Background: Because men who have sex with men (MSM) are over-represented among persons with HIV and STDs, it is important to understand how often they disclose their sexual behaviors to healthcare providers. This analysis tested the hypothesis that internalized homonegativity is negatively associated with disclosing same-sex sexual behaviors to healthcare providers.
Methods: The Young Men’s HPV (YM-HPV) study is a cross-sectional study of young gay, bisexual, and other MSM aged 18–26 years from health clinics in two U.S. cities: Chicago, IL, and Los Angeles, CA. Men who reported ever having a male sex partner were eligible for this analysis. Participants completed an online standardized computer-based questionnaire including demographics, sexual behavior, disclosure, and a condensed 11-item version of Mayfield’s Internalized Homonegativity Inventory (IHNI), with each item rated on a six-point Likert scale. An independent groups t-test with a correction for lack of homoscedasticity was used to test for significance (p<0.05).
Results: A total of 541 young men enrolled in the YM-HPV study during the one-year period July 18, 2012 through July 17, 2013. There were 405 valid responses to questions in the IHNI and the question about disclosure to a regular healthcare provider. More than one-third of the men (n=153, 37.78%) had never disclosed same-sex sexual behavior to their usual healthcare provider. These men scored significantly higher on the measure of homonegativity compared to men who had disclosed same-sex sexual behavior to their regular provider: the mean homonegativity score was 23.33 among those never disclosing versus 21.38 among those ever disclosing (t=1.90, p=0.047).
Conclusions: Internalized homonegativity may be a barrier for young MSM to disclose same-sex sexual behavior to healthcare providers. Providers might benefit these men by de-stigmatizing same-sex sexual behaviors and helping MSM overcome their own negative feelings about their behaviors.