Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6133, Baltimore, MD, 21205, USA.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
Sci Rep. 2023 Oct 23;13(1):18082. doi: 10.1038/s41598-023-44876-z.
Physiological stress levels in response to sexual behavior stigma among men who have sex with men (MSM) in the United States (US) are understudied. The current study aims to explore the relationship between sexual behavior stigma and salivary cortisol both overall and stratified by race/ethnicity. If such an association exists, it may suggest that sexual behavior stigma can be physiologically measured or indicated by the presence of heightened salivary cortisol. A subsample of 667 MSM participants from the 2019 American Men's Internet Survey (AMIS; N = 10,129) submitted morning (AM) and evening (PM) saliva cortisol samples using at-home mail-in collection kits. Average daily cortisol and daily cortisol change were calculated; simple linear regressions estimated associations between cortisol measures and sexual behavior stigma characterized in four different ways (ever and recent experience of individual stigma items; average ever and recent experience of three stigma scales: stigma from family and friends, anticipated healthcare stigma, general social stigma). Participants reported a mean age of 36.0 years (SD = 14.9), with most being non-Hispanic white (n = 480, 72.0%), Hispanic (n = 164, 12.3%), or Black/African American (n = 146, 10.9%), and identified as homosexual/gay (n = 562, 84.3%). Reporting ever experiencing healthcare providers gossiping was significantly associated with higher PM cortisol (β = 0.12, p = 0.001) and higher average daily cortisol (β = 0.11, p = 0.004), while reporting ever experiencing police refusing to protect was associated with higher AM cortisol (β = 0.08, p = 0.03) and higher average daily cortisol (β = 0.09, p = 0.02). Recent experiences of stigma were not significant predictors of any measure of cortisol. Measures of salivary cortisol may be used to characterize sexual behavior stigma among MSM populations, however more insight is needed to determine its exact relationship and strength.
美国男男性行为者（MSM）在性行为方面受到的耻辱感所导致的生理压力水平研究还很少。本研究旨在探索性行为耻辱感与唾液皮质醇之间的关系，同时按种族/民族进行分层分析。如果存在这种关联，这可能表明性行为耻辱感可以通过皮质醇水平的升高来进行生理测量或指示。来自 2019 年美国男性互联网调查（AMIS）的 667 名 MSM 参与者的一个子样本（N=10129）使用家庭邮寄收集套件提交了早晨（AM）和傍晚（PM）的唾液皮质醇样本。计算了平均日皮质醇和日皮质醇变化；简单线性回归估计了皮质醇测量值与以四种不同方式描述的性行为耻辱感之间的关联：个体耻辱感项目的既往和近期经历；三个耻辱感量表的既往和近期平均经历：来自家庭和朋友的耻辱感、预期医疗保健耻辱感、一般社会耻辱感。参与者报告的平均年龄为 36.0 岁（SD=14.9），大多数是非西班牙裔白人（n=480，72.0%）、西班牙裔（n=164，12.3%）或非裔美国人（n=146，10.9%），并自认为是同性恋（n=562，84.3%）。报告曾有过医护人员八卦的经历与 PM 皮质醇升高（β=0.12，p=0.001）和平均日皮质醇升高（β=0.11，p=0.004）显著相关，而报告曾有过警察拒绝保护的经历与 AM 皮质醇升高（β=0.08，p=0.03）和平均日皮质醇升高（β=0.09，p=0.02）显著相关。近期的耻辱感经历并不是皮质醇任何测量值的显著预测指标。唾液皮质醇的测量值可用于描述 MSM 人群中的性行为耻辱感，但需要更多的深入了解来确定其确切关系和强度。
