Symposia
Health Psychology / Behavioral Medicine - Adult
Amelia Stanton, Ph.D.
Fellow
Harvard Medical School/Massachusetts General Hospital
Cambridge, Massachusetts
Conall O'Cleirigh, Ph.D.
Director, Behavioral Medicine
Harvard Medical School/ Massachusetts General Hospital,
Boston, Massachusetts
Jacklyn D. Foley, Ph.D.
Postdoctoral Fellow
Massachusetts General Hospital
Boston, MA
Samantha McKetchnie, MSW
Graduate Student
Boston College
Chestnut Hill, Massachusetts
Jennifer Muten, BA
Field Interviewer
The Fenway Institute
Boston, Massachusetts
Peter Chai, MD
Assistant Professor of Emergency Medicine
Brigham and Women's Hospital
Boston, Massachusetts
Calvin Fitch, PhD
Post-Doctoral Fellow, Behavioral Medicine, Department of Psychiatry
Massachusetts General Hospital
Boston, MA
Monina Klevens, DDS, MPH
Director of Research and Evaluation at the Bureau of Infectious Disease and Laboratory Sciences
Massachusetts Department of Public Health
Jamaica Plain, Massachusetts
Background: In the United States (US), men who have sex with men (MSM) and identify as persons of color are at elevated risk for acquiring HIV. MSM of color also face significant intersectional stigma, which has been demonstrated to be a formidable barrier to engaging in HIV prevention behaviors. Understanding the manifestations of stigma as well as the impacts of stigma on sexual activity and sexual relationships is particularly important in the era of COVID-19, when access to sexual partners has shifted and changes in sexual behavior may have implications for HIV prevention.
Methods: In a series of qualitative interviews with 18 MSM of color, we explored experiences of stigma and discrimination in the context of sexual activity and relationships. Interviews were conducted through the National HIV Behavioral Surveillance Project (cycle 6) in Boston, MA in late 2020 and early 2021, prior to the widespread availability of COVID-19 vaccines in the US. Individuals who identified as men or non-binary assigned male at birth and as persons of color were eligible to participate if they were at least 18 years of age, residents of the Boston Metropolitan area, and had endorsed ever having sex with a man. The data were analyzed via thematic analysis in the NVivo software.
Results: Participants had an average age of 26.4 years, and the majority identified as men (n=17, 94.5%), Hispanic/Latino (n=15, 83.3%), and had an associate’s degree, bachelor’s degree, or post-graduate degree (n=11, 61.1%). Three themes related to experiences of race- and ethnicity-related stigma and discrimination emerged: (1) sexual fetishization and objectification, (2) sexual rejection, and (3) ostracization from potential partners. Participants also described strategies they used to avoid stigmatizing experiences during the pandemic, which included disclosing more about their identities on sexual networking apps as well as being more selective about potential partners online.
Conclusion: Participants experienced multiple forms of stigma and discrimination related to sexual activity and networking. The ways in which participants chose to navigate that stigma during the pandemic, when partner availability decreased and virtual/online sexual activity increased, could have implications for HIV prevention. Targeted prevention strategies that take intersectional stigma in sexual contexts, type of sexual encounter (in-person vs. virtual), and partner (short term vs. long term) into account may be warranted, especially if pandemic-related changes in sexual activity are durable.