HIV-related stigma wh muni of gay men: A lerature review - PMC

Contents:

• HIV IS A STORY FIRST WRTEN ON THE BODI OF GAY AND BISEXUAL MEN
• HIV-RELATED STIGMA WH MUNI OF GAY MEN: A LERATURE REVIEW
• GAY AND HIV/AIDS LERATURE SEARCH
• PATTERNS OF HIV TTG PRACTIC AMONG YOUNG GAY AND BISEXUAL MEN LIVG STLAND: A QUALATIVE STUDY
• SCHOLARLY LERATURE HIV-RELATED LBIAN, GAY, BISEXUAL, AND TRANSGENR STUDI: A BIBLMETRIC ANALYSIS
• SEXUAL HEALTH STUDI GAY AND LBIAN PEOPLE: A CRIL REVIEW OF THE LERATURE
• MEDIA REPRENTATN, PERCEPTN AND STIGMATISATN OF RACE, SEXUALY AND HIV AMONG YOUNG BLACK GAY AND BISEXUAL MEN

HIV IS A STORY FIRST WRTEN ON THE BODI OF GAY AND BISEXUAL MEN

In 1983, trated by their shared experienc of stigma, gay men wh AIDS at the Fifth Annual Gay and Lbian Health Conference brought forth the Denver Prcipl, which talyzed self-empowerment across health movements for s to signifint as the time markers are, the HIV story the Uned Stat likely dat back two or more s before the 1980s. And the goal of this edorial memoratg the first published s of AIDS is to unrsre the cril importance of human rights for sexual mory men and women and as the basis of the HIV AMONG GAY AND BISEXUAL MENRace, class, and sexual orientatn ntue to shape the HIV epimic the Uned Stat and around the world, wh new fectns disproportnately affectg men who have sex wh men Black and Brown muni. COMMUNITY-LED HIV RESPONSESBuildg on the civil rights, women’s rights, and gay and lbian liberatn movements the Uned Stat, lbian, gay, bisexual, transgenr, queer (LGBTQ) people, and their alli worked together to tablish HIV service anizatns even as ernments stggled to rpond.

Stigma clud discrimatn and rejectn by HIV-negative gay men, stigma related to ageg, chang physil appearance, race/ethnicy and of HIV-related stigma wh gay muniDiscrimatn and rejectn by non-HIV fected gay menSome HIV-negative gay men feel that HIV-posive men threaten gay muni, eher terms of health or general perceptns of gay men (Flowers, Dunn, & Franks, 2000). Furthermore, the study suggted that the attus of non-black gay men, and social works and environments found gay venu n also separate black gay men om their addn to the perceived stigma om external sourc, “ternal stigma” or “self-stigma” is a nfoundg issue among HIV-posive gay men and n be the rult of ongog external stigma. Consequenc and impact of stigma on HIV-posive menMental and emotnal well-begAmong HIV-posive gay men, stigma has a nsirable impact on mental and emotnal well-beg, g signifintly creased levels of anxiety, lonels, prsive symptoms, suicidal iatn and engagement avoidant strategi such as social whdrawal (Courtenay-Quirk et al., 2006; Grov et al., 2010).

From self-pleted surveys of major prsive disorr (MDD) sexually active gay men attendg general practic urban Atralia (Mao et al., 2009), appeared that the rate of MDD among the 195 HIV-posive gay men was signifintly higher than that among the 314 HIV-negative gay men (31. Furthermore, a study of HIV-posive MSM New York and San Francis, participants perceived a “rift” based on HIV stat wh their gay muny that was lked to prsn, anxiety and lonels (Wolski, Dey, Parsons, & Gomez, 2002) segregatn based on HIV statStudi of “serosortg” have emerged the lerature, whereby gay men and MSM associate predomately wh others of the same HIV stat (Barber, 1991; Johnson, 1995; Yi, Shidlo, & Koegel, 2004). Some thors report posive aspects of serosortg for both HIV-negative and HIV-posive gay men, while others have likened to an “AIDS apartheid”1 based on ternal or outwardly perceived stigma (Barber, 1991) studi have suggted that serosortg may rce transmissn among high-risk HIV-negative gay men (Eaton, Kalichman, O'Connell, & Karchner, 2009; Philip, Yu, Donnell, Vtghoff, & Buchbr, 2010; Wilson et al., 2010).

