Experiences of stigma and health care engagement among Black MSM newly diagnosed with HIV/STI.

Abstract

Rates of HIV/STI transmission among Black men who have sex with men (BMSM) are alarmingly high and demand urgent public health attention. Stigma related concerns are a key barrier to accessing health care and prevention tools, yet limited research has been focused in this area. Experiences of stigma related to health care were evaluated among 151 BMSM residing in the Atlanta, GA area, both prior to and post HIV or STI diagnosis in a longitudinal study (data collected from 2014 to 2016). Findings demonstrated that inadequate health care engagement is associated with post-diagnosis anticipated stigma (b = - 0.38, SE =0.17 p ≤ .05). Pre-diagnosis prejudice is a predictor of post-diagnosis enacted (b = 0.39, SE=0.14, p < .01), anticipated (b = .28, SE=0.14, p < .05), and internalized (b = .22, SE =0.06, p < .001) stigmas. This study is the first of its kind to assess experiences of stigma among BMSM during a critical time (i.e., before and after diagnosis) for HIV/STI prevention and treatment. Results provide a novel understanding of how stigma unfolds over-time and provide direction for stigma intervention development.