Stigma, HIV Risk, and Access to HIV Prevention and Treatment Services Among Men Who have Sex with Men (MSM) in the United States: A Scoping Review
Open accessAbstract
In light of recent advances in HIV prevention and treatment, we reviewed the literature to understand how different types of stigma impact HIV risk; access to HIV prevention, care, and treatment services; and related health outcomes among men who have sex with men (MSM) in the US. We conducted a scoping literature review of observational and qualitative studies that examined stigma and HIV-related outcomes among MSM. Our search identified 5794 studies, of which 47 met the eligibility criteria and were included in the final analysis. The review suggests that stigma remains a formidable barrier to engaging in HIV prevention and treatment among both HIV-negative and HIV-positive MSM. Among the studies of HIV-positive MSM, internalized stigma was related to lower levels of treatment engagement. HIV-positive MSM in the Southern part of the US were also more likely to engage in risky sexual behavior. Perceived health care discrimination was negatively associated with PrEP awareness, particularly among HIV-negative Black MSM. Among young MSM of color, intersectional stigma compounded the social structural barriers to PrEP adherence. Findings indicate that stigma reduction interventions should be implemented in diverse MSM communities to address the disproportionate burden of HIV along with critical gap in the care continuum. Further research should examine how individual types of stigma, including intersectional stigma, affect viral suppression and PrEP uptake and adherence, especially among MSM of color.
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Minority stress and mental health conditions are linked to behavioral health problems, including sexual risk behaviors, substance use, and HIV/STI risk.
“Minority stress and these mental health conditions are linked to behavioral health issues, including sexual risk behaviors, substance use, and HIV/STI risk.”
From Mindfulness for Reducing Minority Stress and Promoting Health Among Sexual Minority Men: Uncovering Intervention Principles and Techniques (2022) · cites this paper as Babel et al., 2021
The Introduction and Results (Stigma and Syndemic Conditions; page not provided) link minority stress, mental health distress, substance use, sexual risk behavior, and HIV risk among MSM. The copy supports the HIV component but does not establish the claimed STI risk. (LLM, conf=0.84)
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“1 3 homophobia, identity concealment, depression/anxiety, and low self-esteem confer vulnerability to high-risk contexts such as difficulty negotiating safe sex, decreased access and engagement to HIV/STI testing and LGBTQ + care, and sex under the influence of alcohol and other substances (Babel et al., 2021; Operari…”
Background
- Authors
- Babel, R. A., Wang, P., Alessi, E. J., Raymond, H. F., & Wei, C.
- Affiliations
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Babel, Riddhi A.
- Venue
- AIDS and Behavior
- Published
- 2021-04-18
- Volume
- 25
- Issue
- 11
- Pages
- 3574-3604
- ISSN
- 1090-7165 (ISSN-L)
- 1573-3254
- PMC
- PMC8053369
- OpenAlex
- W3154006242
- Cited by
- 277
- References
- 78
- Citations by year
- 2026: 59 · 2025: 89 · 2024: 57 · 2023: 41 · 2022: 27 · 2021: 4
- FWCI
- 3.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- AIDS and Behavior (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Rutgers University Community Repository (Rutgers University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Keywords
- HIV stigma, men who have sex with men, self-stigma, HIV prevention, HIV treatment engagement, HIV care continuum, PrEP uptake, PrEP adherence, health care discrimination, intersectional stigma, Black MSM, HIV risk behavior, Southern United States, stigma reduction interventions, viral suppression
- MeSH terms
- Sexual and Gender Minorities, Humans, Male, Sexual Behavior, United States, HIV Infections, Homosexuality, Male, Social Stigma, Pre-Exposure Prophylaxis
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