Gay, bisexual, and other men who have sex with men (MSM) represent around 2% of the United States population, yet are the population most severely affected by HIV.
Being a group with such high percentages of people living with HIV, gay and bisexual men have an increased chance of exposure.
Gay and bisexual men account for around 63% of new HIV infections and around 55% of the number of people diagnosed with AIDS in the United States.
Many HIV infections of gay and bisexual men are due to risky sexual behaviors. Most gay and bisexual men acquire HIV through anal sex, which is the type of sex with the highest chance of transmitting HIV. They also tend to have more sexual partners than other men, making it more likely to acquire HIV.
What is Homophobia?
“Homophobia is a pervasive, irrational fear of homosexuality. Homophobia includes the fear heterosexuals have of any homosexual feelings within themselves, any overt mannerisms or actions that would suggest homosexuality, and the resulting desire to suppress or stamp out homosexuality; and includes the self-hatred and self-denial of homosexuals.”
Homophobia and HIV
Homophobia is a significant barrier to HIV diagnosis, treatment, and prevention, and is a critical public health issue.
Homophobia and heterosexism interfere with health care access and services for LGBT individuals, feed support for counterproductive abstinence-only-until-marriage programming, fuel antigay social policies and other violence, and otherwise marginalize queer people of all ages.
Studies consistently demonstrate that homophobia contributes to the spread of HIV and that internalized homophobia increases HIV risk.
Speak Out: Real Voices
From Greater than AIDS
How HIV Stigma Compounded the Trauma of a Violent Anti-Gay Attack
By Todd Heywood
After I was attacked in my apartment by two men who targeted me for being gay and HIV positive, my face was swollen like a chipmunk during an autumn nut collection frenzy, and I had bloody wounds on the side of my face. To this day, my thumbs retain areas of numbness from radial nerve damage caused by the handcuffs they used to restrain me. My laptops, digital cameras, cash, digital recorder, television, cellphone and medications, including my HIV meds, were gone.
Homophobia and HIV
A news report in the medical journal The Lancet features the available data about how stigma against homosexuality across the globe is interfering with struggles to slow down the spread of HIV. The article notes that “most global cases of HIV are not due to homosexual transmission,” but anti-gay laws, harassment, intimidation, silence, and invisibility.
Homophobia and HIV stigma often leads to a lack of participation by people of color in HIV prevention services, a reluctance to test for HIV or to use condoms, and difficulty talking about HIV and sex. Being able to address homophobia and HIV stigma is vital in decreasing the spread of HIV in people of color.
In Sri Lanka, HIV health care providers identify that one of the major barriers in preventing HIV/AIDs from spreading in the society is the homophobic attitude present among people.
Researchers from the journal AIDS from United States, Norway, Germany, and the United Kingdom first measured national homophobic impulses across Europe by examining countries’ laws and social attitudes reported in surveys.
HIV and Homophobia in European Countries
The 2010 European MSM Survey (EMIS) from 175,000 reportedly gay or bisexual men living in 38 of these countries. The survey examined HIV-related service use, need, and behaviors, which varied among men in more homophobic countries and less homophobic countries.
Researchers found these men tended to know less about HIV and how to prevent it, and were less likely to use condoms. As a result, these men were at higher risk of contracting HIV when they did choose to have sex, although it was not as frequently.
According to the doctor in charge of Russia’s Federal AIDs Center, Vadim Pokhrovsky, “Our region is the only part of the world where the number of new cases keeps increasing and the treatment does not reduce mortality.”
Information campaigns and training programs have stopped and the rate of infection increased last year by 10%. The number of Russians who died from AIDS in 2013 increased 15%.
The suppression of outreach and education means that Russians are no longer talking about HIV and AIDS. Most people at risk are not tested, are increasingly marginalized, and don't even know how HIV is spread.
HIV Stigma and Public Health Concerns:
Negative attitudes toward HIV and homosexuality in people of color can hinder HIV prevention and treatment efforts. The isolation that homophobia and HIV stigma causes results in the silence around HIV.
