Sexual Identity Development and Social Ecological Facilitators and Barriers of PrEP Uptake and Adherence Among Latinx Men Who Have Sex with Men

Latinx gay, bisexual, and other men who have sex with men (LMSM) report lower pre-exposure prophylaxis (PrEP) use than their white, non-Latinx counterparts. We hypothesize that this disparity is partially attributable to social ecological factors that can be addressed via prevention interventions. In this retrospective study, we first examined data from 253 LMSM to determine whether theorized associations existed between acquisition of a PrEP prescription (uptake) in relation to several social ecological factors based on a conceptual framework of determinants of access to and uptake of PrEP for LMSM. We also explored relations between frequency of PrEP use (adherence) and social ecological factors with a subsample of 33 LMSM who had initiated PrEP 12 months prior to assessment. In this study, individual-level factors from this framework included age and socioeconomic status. Perceived access to medical care represented both individual- and community-level determinants of PrEP uptake and adherence. Interpersonal-level factors were social support and relationship status. Structural/cultural-level factors were sexual identity development status, the masculinity norm of heterosexual self-presentation, traditional Latinx masculine gender role beliefs of machismo and caballerismo, racial identity, and immigration status. Results indicated that older men and those who endorsed the synthesis/integration status of sexual identity development were more likely to acquire a PrEP prescription during their lifetime in comparison to peers. PrEP adherence was linked with being older, reporting higher socioeconomic status, reporting more appraisal social support, self-identifying as white-Latinx, being U.S.-born, and endorsing less sexual identity uncertainty and more heterosexual self-presentation. Results specify modifiable factors that may inform tailored, community-based prevention efforts to increase PrEP use and decrease existing HIV/AIDS disparities among LMSM.

“I wouldn’t say that I’m overly campy”: The socio-cultural subjugation of femininity within gay socio-sexual applications

The prevalence of femmephobic attitudes amongst gay, bisexual, and queer (GBQ) men is well-reported, yet under-discussed employing femme theory. Femmephobia, or the socio-cultural regulation of femininity, is common within GBQ online socio-sexual applications, yet more research is needed to analyze the different ways femmephobia takes place within GBQ socio-sexual applications predominately used by GBQ men. This study analyzes qualitative data from semi-structured interviews with 79 participants who described their experiences using socio-sexual applications and interacting with online outreach and health information workers. Participants described the different ways femmephobia and the regulation of femininity manifests within GBQ socio-sexual applications and how such forms of regulation relate to self-presentation and the privileging of masculinity within GBQ socio-sexual applications. Participants further described how femmephobia and the denigration of femininity intersected with anti-Asian racism online.

It’s a Man’s World: A Qualitative Study of Gender and Sexuality amongst Australian Gay Men

Currently, research explicitly examining masculinity and internalized homonegativity is sparse, and even sparser studies are those using qualitative methods. To address this, this study aims to explore: how gender norms are constructed and experienced amongst gay men; and how gender and sexual identity are experienced in relation to masculine norms amongst gay men. A sample of 32 self-identified gay men aged 22–72 years (M = 34.34, SD = 12.94) participated in an online semi-structured interview on masculinity and homosexuality. The study used Zoom to facilitate the online interviews as it offered privacy, accessibility, ease of use, and voice recording, among other benefits. Thematic analyses revealed gay men’s understandings of masculinity, femininity, and sources of pressure to conform. Furthermore, gay men emphasize the conflict experienced between heteronormative gender and sexuality norms, which highlights the term homosexual male as an oxymoron.

Out of the Closet, Not Yet Out of the House: Gay Men's Experiences of Homonegativity and Internalized Homonegativity

This paper explores how Australian gay men experience gender and sexuality in relation to heteronormative gender norms, specifically masculinity. A sample of 32 gay men 22-72 years of age participated in an online interview, using a videoconferencing software, on masculinity and homosexuality. Thematic analyses revealed that gay men experience gender and sexuality-related strain across all levels of their socioecological environment through social regulation, homophobic discrimination/harassment, and anti-effeminacy prejudice. The gay men expressed feelings of self-loathing, shame, internalized homonegativity, and isolation as a result. In examining interactions at each level of the socioecological environment, future research and practice may gain understanding in the social phenomena and how to ameliorate such strain.

