The impact of stigma on HIV testing decisions for gay, bisexual, queer and other men who have sex with men: a qualitative study

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Abstract

Background

Stigmatization may prompt gay, bisexual, queer and other men who have sex with men (GBQMSM) to avoid or delay HIV testing. There has been little attention to GBQMSMs’ perspectives about how stigma may influence their decisions about whether, where, and how often to get tested for HIV.

Methods

We conducted nine focus groups with 64 adult GBQMSM in Metropolitan Detroit, including HIV-negative men and people living with HIV (PLWH). Data were thematically analyzed deductively and inductively in three rounds.

Results

Three themes emerged regarding whether to get tested: (1) Perceived promiscuity, risk perceptions and HIV testing; (2) Fearing sexual rejection; and (3) Fearing friend and family member distancing and rejection. Themes concerning where to get tested included: (4) Conflating HIV testing and diagnosis; and (5) Seeking privacy and safety at specialized services. As for how often to get tested, themes included: (6) Reducing contact with healthcare providers due to intersectional stigma; (7) Responsibility and regular testing; and (8) HIV stigma and testing as routine care. Black participants articulated themes (3), (4), and (6) with greater frequency than other participants. Framing HIV testing as a personal responsibility may have created a “new stigma,” with unintended consequences not observed with “routine healthcare” messaging.

Conclusions

GBQMSMs’ perspectives indicate the potential for new foci for HIV testing promotion interventions based on stigma-related issues that they deem important. There is a need for interventions to challenge the “promiscuity” stereotype, and to reduce the sexual stigmatization of GBQMSM living with HIV/AIDS—especially online. Provider stigma requires both intervention and continued availability of specialized services. Future stigma-reduction interventions for Black GBQMSM could focus on building family support/acceptance, awareness of multiple testing options, and integrating LGBTQ-related issues into initiatives for racial justice in health care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12761-5.

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Author and article information

Contributors

Tiffany C. Veinot: tveinot@umich.edu

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 9 March 2022

Publication date PMC-release: 9 March 2022

Publication date Collection: 2022

Volume: 22

Electronic Location Identifier: 471

Affiliations

[1 ]GRID grid.214458.e, ISNI 0000000086837370, School of Information, , University of Michigan, ; Ann Arbor, MI USA

[2 ]GRID grid.214458.e, ISNI 0000000086837370, Department of Health Management and Policy, School of Public Health, , University of Michigan, ; Ann Arbor, MI USA

[3 ]Washtenaw County Health Department, Ypsilanti, MI USA

[4 ]Detroit Health Department, City of Detroit, Detroit, MI USA

[5 ]Unified – HIV Health and Beyond, Ypsilanti, MI USA

[6 ]GRID grid.214458.e, ISNI 0000000086837370, School of Nursing, , University of Michigan, ; Ann Arbor, MI USA

[7 ]GRID grid.25879.31, ISNI 0000 0004 1936 8972, School of Nursing, , University of Pennsylvania, ; Philadelphia, PA USA

[8 ]GRID grid.214458.e, ISNI 0000000086837370, Department of Health Behavior and Health Education, School of Public Health, , University of Michigan, ; Ann Arbor, MI USA

Article

Publisher ID: 12761

DOI: 10.1186/s12889-022-12761-5

PMC ID: 8908600

PubMed ID: 35264132

SO-VID: cb2e89de-0a53-460d-b804-0accb417fb3a

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 6 August 2021

Date accepted : 11 February 2022

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ScienceOpen disciplines: Public health

Keywords: stigma,hiv testing,decision-making,men who have sex with men,detroit

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ScienceOpen disciplines: Public health

Keywords: stigma, hiv testing, decision-making, men who have sex with men, detroit

The impact of stigma on HIV testing decisions for gay, bisexual, queer and other men who have sex with men: a qualitative study

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Supplementary Information

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Most cited references 127

Saturation in qualitative research: exploring its conceptualization and operationalization

Conceptualizing Stigma

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