HIV-RELATED STIGMA WH MUNI OF GAY MEN: A LERATURE REVIEW

It has been suggted that most HIV-negative and HIV-posive men may more accurately be scribed as practisg “serogusg” selectn based on perceived rather than actual HIV stat (Zablotska et al., 2009) whdrawal due to chang physil appearanceA seri of terviews Atralia wh HIV-posive gay men lked the prence of lipodystrophy wh feelgs of isolatn (Persson, 2005). Rejectn relatnshipsIn a study of HIV-posive gay men the UK (Bourne, Dodds, Keogh, Weatherburn, & Hammond, 2009), the greatt ncern, shared by nearly all of the men the study regardls of lol HIV prevalence, was the possibily of rejectn by sexual partners followg disclosure of stat. In this example of self-stigmatisatn imposed om external perceptns, also known as meta-stereotypg (Kle & Azzi, 2001), the rponnts felt strongly that beg associated wh HIV-posive sexual spac, eher onle or offle, would pound stigma directed towards one qualative study of relatnships between HIV-posive and HIV-negative men Toronto, Canada, many HIV-posive gay men reported rejectn and lack of empathy om HIV-negative iends and/or partners (Maxwell, 1998).

In addn, a survey the UK reported anecdotal evince om gay men who faced rejectn and vlence by potential partners upon disclosure of their HIV stat, while others were surprised that HIV-negative gay men were not more supportive (Weatherburn et al., 2009) behavurHIV-posive gay men may participate high-risk behavurs, such as dg e and unprotected anal terurse (UAI), as a means of pg wh livg wh HIV (Kelly, Bimbi, Izienicki, & Parsons 2009). Men wh HIV participatg high-risk behavurs, cludg UAI, tend to report creased stigma, gay-related strs, self-blame-related pg and substance abe (Kelly et al., 2009; Radcliffe et al., 2010) a review of the soclogy of “barebackg” (UAI), numero theori are proposed for why gay men engage unprotected sex, cludg the fact that many HIV-posive men feel socially alienated om HIV-negative men (Shernoff, 2005). In a seri of terviews on disclosure practic, risk takg and attus about HIV fectn nducted among 150 gay men the USA who had participated UAI, rponnts ced a muny-wi shift towards non-disclosure and UAI sce the advent of effective anti-retroviral therapy (ART) (Sheon & Crosby, 2004).

Acrdg to UNAIDS, crimalisatn of HIV transmissn may rerce HIV-related stigma, spread misrmatn about HIV, hr HIV ttg and unsellg support and, importantly, create a false sense of secury by enuragg HIV-negative men to dulge risky behavurs, believg themselv legally protected om transmissn (UNAIDS, 2008) rearch is required to fully asss the extent, nsequenc and potential untermeasur relatn to HIV-related stigma wh gay muni. The nsequenc of such missg data negatively affects dividuals livg wh HIV, and may also threaten to further divi muni of gay men and prent a signifint barrier to efforts aimed at addrsg the overall HIV stigma-rctn programm have been intified and shown to be effective small-sle, short-term trials, none have been nducted specifilly among gay men, and many gaps rema, pecially relatn to the size, duratn and impact of the iativ (Brown, Mactyre, & Tjillo, 2003).

GAY AND HIV/AIDS LERATURE SEARCH

A more -pth unrstandg of HIV ttg practic among young MSM is ccial velopg strategi to crease uptake and equency of ttg, and to rm the velopment of terventns which seek to change ttg practic among men muni most at risk of qualative study explored young gay and bisexual men’s unrstandgs of HIV risk the ntext of their sexual practice and muny norms of safer sex. Ethil approval was obtaed om the Universy of Glasgow College of Social Scienc Ethics Commtee [Applitn number: CSS20120206] cln creria were that the men were aged between the ag of 18 and 29 years and intified as gay, bisexual, or as a man who has sex wh other men.