Modelo Relacional da Antiafeminação em Homens Não-Heterossexuais: Estudo Exploratório

Homens gays e bissexuais afeminados são alvo de dupla estigmatização por conta da antiafeminação e da homofobia da sociedade mesmo entre a comunidade não-heterossexual. O objetivo deste estudo foi investigar, de forma exploratória, a estrutura relacional da antiafeminação por meio de uma análise de rede. Realizou-se um levantamento on-line com 1.123 homens não-heterossexuais brasileiros, maiores de 18 anos e com média de idade de 26,85 anos (DP = 8,51). O modelo relacional da antiafeminação produzido neste estudo encontrou associações com a homofobia internalizada (rp = 0,32) e a predileção por parceiros mais másculos (rp = 0,45). Além disso, foi possível identificar relação indireta com abertura da orientação sexual, que ocorre por meio da homofobia internalizada. Este estudo, além de ser o primeiro a desenvolver uma análise de rede sobre a antiafeminação, contribui para o entendimento do fenômeno no contexto brasileiro, fornecendo perspectivas para o aprofundamento de pesquisas no campo.

The Relationship between Masculinity and Internalized Homophobia amongst Australian Gay Men

Due to the heterosexist ideals associated with gender norms, gay men often experience negative attitudes towards their own sexuality—internalized homophobia. As a result, gay men often feel compelled to compensate for their perceived lack of masculinity. The study aimed to investigate the relationship and predictive power of masculinity on gay men’s experiences of internalized homophobia. A sample of 489 self-identified Australian gay men 18–72 years old participated in an online survey on masculinity and homosexuality. Descriptive statistics, bivariate correlations, and sequential multiple regressions were used to test the study’s aims. Sequential multiple regressions revealed that conformity to masculine norms and threats to masculinity contingency were stronger predictors of internalized homophobia over and above demographic and other factors. Given the already known psychological risks associated with social isolation, internalized homophobia, and the poor mental health outcomes associated with sexual minority groups, it is suggested that gay men who are experiencing high degrees of internalized homophobia should not be distancing themselves from other gay men but, conversely, seek a strong relationship with the LGBTI community.

Machismo and anabolic steroid misuse among young Latino sexual minority men

Latino sexual minority men (SMM) have elevated anabolic-androgenic steroid (AAS) misuse in comparison to their heterosexual and non-Latino peers. Within a gender role framework, desire to present as masculine through heightened muscularity may be related to increased AAS misuse. To assess the association between AAS misuse and a culturally-distinct masculinity, this study examined the relationship of two aspects of machismo, traditional machismo and caballerismo, with AAS misuse in the past month. Participants were 141 young adult Latino SMM recruited from the San Diego area. Participants completed a self-report questionnaire online in English or Spanish, which included measures of machismo and AAS misuse. Out of 141 participants, 27 reported AAS misuse (19.1%). Traditional machismo was positively associated with AAS misuse and caballerismo was negatively associated with AAS misuse. Traditional machismo, which emphasizes dominance, may be positively associated with AAS misuse due to its facilitation of muscle development, which could enable physical intimidation; greater musculature may also counteract assumptions about femininity and sexual orientation. Caballerismo may be negatively associated with AAS by providing a flexible masculinity model that emphasizes social cohesion over dominance. Future AAS misuse interventions could include values-based work and cognitive restructuring of masculinity schemas.

Individual and structural factors predicting HIV testing among Latinx MSM: substance use as a moderator

The rate of HIV infection for Latinx men who have sex with men (LMSM) increased by 20% from 2008 to 2014 even as rates stabilized among MSM of other racial and ethnic backgrounds. We hypothesize that this disparity is partially attributable to individual and structural factors associated with HIV testing, including substance use practices, among LMSM. In this retrospective study, we examined data from 502 LMSM to determine whether (a) hypothesized relationships exist between individual factors (perceived HIV susceptibility, experiences with HIV prevention, condom use, sex under the influence, sexual identity development status, heterosexual self-presentation, and traditional Latinx gender norms) and structural factors (access to healthcare resources and social support) and HIV testing for LMSM. We also tested whether (b) substance use practices moderate relations between individual and structural factors and HIV testing. Findings indicate that (a) relationships exist between several individual and structural factors and HIV testing and that (b) substance use moderated these relationships to HIV testing in a number of hypothesized ways. Practice and prevention implications are discussed.