HIV and sexuality stigma impede HIV prevention and care efforts. HealthMpowerment.org
(HMP) is an interactive mobile phone- and web-based HIV prevention and care intervention
for young Black men who have sex with men (YBMSM; ages 18–30) in the United States.
HMP included three forums where participants could share their experiences. In this
study, we explored whether engaging in stigma-related discussions was associated with
changes in YBMSM’s stigma-related scores throughout the trial. YBMSM (ages 18–30;
N=238) participating in HMP completed surveys at baseline, and three- and six-month
follow-ups that included a series of scales focused on HIV and sexuality (internalized
homophobia; sexual prejudice) stigma. Sixty-two participants contributed to the forums
(1,497 posts). We coded instances where YBMSM’s conversations were stigma related
(915 posts, 61.1%), including discussions of anticipated (74/915, 8.1%), experienced
(125/915, 13.7%), internalized (410/915, 44.8%), and/or challenged (639/915, 69.8%)
stigma regarding sexuality and HIV. Using a mixed methods approach, we examined whether
changes in YBMSM’s stigma scores were associated with stigma-related discussions within
the forum. We controlled for age, HIV status, income, and educational attainment in
these multivariable models. YBMSM who discussed experiencing HIV stigma in the forums
reported decreases in perceived HIV stigma over time (b=−.37, p≤.05). YBMSM whose
forum posts indicated anticipated HIV stigma reported increases in HIV stigma over
time (b=.46, p≤.01). Participants who challenged sexuality-related stigma in forums
had lower internalized homophobia (b=−.68, p≤.01) at baseline. YBMSM whose discussions
focused on experiencing sexuality-related stigma reported increases in internalized
homophobia (b=.39, p≤.01) and sexual prejudice (b=.87, p≤.05) over time. Developing
strategies to combat stigma remains a key priority. HMP created an online space where
YBMSM could discuss HIV and sexuality stigma. Although a limited number of HMP participants
authored the majority of these forum discussions, the discussions were associated
with changes in the sample’s stigma scores over time. Online interventions (e.g.,
social media, apps) should consider the inclusion of forums to address stigma and
test the efficacy of forums to improve YBMSM’s HIV prevention and care continuum outcomes.