Anti-LGBT and Anti-immigrant Structural Stigma: An Intersectional Analysis of Sexual Minority Men's HIV Risk When Migrating to or Within Europe.
Anti-LGBT and Anti-immigrant Structural Stigma: An Intersectional Analysis of Sexual Minority Men's HIV Risk When Migrating to or Within Europe.
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DOI：
10.1097/qai.0000000000001519
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发表时间：
2017-12-01
期刊：
影响因子：
--
通讯作者：
Schmidt AJ
中科院分区：
文献类型：
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作者：
Pachankis JE;Hatzenbuehler ML;Berg RC;Fernández-Dávila P;Mirandola M;Marcus U;Weatherburn P;Schmidt AJ
男同性恋者、双性恋者和其他与男性发生性关系的男性(MSM)可能特别有可能迁移到他们的国家享受不到的自由。男男性接触者移民发送国和接收国的结构性污名(例如，促进对受压迫人口的不平等待遇的法律和政策)是在这一群体中预防艾滋病毒的潜在障碍。这项研究是第一次在MSM移民的大样本中对艾滋病毒风险的结构性决定因素进行调查。2010年欧洲男男性接触者互联网调查(EMIS)(n=23,371名移民)在38个欧洲国家进行。结构性污名的评估使用了(1)促进全球181个国家不平等对待男男性接触者的国家法律和政策，以及(2)38个接受国对移民的国家态度。我们还评估了语言状况、移民以来的时间和五项艾滋病毒预防成果。对性少数群体(在发送国和接受国)和对移民(在接受国)的结构性污名与MSM移民缺乏艾滋病毒预防知识、服务覆盖面和预防行为有关。语言状况和移民以来的时间缓和了结构性污名和缺乏艾滋病毒预防之间的一些联系。对MSM和移民的结构性污名是全球艾滋病毒流行的一个可改变的结构性决定因素。
Gay, bisexual, and other men who have sex with men (MSM) might be particularly likely to migrate to experience freedoms unavailable in their home countries. Structural stigma (e.g., laws and policies promoting the unequal treatment of oppressed populations) in MSM migrants’ sending and receiving countries represent potential barriers to HIV prevention among this intersectional population. This present study represents the first investigation of structural determinants of HIV risk in a large, geographically-diverse sample of MSM migrants. The 2010 European MSM Internet Survey (EMIS) (n=23,371 migrants) was administered across 38 European countries. Structural stigma was assessed using (1) national laws and policies promoting unequal treatment of MSM across 181 countries worldwide and (2) national attitudes against immigrants in the 38 receiving countries. We also assessed linguistic status, time since migrating, and five HIV-prevention outcomes. Structural stigma toward sexual minorities (in sending and receiving countries) and toward immigrants (in receiving countries) was associated with a lack of HIV-prevention knowledge, service coverage, and precautionary behaviors among MSM migrants. Linguistic status and time since migrating moderated some associations between structural stigma and lack of HIV prevention. Structural stigma toward MSM and immigrants represents a modifiable structural determinant of the global HIV epidemic.