Public health efforts in communities of color would be better if homophobia and HIV stigma did not exist. If gay and/or HIV-positive men felt supported in their families, at work, at school, at church, and on the street, they would be more likely to care about their health and the health of others.
Internalized homophobia may impact MSM’s ability to make healthy choices. In addition, the stigma that surrounds the HIV epidemic may limit their willingness to access health and preventive care.
Criminalization and homophobia severely hinder the ability of many MSM to access HIV prevention information and treatment. Faced with legal or social sanctions, male-male relationships are either excluded or exclude themselves from sexual health and welfare agencies because they fear being identified as homosexuals.
The marginalization of MSM relationships results in higher numbers of multiple sexual partnerships and lower self-esteem, again leading to risky behaviors.
Homophobia: Endless Challenges for HIV Prevention:
HIV stigma, homophobia, and negative stereotyping of LGBTQ relations are key major factors to be approached in HIV prevention efforts
The Center for Disease Control and Prevention (CDC) has stated that stigma and homophobia may have a profound impact on the lives of MSM, and could influence them to engage in HIV risky behaviors.
Homophobia affects HIV in direct ways by driving discussion about MSM and homosexuality underground, legitimizing fear and prejudice, and compromising AIDS service organizations so that they cannot work publicly with LGBT and MSM communities.
Further Information on Global Cases of AIDS’ Connection with Homophobia:
“Researchers from Oxford University, the Population Council of Ghana and the Kenya Medical Research Institute reviewed AIDS studies conducted over the past few years and concluded that male-male sex was a major blind spot in AIDS research and policy in Africa.”
“According to Jamaican attorney Maurice Tomlinson, by denying these people the opportunity to be themselves, particularly the gay men are driven to have sex with men to mask their sexuality or try to “cure” it while others are forced underground thereby, away from HIV prevention and treatment.”
For example, a study published in 2016 on men who have sex with men in China found that depression experienced by Chinese men who have sex with men due to community norms and feelings of self-stigma around homosexuality directly affected HIV testing uptake.
In 2014, MSMGF (the Global Forum on men who have sex with men and HIV) conducted its third biennial Global Men's Health and Rights Study of just under 5,000 men who have sex with men from countries across the world. The results, published in 2016, indicate significant gaps in HIV prevention and treatment for both HIV-negative and HIV-positive men who have sex with men. It found perceptions and experiences of sexual stigma and discrimination to be associated with lower access to HIV services and lower odds of viral suppression.
Similarly, a study of men who have sex with men in Tijuana, Mexico found that self-stigma, or what the study describes as ‘internalized homophobia’ caused by cultural norms of machismo and homophobia, was strongly associated with never having tested for HIV, while testing for HIV was associated with identifying as homosexual or gay and being more ‘out’ about having sex with men.
In various communities of color, such as Latinos and African-Americas, an antigay bias is rooted in these communities and is considered the “norm”. It is part of the family’s traditions, attitudes, and values.
In the Latino community, for example, homosexuality is equated to weakness and is perceived to run counter to notions of machismo (community norms on what it means to be a man). As such, homosexuality in the Latino community is thought to hurt or embarrass the family.
The African-American community sees homosexuality as an embarrassment to the African-American race as a whole. More specifically, homosexuality in the African-American community is often perceived as conflicting with gender roles and community norms about sexuality, and even to being sinful and unnatural.
With these traditions, customs, and abrasive remarks shoved down the proverbial throat of a young member of the LGBTQ+ community, being proactive in going to the clinic to get educated and even treated about HIV/AIDs, or even STIs is against what is taught to a person of color whom is part of the LGBTQ+ community.
With the constant negative perceptions from communities of color, over 40% of homeless youth are LGBT and many turn to sex work. This not only puts them at a higher risk for HIV, but may also increase their feelings of helplessness and loss of community.
All graphics by Jaclyn Saik