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Intersectional Effects of Sexual Orientation Concealment, Internalized Homophobia, and Gender Expression on Sexual Identity and HIV Risk Among Sexual Minority Men of Color: A Path Analysis

Year: 2021

Type: article

Abstract: ABSTRACT: In the United States, 13 million people identify as sexual and gender minorities. The purposes of this article were to (a) examine the associations among sexual orientation concealment and internalized homophobia with HIV knowledge, health literacy, and transactional sex through sexual identity; and (b) assess whether gender expression moderates those relationships in sexual minority men of color. A multigroup mediation path model examined the association between sexual orientation concealment and internalized homophobia on HIV knowledge, health literacy, and transactional sex through sexual identity by gender expression. Results suggest that, among those with a masculine gender expression, as sexual concealment increased, health literacy decreased. The association between sexual orientation concealment and transactional sex varied by participant's gender expression as did the association between internalized homophobia and HIV knowledge. Multiple intersecting identities, when faced with anticipated discrimination and homophobia, can negatively affect health outcomes and increase HIV risk in sexual minority men of color.

Source: Journal of the Association of Nurses in AIDS Care

DOI: 10.1097/jnc.0000000000000274