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, Rodman E. Turpin, Donte T. Boyd, José I. Gutierrez, Chase Nicole Williams, Laron E. Nelson, Trace Kershaw

Research output: Contribution to journalArticlepeer-review

Abstract

In the United States, 13 million people identify as sexual and gender minorities. The purposes of this article were to (a) examine the associations among sexual orientation concealment and internalized homophobia with HIV knowledge, health literacy, and transactional sex through sexual identity; and (b) assess whether gender expression moderates those relationships in sexual minority men of color. A multigroup mediation path model examined the association between sexual orientation concealment and internalized homophobia on HIV knowledge, health literacy, and transactional sex through sexual identity by gender expression. Results suggest that, among those with a masculine gender expression, as sexual concealment increased, health literacy decreased. The association between sexual orientation concealment and transactional sex varied by participant's gender expression as did the association between internalized homophobia and HIV knowledge. Multiple intersecting identities, when faced with anticipated discrimination and homophobia, can negatively affect health outcomes and increase HIV risk in sexual minority men of color.

Original languageEnglish (US)
Pages (from-to)495-511
Number of pages17
JournalJournal of the Association of Nurses in AIDS Care
Volume32
Issue number4
DOIs
StatePublished - 2021

Keywords

  • HIV
  • gender expression
  • homophobia
  • intersectionality
  • sexual behavior
  • sexual minority men
  • transactional sex
  • HIV Infections
  • Sexual Behavior
  • Humans
  • Male
  • Homosexuality, Male
  • Sexual and Gender Minorities
  • Skin Pigmentation
  • Homophobia
  • Female

ASJC Scopus subject areas

  • Advanced and Specialized Nursing

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