Still Stigma after All These Years

Background: Stigma has been seen as a barrier to HIV prevention and treatment efforts since very early in the epidemic. Efforts to reduce stigma have included opt-out HIV testing at routine clinical visits. However, many young, minority men who have sex with men (MSM) do not access routine health services and need special efforts to provide HIV testing, necessitating the need to understand current barriers.

Methods: As part of a SAMHSA-funded prevention project, focus groups and individual semi-structured interviews were conducted from November, 2015 through February 2016 with 22 young, Black and Latino MSM recruited at a large university and surrounding community. Among other questions, respondents were asked about testing for HIV and hepatitis C virus (HCV) experience and barriers.

Results: Shame related to being gay and the stigma related to HIV being a gay-disease were commonly cited as a major barrier to HIV testing, while lack of knowledge about HCV was the most common barrier to HCV testing. Stigma was especially cited as a barrier for closeted young black men. One respondent said, for example, “… a lot of black men who have sex with men will never admit it to the world so they keep it a secret so it prevents them from getting tested because if they get tested they feel like they will be judged by somebody, you know, there is a stigma attached to queer men of color….” Support from peer leaders was seen as helpful in reducing stigma and encouraging HIV testing. Regarding HCV testing, respondents said things like, “I have never heard of it,” and “I have never had any conversations about HEP C at all.”

Conclusions: Efforts to reduce HIV-related stigma and provide support for HIV and HCV testing are still needed.