Community acceptance and HIV sexual risk among gay and bisexual men in a 'typical' Canadian city

Greta R. Bauer, Rachel Giblon, Todd A. Coleman, Gloria Aykroyd, Meredith Fraser, Daniel Pugh

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Included in Statistics Canada's largest geographical "peer group," London, Ontario is typical of many midsize Canadian cities. A local health forum identified community acceptance and homophobia as key factors impacting LGBTQ health; we studied these with regard to HIV-related sexual risk in gay and bisexual men. Survey data were collected from 201 gay and bisexual men in Middlesex-London, Ontario; 173 reported their HIV status as negative/unknown and were included in this analysis. Unadjusted and adjusted prevalence risk ratios (PRRs) were modelled using modified Poisson regression. First, a model was fit for non-modifiable sociodemographic and background factors. Community factors were then added: social support; internalized homonegativity; perceptions of community acceptance of people like oneself (based on orientation, racialization, gender identity). Older age was associated with decreased risk; other sociodemographic and background factors were not. For each 10-year increase in age, prevalence of high-risk sex decreased by 24% (PRR 0.76; 95% CI: 0.60, 0.95). Controlling for age, we found an interaction between perception of broader community acceptance and gay community acceptance of people like oneself. As broader community acceptance increased, high-risk sex decreased; however, this effect varied depending upon perceptions of gay community acceptance, with men feeling most accepted within the gay community having the smallest reductions in high-risk sex. This interaction raises a series of questions. Among these: How do community norms and availability of partners shape sexual risk-taking? Are conventional "contextualized" measures of sexual risk sufficient, or do they miss important risk-mitigation strategies used within gay communities?

Original languageEnglish (US)
Pages (from-to)7-16
Number of pages10
JournalCanadian Journal of Human Sexuality
Volume26
Issue number1
DOIs
StatePublished - 2017
Externally publishedYes

Keywords

  • Bisexual
  • Community
  • Gay
  • HIV
  • MSM
  • Sexual risk

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