PATTERNS OF HIV TTG PRACTIC AMONG YOUNG GAY AND BISEXUAL MEN LIVG STLAND: A QUALATIVE STUDY

Ined, acunts typilly foced on regular HIV ttg as an tegral part of leadg a rponsible gay sexual life and the men amed their ttg practic wh an ethic of re; a rponsibily for self-re, re of potential sexual partners, and towards men their wir muni enuragg them to tt as part of a regular route. The social support David and his iends received om each other around ttg appeared to allay some of their anxieti about ttg dividually, and rerced their mment to rg for themselv, their close iends, and wir muni of gay is important to note that men who scribed havg habual ttg practic did report stanc of ttg rponse to perceived risk events; for example CAI wh a sual partner of unknown stat, or after partner notifitn of an STI.

SCHOLARLY LERATURE HIV-RELATED LBIAN, GAY, BISEXUAL, AND TRANSGENR STUDI: A BIBLMETRIC ANALYSIS

Although at an dividual level men this group unrstood HIV as a potential risk associated wh sexual behavurs such as CAI, ntrast to men wh habual ttg practic, the younger men this group (n = 6), those aged 24 or unr, exprsed the view that ls emphasis should be placed on HIV transmissn among muni of gay men:HIV is a risk for everyone... A number of men emphasised their anxiety that raisg the topic of HIV uld be terpreted by close iends, sexual partners, and wir gay muni, as an ditn that they were at risk of of open and easy munitn around HIV also appeared to translate to fewer opportuni for beg supported, or enuragg others, to accs HIV ttg.

Quent had recently started volunteerg for a gay men’s chary, and anticipated that this would open up more possibili for supportg, and beg supported, to attend for HIV ttg alternative muny-based wh ad hoc ttg practic who grew up ral areas some distance om the ma urban mercial scen Stland (which are primarily ncentrated wh the ci of Glasgow and Edburgh) often reported gravatg to onle muni and spac when seekg social and sexual nnectns wh other gay men. Dpe proactively seekg rmatn about accsg ttg onle settgs, this group’s acunts suggt that accs to sexual health servic for gay men may be more problematic - or at least appear more problematic - ral areas, and th a ntributory factor not velopg a pattern of regular ntrast to men wh habual ttg practic who emphasised the posive role that support om iends played enuragg them to accs HIV ttg, some men wh ad hoc approach noted that social norms uld ntribute to not velopg a regular route of ttg.

The way which men unr the age of 24 this group sought to distance both themselv, and wir gay muni, om beg lked to HIV risk suggts that HIV stigma, bed wh lack of personal nnectn to people livg wh HIV, pound their anxiety about open munitn around HIV stat and ttg.

SEXUAL HEALTH STUDI GAY AND LBIAN PEOPLE: A CRIL REVIEW OF THE LERATURE

Ined, strategi signed to facilate regular ttg mt take to acunt dividual perceptns of HIV risk, the social and sexual ntexts which such rpons to risk are veloped, particularly wh gay muni, as well as wh stctural issu such as stigma and is important to nsir how disurs of rponsibilisatn around HIV ttg permeate the fdgs.

Moreover, while HIV ttg was regnised as an dividual bodily practice some participants scribed the importance of ttg together, thereby transformg the practice om an dividualised, or medilised event, to a more ‘social’ is cril that rearchers ntue to be attuned to the way which chang the social and sexual world that gay men hab, cludg the creasg foc on pharmactil HIV preventn technologi, shift unrstandgs of risk and rponsibily, and imbue HIV ttg wh new meangs [7]. As Keogh and Dodds’ [7] note, as dividuals and muni engage wh ‘new’ HIV preventn technologi, those volved health promotn and terventn sign mt ntue to engage wh earlier rearch that foced on issu around moraly, rponsibily and rights, wh a view to ensurg that ongog preventn efforts are equable and do not crease health equali among gay, bisexual and other men who have sex wh men. Particular strengths of this study clu: the generatn of rich qualative data which provis sight to the diversy of ways which young men posned themselv and their ttg practic wh ‘muny narrativ’ around HIV ttg [42]; and the foc on young gay and bisexual men livg Stland beyond areas of high HIV prevalence, which are ls well rearched.

