Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
LGBT Health. 2021 Jan;8(1):1-10. doi: 10.1089/lgbt.2020.0274. Epub 2020 Dec 28.
Experienced homophobia-negative treatment and perceptions that gay, bisexual, and other men who have sex with men (MSM) encounter because of their sexual orientations-may promote HIV infection among MSM. We conducted a rapid review and meta-analysis to examine experienced homophobia in relation to HIV infection risk. We searched Embase, MEDLINE, PsycINFO, and Sociological Abstracts to acquire data from U.S. studies published during 1992-2017. Studies examined experienced homophobia in relation to sexual risk behavior, poor HIV care continuum engagement, and diagnosed HIV infection. Random-effects models yielded summary odds ratios (ORs) and 95% confidence intervals (CIs). Experienced homophobia was associated with having any sexual risk behavior (OR = 1.33, 95% CI = 1.25-1.42, = 89.2%), receptive condomless anal sex (CAS) (OR = 1.33, 95% CI = 1.14-1.56, = 63.6%), HIV-discordant CAS (OR = 1.66, 95% CI = 1.29-2.13, = 85.3%), an increased number of sex partners (OR = 1.16, 95% CI = 1.13-1.19, = 0.0%), diagnosed HIV infection (OR = 1.34, 95% CI = 1.10-1.64, = 86.3%), and poor HIV care continuum engagement among MSM living with HIV (OR = 1.45, 95% CI = 1.02-2.08, = 47.0%). Effect sizes for any sexual risk behavior were larger in samples with ≥50% Black or Latino (vs. White) MSM and for family-based mistreatment and perceived sexual minority stigma (vs. other homophobia types). Experienced homophobia is associated with HIV infection risk among MSM. Its association with sexual risk behavior may be stronger among Black and Latino (vs. White) MSM and for family-based mistreatment and perceived sexual minority stigma (vs. other homophobia types). Research is needed to better understand causality in these relationships and the role of interventions to reduce homophobia.
经历过同性恋恐惧症负面对待，以及同性恋、双性恋和其他男男性行为者（MSM）因性取向而遭遇的负面看法，可能会增加 MSM 感染 HIV 的风险。我们进行了快速审查和荟萃分析，以研究经历过的同性恋恐惧症与 HIV 感染风险之间的关系。我们在 Embase、MEDLINE、PsycINFO 和 Sociological Abstracts 中搜索了 1992 年至 2017 年期间在美国发表的研究数据。这些研究调查了经历过的同性恋恐惧症与性行为风险、不良的 HIV 护理连续体参与度以及诊断出的 HIV 感染之间的关系。随机效应模型得出了综合优势比（OR）和 95%置信区间（CI）。经历过的同性恋恐惧症与任何性行为风险（OR=1.33，95%CI=1.25-1.42， =89.2%）、接受无保护肛交（OR=1.33，95%CI=1.14-1.56， =63.6%）、HIV 不一致的肛交（OR=1.66，95%CI=1.29-2.13， =85.3%）、性伴侣数量增加（OR=1.16，95%CI=1.13-1.19， =0.0%）、诊断出的 HIV 感染（OR=1.34，95%CI=1.10-1.64， =86.3%）以及 HIV 阳性 MSM 不良的 HIV 护理连续体参与度（OR=1.45，95%CI=1.02-2.08， =47.0%）有关。在黑人或拉丁裔（与白人相比）MSM 样本中，经历过的同性恋恐惧症与任何性行为风险之间的关联更大，而在家庭虐待和感知到的性少数群体污名（与其他类型的同性恋恐惧症相比）中则更大。经历过的同性恋恐惧症与 MSM 的 HIV 感染风险有关。它与性行为风险之间的关联在黑人或拉丁裔（与白人相比）MSM 中可能更强，而在家庭虐待和感知到的性少数群体污名（与其他类型的同性恋恐惧症相比）中则更强。需要研究来更好地了解这些关系中的因果关系，以及减少同性恋恐惧症的干预措施的作用。
