This article examined the associations between three forms of homosexuality-related stigma (enacted, perceived, and internalized homosexual stigmas) with risky sexual behaviors, and to describe the mechanisms of these associations, among men who have sex with men (MSM) in Hanoi, Vietnam. We used respondent-driven sampling (RDS) to recruit 451 MSM into a cross-sectional study conducted from August 2010 to January 2011. Data were adjusted for recruitment patterns due to the RDS approach; logistic regression and path analyses were performed. Participants were young and single; most had attended at least some college. Nine out of ten participants engaged in sexual behaviors at moderate to high risk levels. Compared to those who had no enacted homosexual stigma, men having low and high levels of enacted homosexual stigma, respectively, were 2.23 times (95 % CI 1.35–3.69) and 2.20 times (95 % CI 1.04–4.76) more likely to engage in high levels of sexual risk behaviors. In addition, there was an indirect effect of perceived homosexual stigma and internalized homosexual stigma on sexual risk behaviors through depression and drug and alcohol use. Our study provides valuable information to our understanding of homosexual stigma in Vietnam, highlighting the need for provision of coping skills against stigma to the gay community and addressing drinking and drug use among MSM, to improve the current HIV prevention interventions in Vietnam.
Bibliographical noteFunding Information:
This research was supported by Research to Prevention (R2P) Small Grants Program funded by United States Agency for International Development, awarded to Dr. Le Minh Giang at the Center for Community Health Research and Development (CCRD). The John Hopkins Bloomberg School of Public Health/Center for Communication Program is the prime contractor for R2P. Authors would like to thank Dr. Giang for his supports and CCRD’s staffs, especially Mr. Nguyen Tri Trung and Ms. Le Mai Phuong for data collection. Additional support was provided by Fogarty International Center through grant D43TW007669. The content of this study is solely the responsibility of the authors and does not necessarily represent the official views of the Fogarty International Center or the National Institutes of Health.
© 2015, Springer Science+Business Media New York.
- Homosexuality-related stigma
- Sexual risk behavior