ArticleAIDS (London, England)2015
State-level structural sexual stigma and HIV prevention in a national online sample of HIV-uninfected MSM in the United States.
Article in AIDS (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
104 citing papers in PubMed, 2 syntheses or guidelines pooled it, 166 citations in OpenAlex.
- Pre-Exposure Prophylaxis Care Continuum, Barriers, and Facilitators among Black Men Who Have Sex with Men in the United States: A Systematic Review and Meta-Analysis.AIDS and behavior · 2021Pooled it
- Human rights protections and HIV prevalence among MSM who sell sex: Cross-country comparisons from a systematic review and meta-analysis.Global public health · 2018Pooled it
- Trial
- Anticipated HIV stigma among HIV negative men who have sex with men in China: a cross-sectional study.BMC infectious diseases · 2020Trial
- HIV Pre-Exposure Prophylaxis Care Continuum in Outpatient Settings: A Systematic Review and Meta-Analysis.AJPM focus · 2026Review
- A Mobile Counseling Program for Gay and Bisexual Men's Mental, Behavioral, and Sexual Health in Eastern Europe: A Randomized Controlled Trial.AIDS and behavior · 2026Article
- Intersecting Epidemics: Examining the Impact of Internalized Homophobia and Depression Symptoms on HIV Testing Through a Suicide Syndemic Among Young Black Men Who Have Sex with Men.Journal of racial and ethnic health disparities · 2026Article
- Discrimination and misconceptions about human immunodeficiency virus among gay and bisexual men.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2025Article
- Sexual behavior stigma among cisgender gay, bisexual, and other men who have sex with men in nine NHBS cities across the United States: Burden and associations with PrEP continuum and HIV care continuum outcomes.Stigma and health · 2025Article
- Sexualized drug use factors among rural sexual minority men.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Neighborhoods, Networks, and HIV Care Among Men Who Have Sex With Men: Proposal for a Longitudinal Study.JMIR research protocols · 2024Article
- Structural Stigma and Disparities in Long-Term Health Conditions Among Australians in Same-Sex Relationships: 2021 Australian Census.American journal of public health · 2024Article
- Willingness to Use Long-Acting Injectable PrEP Among PrEP Naïve Black and Hispanic Sexual Gender Minority Persons.AIDS and behavior · 2024Article
- Access to Federally Qualified Health Centers and HIV Outcomes in the U.S. South.American journal of preventive medicine · 2024Article
- Systemic White supremacy: U.S. state policy, policing, discrimination, and suicidality across race and sexual identity.Journal of psychopathology and clinical science · 2024Article
- Experiences of oral pre-exposure prophylaxis use among heterosexual men accessing sexual and reproductive health services in South Africa: a qualitative study.Journal of the International AIDS Society · 2024Article
- Examining HIV Knowledge and Sexually Risky Behaviors among Female Sex Workers in Kampala, Uganda.International journal of environmental research and public health · 2024Article
- Same-Sex Marriage Laws, Provider-Patient Communication, and PrEP Awareness and Use Among Gay, Bisexual, and Other Men Who have Sex with Men in the United States.AIDS and behavior · 2023Article
- Branched sexuality and sexual health among Black cisgender sexual minority men in Baltimore, Maryland: an exploratory study.Culture, health & sexuality · 2023Article
- Structural racism and homophobia evaluated through social media sentiment combined with activity spaces and associations with mental health among young sexual minority men.Social science & medicine (1982) · 2023Article
44 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundStigmatizing social environments (of which 'structural stigma' is one component) negatively affect health-related outcomes. However, few studies have examined structural stigma related to sexual minority status as a risk factor for HIV outcomes among MSM.
methodsIn August 2013, members of a large MSM social and sexual networking site in the United States completed a survey about HIV-prevention practices. A previously validated composite index provided values for state-level structural stigma, including density of same-sex couples, proportion of public high schools with Gay-Straight Alliances, state laws protecting sexual minorities, and public opinion toward homosexuality. Multivariable logistic generalized estimating equations assessed the relationship between structural stigma and condomless anal intercourse, use and awareness of antiretroviral-based HIV-prevention strategies (i.e. pre and postexposure prophylaxis, or PEP and PrEP), and comfort discussing male-male sex with primary care providers.
resultsAmong the 4098 HIV-uninfected MSM, lower state-level structural stigma was associated with decreased odds of condomless anal intercourse [adjusted odds ratio (aOR) 0.97 per one unit increase in structural stigma score, 95% confidence interval (CI) 0.94-0.99], increased odds of awareness of PEP (aOR 1.06, 95% CI 1.02-1.09), and PrEP (aOR 1.06, 95% CI 1.02-1.10), having taken PEP (aOR 1.15, 95% CI 1.05-1.26) and PrEP (aOR 1.21, 95% CI 1.01-1.44), and comfort discussing male-male sex with providers (aOR 1.08, 95% CI 1.05-1.11), after adjusting for social and state-level confounders.
conclusionMSM living in more stigmatizing environments had decreased use of antiretroviral-based HIV-prevention strategies compared to those in less stigmatizing environments. Legal reforms protecting sexual minorities should be evaluated as structural interventions that could reduce HIV risk among MSM.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.