Sce gay muni are changg [43] rponse to a variety of factors, not least social and sexual media and velopment of onle muni, muny narrativ around HIV ttg uld efully be explored further general, the young men who participated the study reported high levels of sexual health knowledge, specifilly around the transmissn of HIV and other STIs. In the methods, fdgs and discsn sectns we e the term gay, bisexual and, to a lser extent, queer, to reflect the language participants ed when talkg about themselv and this stance we have ed the term unprotected anal terurse (UAI) as this is ditive of the language ed the guil ced, however, throughout the rt of the article we e the term ndomls anal terurse (CAI) as this better reflects current age and sexual practic the ntext of bmedil optns for HIV preventn.

MEDIA REPRENTATN, PERCEPTN AND STIGMATISATN OF RACE, SEXUALY AND HIV AMONG YOUNG BLACK GAY AND BISEXUAL MEN

” Then, wh the HIV/AIDS-related dataset, we ed the followg terms for searchg tle/abstract orr to filter studi about the LGBT populatns:Terms for lbian: lbian, women who have sex wh women, WSW, homosexual female, lbianismTerms for bisexualy: bisexual, bisexualyTerms for transgenr: transgenr, transgenred, transsexualism, transsexual, genr inty disorrs, genr dysphoriaTerms for gay: men who have sex wh men, MSM, gayGeneral terms: LGBT, homosexualy, homosexual, same-sex, queer, sexual mory, not exclively 1 prents the flow chart of the searchg procs. Publitns about gay (or men who have sex wh men) group had the hight number (acunted for nearly 70% of the total number of publitn) over the time perd, followg by bisexual, transgenr, and 1General characteristics of publishedTotal number of papersTotal catnsMean ce rate per yearTotal age last 6  monthTotal age last 5  yearsMean e rate last 6  monthMean e rate last 5  year20191, 2051, 3121. 2%Trends rearch topics by year durg 1990– the 90s , the topics about HIV ttg (topic 2), molecular epimlogy of different typ of HIV (topic 3), substance e (topic 5), equali HIV-related risk behavrs (topic 7), soc-legal aspects of homosexualy (topic 8), pre-exposure prophylaxis (topic 12), and stigma-related barriers (topic 14) showed the posive trend, while the topics about HIV/STI prevalence (topic 1), and opportunistic fectns (topic 10) had the negative tenncy.

Therefore, requir the needs for strong rearch hubs different regns, wh the untry wh the hight productivy as a central, to boost the rearch pacy of untry members the analyzg the growth of publitns different groups, we found that rearch on gay or MSM outweighed other populatns, or other words, global scholars paid more attentn to MSM pared wh lbian, bisexual, or transgenr people. In the upg s, studi that help to crease the verage of HIV ttg and treatment, as well as implement HIV-terventns wh low st and ease to sle-up such as ter-based terventns, which has shown promise HIV preventn and treatment homosexual populatns (Nguyen et al., 2019), n bee the prri the rearch agenda. Stigma affects HIV negative Black gay and bisexual men who have sex wh men obstctg accs to, and e of, preventive servic cludg HIV pre-exposure prophylaxis (PrEP), HIV ttg, and engagement wh healthre provirs (Threats and Bond 2021; Hatzenbuehler, Phelan, and Lk 2013).

To date, most media studi have examed one or two of the inti that young Black gay and bisexual men embody, cludg: reprentatns of HIV Ain Amerin targeted magaz (Clarke, McLellan, and Hoffman-Goetz 2006), the terrelatn between media, Blackns and racial bias (Towns 2015), and media fluence on gay, lbian and bisexual inti (Goln and Giuliano 2011; Towns 2015). Adolcents and young adults teract through multiple media channels throughout the day, wh 91% of 18 to 29 year-olds on YouTube, 79% on Facebook, and 67% on Instagram (Pew Rearch Center 2019) a ponent of the social environment and primary source of rmatn, social media n amplify portrayals of young Black gay and bisexual men that may perpetuate racist, homophobic, and transphobic trop and msagg, ntributg to discrimatn and HIV dispari (Emlet et al. Instagram, Tik Tok, YouTube), dividuals have more tools to ntribute to llective narrativ about race, sexualy and inty (Dillette, Benjam and Carpenter 2018; Jackson and Well 2015; Mundt, Ross and Burt 2018) the bt of our knowledge, no studi have explored how young Black gay and bisexual men perceive, teract wh, and challenge or rist stigmatisg media portrayals (Logie and Rwigema 2014; Han 2007; Fongkaew et al.