doi.org
Sexual Orientation, Gender, and HIV-Related Stigma or Discrimination Among Gay and Bisexual Men and Non-Binary People in Australia: Results of a National Cross-Sectional Survey - Sexuality Research and Social Policy
Background Gay and bisexual men (GBM) and non-binary people may face stigma and discrimination related to their sexual orientation, gender or HIV status, which can negatively impact mental health, wellbeing, and healthcare access. We assessed the prevalence and correlates of each type of stigma or discrimination experienced in everyday life and specifically in healthcare settings. Methods A national, online cross-sectional survey of GBM and non-binary people was conducted in June–July 2023. Participants were asked if they had experienced any stigma or discrimination, or if they had been treated negatively by healthcare workers, in the last year. Sexual orientation-related stigma or discrimination was assessed among all participants, while gender- and HIV-related stigma or discrimination was assessed among trans and gender diverse people or people living with HIV, respectively. Multivariable logistic regression analyses identified factors associated with experiencing stigma or discrimination. Results Of 2,046 completed surveys (median age 35 years; 81.7% gay, 13.5% bisexual, 6.8% living with HIV, 2.2% trans men, 2.8% non-binary), over half the sample (56.2%) reported any stigma or discrimination and 24.9% reported being treated negatively by healthcare workers due to sexual orientation. Sexual orientation-related stigma or discrimination was more common among younger participants (aOR = 0.97, 95% CI = 0.96–0.98) and less common among migrants from non-English-speaking countries (aOR = 0.65, 95% CI = 0.50–0.85 of non-recently-arrived participants and aOR = 0.56, 95% CI = 0.36–0.87 of recently-arrived participants). Being treated negatively by healthcare workers due to sexual orientation was more common among younger participants (aOR = 0.98, 95% CI = 0.97–0.99), and those with multiple male partners in the last six months (aORs = 1.50–1.71), and less common among non-recently-arrived migrants (aOR = 0.72, 95% CI = 0.53–0.99). Any gender- and HIV-related stigma or discrimination were also commonly reported (by 84.3% of transgender and non-binary participants and 46.0% of participants living with HIV, respectively), highlighting intersectional stigma experiences. Conclusions Younger and more sexually active participants were most affected by sexual orientation-related stigma or discrimination. Inclusive, stigma-free sexual health and HIV service provision is needed to engage younger and sexually active GBM and non-binary people.
