Experiences of sexual stigma by MSM in rural Oklahoma

Abstract

Concurrent socioeconomic factors, geography, and cultural context are coalescing for sexual minorities living in rural communities resulting in individuals at risk for HIV infection. By the end of the session, participants will be able to assess sexual stigma in rural communities, its manifestations at the individual or societal level, and its correlates with HIV risk.

Proposal Summary

Background: The nature of the HIV epidemic in the United States has changed with a shift toward rural areas; where sexual minority populations are dispersed and health care resources are limited. Methods: We recruited 40 gay and bisexual men, ages 22 to 66, residing in rural Oklahoma for in-depth qualitative sexual health interviews. Through this inductive approach, we explored experiences with individual-level and community-level stigma, patterns of sexual health-seeking behaviors, and determinants of sexual risk. Results: Participants indicated a lack of desire to discuss their sexual behavior or sexual orientation with peers, family, or medical providers due to rejection concerns. Participants discussed how these factors shaped their attitudes towards HIV/AIDS, status disclosure with sexual partners, and their uptake of HIV/STI screening. Participants described a stigmatizing social environment and less access to quality, LGBT-sensitive medical care within rural communities, and perceived these as substantial barriers to enhancing individual-level and community-level sexual health. Finally, structural issues, including lack of comprehensive sexual health education, institutional practices, and state policies within Oklahoma were noted. Conclusions: Results indicate the need to develop greater awareness of stigma as an etiologic factor that contributes to the health of rural gay and bisexual populations, specifically when it relates to the provision of appropriate care. Addressing stigma situated across ecological levels in an effort to improve sexual health remains necessary. The combination of both individual-level and environmental/policy –level interventions provide the greatest opportunity to achieve substantial changes in health behaviors and health outcomes. Without this, social determinants may continue to negatively influence health outcomes among this population which remains underserved and under resourced.

Relevance And Significance

The unique experiences of gay and bisexual men residing in rural areas are not well represented in the scientific literature. Rural communities are typically more culturally conservative, and therefore may be less welcoming to openly lesbian, gay, bisexual, and transgender individuals. Moreover, the socioeconomic conditions of rural communities mean that most individuals born into these rural communities are unable to move to areas where they would be accepted. Greater attention is needed to build a more comprehensive understanding of the sexual health of marginalized populations living in rural areas of the United States in order to advance the HIV care continuum. There is a continued need to develop greater awareness of stigma as an etiologic factor that contributes to the health of rural gay and bisexual populations, specifically when it relates to the provision of appropriate care and development of HIV interventions.

Session Format

Poster Session

Keywords

sexual health; sexual stigma, rural MSM

Publication Type and Release Option

Event

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Experiences of sexual stigma by MSM in rural Oklahoma

Concurrent socioeconomic factors, geography, and cultural context are coalescing for sexual minorities living in rural communities resulting in individuals at risk for HIV infection. By the end of the session, participants will be able to assess sexual stigma in rural communities, its manifestations at the individual or societal level, and its correlates with HIV risk.