Abstract: Everyday Discrimination and Internalized Homophobia Associated with Negative Affect during Sex Among Gay, Bisexual, Two-Spirit and Other Men Who Have Sex with Men (GB2MSM) in Canada (Society for Social Work and Research 26th Annual Conference - Social Work Science for Racial, Social, and Political Justice)

Everyday Discrimination and Internalized Homophobia Associated with Negative Affect during Sex Among Gay, Bisexual, Two-Spirit and Other Men Who Have Sex with Men (GB2MSM) in Canada

Thursday, January 13, 2022
Liberty Ballroom J, ML 4 (Marriott Marquis Washington, DC)
* noted as presenting author
David J. Brennan, PhD, Professor, University of Toronto, Toronto, ON, Canada
David Collict, MA, PhD Student, University of Toronto, Toronto, ON, Canada
Nathan J. Lachowsky, PhD, Assistant Professor, University of Victoria
Barry Adam, PhD, Distinguished University Professor Emeritus of Sociology, University of Windsor, Toronto, ON, Canada
Shelley Craig, PhD, Professor, University of Toronto, Toronto, ON, Canada
Lance McCready, PhD, Associate Professor, University of Toronto, Toronto, ON, Canada
Maya Kesler, PhD, Lead Epidemiologist, Ontario HIV Treatment Network, Toronto, ON, Canada
Trevor A. Hart, PhD, Professor, Ryerson University, ON, Canada
Travis Salway, PhD, Assistant Professor, Simon Fraser University, BC, Canada
Adam Davies, PhD, Assistant Professor, University of Guelph, ON, Canada
Tsegaye Bekele, MPH, Research Associate, University of Toronto, Toronto, ON, Canada
Background: Sex remains an important area of human behavior and function. Internalized homophobia (i.e., shame about one’s sexual minority status) and experiences of everyday discrimination (herein “discrimination”) are associated with negative mental health outcomes such as anxiety and depressive symptomology among gay, bisexual, Two-Spirit and other men who have sex with men (GB2MSM). Almost no research has examined how these relate to emotional affect associated with sexual behavior outside of sexual risk among GB2MSM. The current study sought to examine the relationship between internalized homophobia and discrimination, and Positive and Negative Affect related to sexual behavior among a sample of sexually active GB2MSM. We hypothesized that GB2MSM with greater reported internalized homophobia and discrimination would be more likely to experience Negative Affect associated with sexual behavior.

Methods: Data for the current study are from 410 sexually active GB2MSM who completed the baseline questionnaire of the iCruise study. Participants were GB2MSM who live or work in Ontario, Canada and were asked to indicate their mood/emotion/affect the last time they had sex. They rated feeling five Positive Affects (i.e., alert, inspired, excited, enthusiastic, determined) and 11 Negative Affects (i.e., sluggish, discouraged, distressed, upset, depressed, stressed, afraid, anxious, nervous, scared, jittery) on a scale of 1 (Not at all) to 5 (Extremely). Positive Affect and Negative Affect summary scores were generated by averaging responses of items included in each subscale. Participants also completed Herek et al.’s (2009) Internalized Homophobia Scale and the Everyday Discrimination Scale (Sternthal et al., 2011). Multivariable linear regression was used to identify demographic and psychosocial factors associated with Positive and Negative Affects related to sex.

Results: In unadjusted analysis, Positive Affect was inversely associated with internalized homophobia (B= -0.215, p=0.016), but not with discrimination (B= -0.026, p=0.447). Significant associations were identified between higher Negative Affect related to recent sex and higher discrimination (B=0.077, p=0.005) and higher internalized homophobia (B=0.281, p<0.001) levels.

In multivariable linear regressions controlling for age, race/ethnicity, sexual orientation outness, and sexualized drug use, the inverse association between Positive Affect and internalized homophobia was not significant (B= -0.109, p=0.256) while the association between Negative Affect and discrimination (B= 0.070, p=0.010) and internalized homophobia (B= 0.228, p=0.002) remained significant. Among the control variables, older age was associated with higher levels of Positive Affect and lower levels of Negative Affect. South Asian GB2MSM reported higher Negative Affect scores (B= 0.772, p<0.01) than white participants. Those who were out to only a few people versus (almost) everyone reported lower Negative Affect scores (B= -0.365, p=0.038).

Conclusions: This is the first known study to examine how negative and positive affect are related to recent sexual behavior and experiences of discrimination and internalized homophobia among GB2MSM. These findings suggest that the pernicious and ongoing effects of internalized homophobia and discrimination may disrupt the enjoyment of sex among GB2MSM. Further research is needed to enhance the sexual health of GB2MSM and to test potential mediating or confounding models to better understand the relationship between outness and affect associated with sex.