A Comparative Analysis of Stigma Among Self-Identified HIV-Negative Gay and Bisexual Latino Men in Chicago and San Francisco

Background and Purpose:

Latino men who have sex with men (MSM) continue to be disproportionately affected by HIV and other sexually transmitted infections (STIs). While many researchers have attributed the lack of knowledge of HIV status and substance abuse to the continued transmission of HIV/STIs in the Latino MSM community, fewer have analyzed the intrapersonal, interpersonal, and structural effects of stigma on Latino MSM. Indeed, the pervasiveness of social and cultural stigma in the Latino community has historically reduced access to various HIV/STI prevention tools and services.

The purpose of this study was to compare the experiences of self-identified gay and bisexual HIV-negative Latino men in Chicago and San Francisco with regards to psychological and social manifestations of stigma. Stigma was separated into three categories: (1) Perceived, (2) Experienced, and (3) Internalized. This study explored whether the bisexual men in the sample experienced significantly different types of stigma when compared to the gay men in the sample.

Methods:

This study was a secondary data analysis of Ramirez-Valles et al.’s (2008) extensive study of HIV infection and substance use among Latino gay and bisexual men and transgender women in Chicago and San Francisco in the summer and fall of 2004. Ramirez-Valles et al. (2008) collected this data through respondent-driven sampling and computer-assisted self-administered interviews. For this study, the researcher analyzed data from 350 Latino HIV-negative gay and bisexual men. About 75% (n=263) identified as gay, homosexual, or queer and 25% (n=87) identified as bisexual.

Results:

A one-way between-groups multivariate analysis of variance (MANOVA) was performed to investigate sexual self-identification differences in overall stigma. There was a statistically significant difference between gay and bisexual men on the three combined dependent variables of stigma (p<.0001; Wilks' Lambda=.91; partial eta squared=.10). When the results for the dependent variables were considered separately, the only difference to reach statistical significance, using a Bonferroni adjusted alpha level of .017, was internalized stigma (p<.001; partial eta squared=.08). The effect size was 7.5% (medium); thus, 7.5% of variance in internalized stigma was explained by sexual self-identification. An inspection of the mean scores indicated that bisexual HIV-negative Latino men reported slightly higher levels of internalized stigma (M=39.10, SD=10.57) than gay HIV-negative Latino men (M=32.76, SD=9.26).

Conclusions and Implications:

There was a difference between overall stigma (perceived, experienced, and internalized) and self-identification as gay or bisexual for the HIV-negative Latino men in the sample. Bisexual men in the sample were impacted by internalized stigma more than gay men. Bisexual Latino men are seldom considered in research surrounding the impact of stigma on the sexual health outcomes of Latino MSM. Examining the impact of internalized stigma on bisexual men has the potential to create improved medical and therapeutic interventions for HIV prevention amongst Latino MSM. Moreover, further explorations of the impact of internalized stigma on Latino MSM can promote more innovative programs and services focused on reducing sexual risk behavior for Latino MSM.