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Laney Graduate School

Rollins School of Public Health

Candler School of Theology

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Perceived Sexual Identity Stigma and Associated Factors among Black and White Men who have Sex with Men

Pitasi, Marc A. (2013)
Master's Thesis (79 pages)
Committee Chair / Thesis Adviser: Sanchez, Travis
Committee Members:
Research Fields: Health Sciences, Epidemiology; Health Sciences, Public Health
Partnering Agencies: Does not apply (no collaborating organization)
Keywords: MSM; stigma; minority stress; racism
Program: Rollins School of Public Health, Epidemiology (Epidemiology)
Permanent url: http://pid.emory.edu/ark:/25593/dw9cn

Abstract

Background: Sexual minority populations, including gay, bisexual, and other men who have sex with men (MSM), continue to face unique health disparities in the United States. Disparities in HIV infection and other adverse health outcomes are likely to be influenced by a complex, interrelated mix of biological, behavioral, and social processes. A small but growing body of research has explored the possible role of sexual identity stigma in shaping patterns of risk. However, few epidemiologic studies have attempted to identify factors associated with experiencing stigma. Objectives: To assess the prevalence of perceived sexual identity stigma among black and white MSM and to identify and compare demographic and community factors associated with stigma in these subgroups. Methods: Eligible participants completed a questionnaire assessing demographic, behavioral, clinical, and psychological information. Perceived sexual identity stigma was measured with a seven-item scale. Multiple linear regression was used to model participant and community characteristics in 454 black MSM, 349 white MSM, and a combined sample of 803 MSM. Results: Compared with white MSM, black MSM reported significantly higher levels of sexual identity stigma (p<0.01), racial stigma (p<0.01), and resilience (0.01). Age (p=0.02), sexual identity (p=0.03), connectedness to the gay community (p<0.01), and racial stigma (p<0.01) were associated with sexual identity stigma among black MSM. The magnitude of the association between connectedness and sexual identity stigma was greater among non-gay-identified black MSM compared with gay-identified black MSM (p<0.01). Among white MSM, perceived neighborhood quality (p=0.02), connectedness to the gay community (p<0.01), and racial stigma (p<0.01) were independently associated with sexual identity stigma. Discussion: These results suggest that black and white MSM may have very different experiences within both the gay community and their communities at large. Both individual and community characteristics appear to play an important role in experiences of sexual identity stigma among black MSM. Nearly a quarter of black MSM in our sample self-identified as bisexual, and this subgroup may face additional barriers in adapting to multiple minority stressors. Interventions attempting to reduce community stigma must address the unique needs of MSM subgroups.

Table of Contents

Background…………..…………………………………………………………………...1 -- Minority Stress……….………………………………………………………….........2 -- Stigma…………….…………………………………………………………………..4 -- Coping and Adaptive Processes…….…………………………………………….…..7 -- Objectives…………….…………………………………………………………….....9 -- Manuscript……………….……………………………………………………………..10 -- Introduction……….…………………………………………………………………10 -- Methods…..………………………………………………………………………….12 -- Sampling………..………………………………………………………………12 -- Measures.……………………………………………………………………….13 -- Analysis.………………………………………………………………………..15 -- Results...…………………………………………………………………………….16 -- Participant Characteristics…………………………………………………….16 -- Stigma...……………………………………………………………………….17 -- Discussion…..………………………………………………………………………18 -- References.………………………………………………………………………….23 -- Tables.…........………………………………………………………………………26 -- Summary and Public Health Implications…..…………………………………………30 -- References…..…….……………………………………………………………………34 -- Appendix A: Scale Items......…………………………………………………………..41 -- Appendix B: SAS Code…...….………………………………………………………..46

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