Minority Stress, Relationship Functioning and HIV among Male-Male Couples Open Access

Abstract

Men who have sex with men (MSM) remain disproportionately affected by the HIV epidemic in the US and estimates suggest that one to two-thirds of new infections occur among main partners. Previous research has focused on individual MSM and their risk for HIV, yet couples' ability to manage risk has been largely understudied. In order to develop effective couple-level interventions, the role that stress and stigma play in shaping the ability of male-male couples to cope with HIV risk must be examined. A sample of 447 gay/bisexual men with main partners was taken from a 2011 survey of gay and bisexual men in Atlanta. Linear regression models were fitted for three couples' coping outcome scales (outcome efficacy, couple efficacy, communal coping) and included covariates measuring minority stress (internalized homophobia, gay discrimination, race discrimination). Findings indicate that reporting of increased levels of internalized homophobia and race discrimination were consistently associated with decreased outcome measures of couples' coping ability around risk management. The results highlight the role that stressors play in male-male couples' relationships and HIV risk, extending the existing literature in the field of same-sex relationships as influenced by minority stress. Understanding internalized homophobia and homophobic discrimination in the context of marriage equality in the US is a critical step in the reduction of sexual risk-taking behaviors and the development of effective interventions to improve health among all same-sex couples in the US.

Table of Contents

Table of Contents

CHAPTER 1: Background and Introduction............................................. 1

CHAPTER 2: Manuscript ..................................................................... 10

Abstract............................................................................................ 11

Introduction...................................................................................... 12

Methods............................................................................................ 15

Results.............................................................................................. 20

Discussion......................................................................................... 22

Limitations......................................................................................... 25

Conclusion......................................................................................... 25

References......................................................................................... 26

CHAPTER 3: Public Health Implications................................................... 34

REFERENCES...................................................................................... 37

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	HIV relationship functioning MSM male-male couples minority stress
Committee Chair / Thesis Advisor	Stephenson, Robert, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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