@article{920c9a24f24a44cc82e02125a952e668,
title = "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",
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.",
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",
author = "Ramos, {S. Raquel} and Lardier, {David T.} and Ijeoma Opara and Turpin, {Rodman E.} and Boyd, {Donte T.} and Gutierrez, {Jos{\'e} I.} and Williams, {Chase Nicole} and Nelson, {Laron E.} and Trace Kershaw",
note = "Funding Information: The primary study, from which the data are derived, is registered on ClinicalTrials.gov Identifier: NCT04061915. This study was funded by NIH/NHLBI (K01HL145580, LEveraging A viRtual eNvironment [LEARN] to Enhance Prevention of HIV-related Comorbidities in at-risk Minority MSM, PI: S. R. Ramos) and NIH/NIMH (R25MH087217, Research Education Institute for Diverse Scholars [REIDS], PI: T. Kershaw). S. R. Ramos and R. E. Turpin are both funded as HIV Prevention Trials Network Scholars through the HIV Prevention Trials Network and by the National Institute of Allergy and Infectious Diseases (UM1AI068619, UM1AI068613, UM1AI1068617), with co-funding from the National Institute of Mental Health and the National Institute on Drug Abuse, all components of the US NIH. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. R. E. Turpin is funded by The University of Maryland Prevention Research Center (cooperative agreement #U48 DP006382) from the Centers for Disease Control and Prevention. I. Opara is funded by the NIH, Office of the Director, Early Independence Award (1DP5OD029636). Publisher Copyright: {\textcopyright} 2021 Elsevier USA. All rights reserved.",
year = "2021",
doi = "10.1097/JNC.0000000000000274",
language = "English (US)",
volume = "32",
pages = "495--511",
journal = "Journal of the Association of Nurses in AIDS Care",
issn = "1055-3290",
publisher = "Elsevier USA",
number = "4",
}