men," Santos said.