Sexual Behavior Stigma Among Cisgender Gay, Bisexual, and Other Men Who Have Sex With Men in Nine Nhbs Cities Across the United States: Burden and Associations With PrEP Continuum and HIV Care Continuum Outcomes

Authors

John Mark Wiginton
Sarah M Murray
Bridget J Anderson
Kwa Sey
Yingbo Ma
Colin P Flynn
Danielle German
Emily Higgins
Timothy W Menza
E Roberto Orellana
Stephanie Sanz
Nabeeh A Hasan
Alia Al-Tayyib
Jennifer Kienzle
Garrett Shields
Zaida Lopez
Paige Wermuth
Stefan D Baral

Language

English

Publication Date

2-1-2025

Journal

Stigma Health

DOI

10.1037/sah0000495

PMID

39935519

PMCID

PMC11810123

PubMedCentral® Posted Date

2-1-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

In the United States (US), sexuality-based stigma continues to undermine HIV prevention and care efforts. We assessed sexual behavior stigma burden across family, healthcare, and social domains and determined associations with HIV-related outcomes among cisgender gay, bisexual, and other men who have sex with men (MSM) in nine US metropolitan statistical areas. MSM (N = 4,086) recruited at places of MSM social congregation via venue-based, time-sampling procedures completed a survey on sexual behavior stigma, PrEP (pre-exposure prophylaxis) continuum and HIV care continuum outcomes, sociodemographic characteristics, and other measures. We calculated prevalence and overall mean stigma subscale scores (range: 0.00–1.00) and used logistic and mixed effects logistic regression to determine stigma-HIV outcome associations. Most participants identified as gay, were employed, and were from West Coast cities; roughly 40% were non-Hispanic white, aged 25 to 34 years, and had completed some college. One in five were living with HIV. Family stigma (prevalence = 47.5%; mean = 0.36) was associated with greater odds of healthcare engagement, PrEP awareness, and PrEP use among HIV-negative MSM. Anticipated healthcare stigma (prevalence = 14.5%; mean = 0.11) was associated with lower odds of healthcare engagement, current ART (antiretroviral therapy) use, and viral load undetectability among MSM living with HIV. General social stigma (prevalence = 49.9%; mean = 0.20) was associated with greater odds of PrEP awareness and use among HIV-negative MSM and lower odds of current ART use among MSM living with HIV. Targeted stigma-mitigation in family, healthcare, and other social contexts remains paramount to ending the HIV epidemic in the US.

Keywords

sexual behavior stigma, MSM, stigma prevalence, PrEP continuum, HIV care continuum

Published Open-Access

yes

Recommended Citation

Wiginton, John Mark; Murray, Sarah M; Anderson, Bridget J; et al., "Sexual Behavior Stigma Among Cisgender Gay, Bisexual, and Other Men Who Have Sex With Men in Nine Nhbs Cities Across the United States: Burden and Associations With PrEP Continuum and HIV Care Continuum Outcomes" (2025). Faculty, Staff and Student Publications. 1333.
https://digitalcommons.library.tmc.edu/uthsph_docs/1333