Classes of Sexual Identity, Homophobia, and Sexual Risk among Black Sexual Minorities in HPTN 061.

Rodman Turpin, Typhanye Dyer, Lakeshia Watson, Kenneth Mayer
Author Information
  1. Rodman Turpin: Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland at College Park. ORCID
  2. Typhanye Dyer: Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland at College Park. ORCID
  3. Lakeshia Watson: Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland at College Park.
  4. Kenneth Mayer: Fenway Institute, Fenway Health, Boston, MA, USA. ORCID

Abstract

Homophobia is associated with sexual risk among sexual minorities, including Black sexual minority men, though experienced homophobia may differ across sexual identities. We conducted latent class analysis of sexual identities and experienced homophobia associated with sexual risk, and tested mediators of this association. We used longitudinal data from the HIV Prevention Trials Network Study 061 (n = 1,553). We generated rate ratios between baseline latent classes of experienced homophobia and sexual identity and 12-month outcomes: Condomless receptive anal intercourse (CRAI), number of partners, and transactional sex. Mediators included 6-month internalized homophobia, depression, social support, and substance use. We selected the following 7-class model: "Bisexual, rare homophobia" (reference), "Mixed identities, mixed homophobia", "Bisexual, frequent homophobia", "Heterosexual/Same-gender loving, frequent homophobia", "Gay, frequent homophobia", " Gay/Same-gender loving, frequent homophobia," and "Gay, rare homophobia." All other classes had greater CRAI than the reference. For bisexual/mixed/heterosexual classes, approximately 20% of this association was positively mediated through our mediators ( < .05). The Heterosexual/Same-gender loving class had the largest proportion mediated through internalized homophobia. For gay-identifying classes, mediation was marginally significant (.05 <  < .10). Classes of sexual identity and experienced homophobia were associated with CRAI among Black sexual minority men, partially mediated through internalized homophobia, depression, social support, and substance use.

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Grants

  1. U48 DP006382/NCCDPHP CDC HHS
  2. UM1 AI069412/NIAID NIH HHS
  3. UM1 AI068619/NIAID NIH HHS
  4. P2C HD041041/NICHD NIH HHS
  5. P30 AI060354/NIAID NIH HHS

MeSH Term

Bisexuality
Homophobia
Homosexuality, Male
Humans
Male
Sexual Behavior
Sexual and Gender Minorities

Word Cloud

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