Intersectional Effects of Sexual Orientation Concealment, Internalized Homophobia, and Gender Expression on Sexual Identity and HIV Risk Among Sexual Minority Men of Color: A Path Analysis.
S Raquel Ramos, David T Lardier, Ijeoma Opara and 6 others
PMID 34101701WHAT IT FOUND
Concealing sexual orientation was linked to lower health literacy and more transactional sex; internalized homophobia was linked to lower HIV knowledge and health literacy.
Some links varied by masculine, feminine, or mixed gender expression.
Key findings
01Internalized homophobia was associated with lower HIV knowledge and health literacy, while sexual orientation concealment was associated with more transactional sex and lower health literacy.
02Among participants with a masculine gender expression, greater sexual concealment was associated with lower health literacy and greater internalized homophobia was associated with lower HIV knowledge.
03Among participants with a feminine gender expression, greater sexual concealment was associated with more transactional sex.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data were cross-sectional, so they cannot show whether concealment or internalized homophobia came before lower knowledge, literacy, or transactional sex. It was a secondary analysis of existing survey data, so the questions were not built for these research aims. Responses were self-reported and may be affected by social desirability or recall. The sample was limited to sexual minority men of color without HIV infection aged 18 to 34 years, so findings may not apply to other groups. Discrimination was not tested as a causal or moderating variable in these models.
Declared interests
Publication types list NIH and U.S. government P.H.S. research support. The authors report no real or perceived vested interests related to the article.
The easy way to misread this
Do not read these associations as proof that concealment or internalized homophobia causes lower HIV knowledge, lower health literacy, or transactional sex. The data were cross-sectional and self-reported, so they cannot establish what came first.