School of Social Work, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA.
Department of Medicine, University of California-San Diego, San Diego, USA.
BMC Infect Dis. 2022 Aug 13;22(1):690. doi: 10.1186/s12879-022-07672-0.
Cisgender gay, bisexual, and other men who have sex with men (MSM) in Mexico experience disparities in sexual health outcomes, perhaps most notably in HIV prevalence, HIV testing and status awareness, and condom use. Sexual behavior stigma, underpinned by socio-structural factors specific to Mexico (e.g., machismo), uniquely shapes these sexual health disparities. However, few reliable, valid measures are available to document, track, and ultimately mitigate sexual behavior stigma in this context. Exploratory and confirmatory factor analyses were performed on responses to a 13-item sexual behavior stigma scale from 15,681 MSM recruited online across Mexico. Associations with extracted factors were tested to assess construct validity. Three subscales were identified in exploratory factor analysis and validated in confirmatory factor analysis: "stigma from family and friends" (α = 0.65), "anticipated healthcare stigma" (α = 0.84), and "general social stigma" (α = 0.70). External construct validity was indicated through each subscale's strong association (all p < 0.001) with perceived community intolerance of MSM and perceived community discrimination toward people living with HIV. These subscales show promise as reliable, valid measures for assessing sexual behavior stigma among MSM in Mexico, and as tools for documenting and tracking sexual behavior stigma trends, comparing regional burdens of sexual behavior stigma, and tracking the progress of stigma-mitigation interventions among MSM in Mexico. Future research is needed to understand the extent to which each subscale is differentially associated with sexual (and other) health outcomes, which can inform the development and implementation of uniquely tailored stigma-mitigation, HIV-prevention, HIV-care, and other needed interventions for MSM in Mexico.
顺性别同性恋、双性恋和其他与男性发生性关系的男性（MSM）在墨西哥的性健康结果存在差异，这在艾滋病毒流行率、艾滋病毒检测和状况意识以及 condom 使用方面表现得尤为明显。性行为污名是由墨西哥特有的社会结构因素（例如大男子主义）支撑的，这种污名独特地塑造了这些性健康差异。然而，在这种情况下，很少有可靠、有效的措施可以用来记录、跟踪和最终减轻性行为污名。对从墨西哥各地在线招募的 15681 名 MSM 对 13 项性行为污名量表的回答进行了探索性和验证性因素分析。测试了与提取因素的关联，以评估结构有效性。探索性因素分析中确定了三个子量表，验证性因素分析中验证了三个子量表：“来自家庭和朋友的污名”（α=0.65）、“预期的医疗保健污名”（α=0.84）和“一般社会污名”（α=0.70）。通过每个子量表与感知到的对 MSM 的社区不容忍和对艾滋病毒感染者的社区歧视之间的强烈关联（所有 p<0.001），表明了外部结构有效性。这些子量表有望成为评估墨西哥 MSM 性行为污名的可靠、有效的工具，可用于记录和跟踪性行为污名趋势、比较地区性行为污名负担以及跟踪墨西哥 MSM 中污名缓解干预措施的进展。需要进一步的研究来了解每个子量表与性（和其他）健康结果的关联程度，这可以为制定和实施针对墨西哥 MSM 的独特的污名缓解、HIV 预防、HIV 护理和其他必要干预措施提供信息。
