Structural and environmental factors are associated with internalised homonegativity in men who have sex with men: Findings from the European MSM Internet Survey (EMIS) in 38 countries

Rigmor C. Berg, Michael W. Ross, Peter Weatherburn, Axel J. Schmidt

Research output: Contribution to journalArticlepeer-review

116 Scopus citations


Internalised homonegativity refers to a gay person's negative feelings about homosexuality and is believed to stem from negative societal stereotypes and attitudes towards homosexuality. Surprisingly, little research has centred on this link. In this research, we aimed to examine the associations between internalised homonegativity and structural forces, cultural influence, and access to sexual health promotion measures among a sample of 144,177 men who have sex with men (MSM) in 38 European countries. Participants were recruited as part of the European MSM Internet Survey (EMIS) during 2010. It was a self-completion, multilingual Internet-based survey for men living in Europe who have sex with men and/or feel attracted to men. Assumed causal relations were tested through multiple regression models. Variables at the structure of rule-systems (macro-level) that were significantly and negatively associated with internalised homonegativity were the presence of laws recognising same-sex relationships and same-sex adoption. In the meso-level model, greater proportions of the population expressing that they would not like to have homosexuals as neighbours predicted higher internalised homonegativity. In the last model, five variables were significantly and negatively associated with internalised homonegativity: being exposed to HIV/STI information for MSM, access to HIV testing, access to STI testing, access to condoms, and experience of gay-related hostility. In turn, men who had tested for HIV in the past year evidenced lower internalised homonegativity. This is the largest and certainly most geographically diverse study to date to examine structural and environmental predictors of internalised homonegativity among MSM. Our results show that one insidious consequence of society's stigma towards homosexuals is the internalisation of that stigma by gay and bisexual men themselves, thus, drawing attention to the importance of promoting social equity for self-acceptance around gay identity in building a positive sense of self.

Original languageEnglish (US)
Pages (from-to)61-69
Number of pages9
JournalSocial Science and Medicine
Issue number1
StatePublished - Feb 2013

Bibliographical note

Funding Information:
The EMIS Network thanks the more than 180,000 men who responded to the survey, the more than 235 websites that promoted the survey, and particularly those that sent individual messages to their users: PlanetRomeo, Gaydar, Manhunt, Qruiser, and Qguys. We also thank all NGOs that promoted our survey. Without this help, EMIS's success would not have been possible. We are grateful for being granted permission to use European Values Survey data and the statistical expertise provided by Jan Odgaard-Jensen. EMIS was funded by: Executive Agency for Health and Consumers (EAHC) ; Centre d’Estudis Epidemiológics sobre les ITS/HIV/SIDA de Catalunya (CEEISCat) ; Terrence Higgins Trust for the CHAPS partnership (England) ; Regione de Veneto; Robert Koch Institute ; Maastricht University ; German Ministry of Health ; Finnish Ministry of Health ; Norwegian Institute of Public Health ; and the Swedish Board of Health and Welfare .


  • Europe
  • Internalised homonegativity
  • Men who have sex with men
  • Predictors


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