Experiences of homophobia and adherence to antiretroviral treatment (ART) in men who have sex with men (MSM)

Ortiz-Hernández, Luis; Pérez-Salgado, Diana; Miranda-Quezada, Itzel Patricia; Staines-Orozco, María Guadalupe; Compean-Dardón, María Sandra

Luis Ortiz-Hernández

Universidad Autónoma Metropolitana. Departamento de Atención a la Salud. Ciudad de México, México. E-mail: lortiz@correo.xoc.uam.mx E-mail: dianaps2006@gmail.com E-mail: pih.qm62@hotmail.com E-mail: gstaineso@yahoo.com E-mail: sandrac_d@hotmail.com

https://orcid.org/0000-0002-5870-1729

Diana Pérez-Salgado

Universidad Autónoma Metropolitana. Departamento de Atención a la Salud. Ciudad de México, México. E-mail: lortiz@correo.xoc.uam.mx E-mail: dianaps2006@gmail.com E-mail: pih.qm62@hotmail.com E-mail: gstaineso@yahoo.com E-mail: sandrac_d@hotmail.com

https://orcid.org/0000-0002-9124-6780

Itzel Patricia Miranda-Quezada

Universidad Autónoma Metropolitana. Departamento de Atención a la Salud. Ciudad de México, México. E-mail: lortiz@correo.xoc.uam.mx E-mail: dianaps2006@gmail.com E-mail: pih.qm62@hotmail.com E-mail: gstaineso@yahoo.com E-mail: sandrac_d@hotmail.com

https://orcid.org/0000-0001-5713-1181

María Guadalupe Staines-Orozco

Universidad Autónoma Metropolitana. Departamento de Atención a la Salud. Ciudad de México, México. E-mail: lortiz@correo.xoc.uam.mx E-mail: dianaps2006@gmail.com E-mail: pih.qm62@hotmail.com E-mail: gstaineso@yahoo.com E-mail: sandrac_d@hotmail.com

https://orcid.org/0000-0002-8974-430X

María Sandra Compean-Dardón

Universidad Autónoma Metropolitana. Departamento de Atención a la Salud. Ciudad de México, México. E-mail: lortiz@correo.xoc.uam.mx E-mail: dianaps2006@gmail.com E-mail: pih.qm62@hotmail.com E-mail: gstaineso@yahoo.com E-mail: sandrac_d@hotmail.com

https://orcid.org/0000-0001-7656-5292

Correspondence Luis Ortiz-Hernández. Calzada del Hueso 1100, Col. Villa Quietud, Coyoacán, México, 04960.

Authors’ contributions

Ortiz-Hernández contributed to the research design and data processing. Pérez-Salgado and Miranda-Quezada contributed to data processing. Staines-Orozco and Compean Dardón contributed to the research design. All authors contributed in the discussion of results, as well as in the elaboration of the article.

	TDA	DA	A-DA	A	TA	Factor analysis
	%	%	%	%	%	Factor analysis
Eigen-value						6.42
% variance						71.3
You frequently feel it is better to avoid personal and social involvement with other homosexuals and bisexuals.	59.4	27.4	6.5	4.1	2.6	0.50
You have tried to stop being attracted to men	64.7	29.4	2.6	2.4	0.9	0.83
If someone offered you the opportunity to be completely heterosexual, you would accept	65.3	27.9	2.9	2.4	1.5	0.83
You wish you were no longer homosexual or bisexual	64.7	27.9	4.4	2.1	0.9	0.90
You feel awkward for being homosexual or bisexual	62.6	30.0	5.6	1.2	0.6	0.90
You wish you could develop more erotic feelings for women	61.8	27.9	6.8	1.8	1.8	0.92
You feel that being homosexual or bisexual is a personal shortcoming	63.2	30.3	5.6	0.6	0.3	0.87
You would like to have professional assistance to become heterosexual	62.9	30.6	4.4	1.5	0.6	0.88
You have tried to be more sexually attracted to women	62.1	29.7	5.3	1.8	1.2	0.87

	N	1	2-3	³4	F1	F2
	%	%	%	%
Eigen-value					4.98	1.74
% Variance					49.8	17.4
1. You have been denied a job promotion or salary increase; have been fired, denied a job, or had a similar situation happen to you	74.4	17.6	5.9	2.1	-0.06	0.86
2. You have been denied admission to a school; had a grade reduction; were not recognized for your performance; were mistreated, or had a similar situation happen to you	86.2	7.9	5.6	0.3	-0.07	0.86
3. You have been denied health services in doctor’s offices, clinics or hospitals; have been scolded, humiliated or mistreated by a doctor, nurse or other health professionals	83.8	10.0	5.0	1.2	-0.09	0.82
4. You have been denied services in restaurants, movie theaters or other facilities; have been scolded, humiliated or mistreated by waiters, salespersons, businessmen, etc.	80.0	9.7	7.9	2.4	0.40	0.49
5. The police have detained you, expelled you from some place, threatened you, or extorted.	66.8	17.1	12.9	3.2	0.39	0.49
6. You have been insulted or verbally assaulted with words such as "bitch", "pussy", etc.	39.4	19.7	22.6	18.2	0.71	0.06
7. You have been threatened with violence	54.7	15.9	18.2	11.2	0.91	0.01
8. You have been beaten, hit or physically assaulted	58.2	15.9	15.6	10.3	0.89	0.01
9. You have been sexually harassed with obscene or sexual words	46.5	18.8	18.8	15.9	0.90	-0.06
10. You have been robbed, assaulted or had an object of yours damaged or broken	47.6	19.7	15.6	17.1	0.85	-0.16

Marital Status	%
Single	79.4
Married or in common-law union	15.3
Divorced or widowed	5.3
Sexual orientation
Homosexual	75.3
Bisexual	24.7
Social support
Schooling of head of household
<High school	33.8
High school or school diploma	40.0
Undergraduate or graduate	26.2
Food insecurity
Food security	40.3
Food insecurity	59.7

		Proximal stressor				Distal stressors
		Internalized homophobia				Interpersonal violence			Interpersonal discrimination
	Total	SHI	HIL	HI		No	Yes		No	Yes
(n)	(340)	(168)	(118)	(45)		(183)	(157)		(183)	(157)
	%	%	%	%	p	%	%	p	%	%	p
Low adherence	5.9	6.0	4.1	10.2	0,303	3.3	8.9	0,028	2.7	9.6	0,008
Changed the antiretroviral therapy	41.1	45.8	43.1	20.4	0,005	39.9	42.7	0,603	39.3	43.3	0,459
	M	M	M	M		M	M		M	M
Length in treatment, years	5.12	5.65	4.59	4.65	0,146	4.46	5.89	0,007	4.61	5.72	0,036

	Low adherence in previous month
	RP	p
Separate models
Violence
No	Ref.	Ref.
Yes	2.60	0,062
Discrimination
No	Ref.	Ref.
Yes	3.25	0,025
Interaction model 1
No discrimination or violence	Ref.
Only violence	4.36	0,115
Only discrimination	5.67	0,050
Discrimination and violence	6.49	0,018
Interaction model 2
No social support and no violence	Ref.
No social support and yes violence	2.67	0,161
Yes social support and no violence	0.45	0,348
Yes social support and yes violence	1.11	0,885
Interaction model 3
No social support and no discrimination	Ref.
No social support and yes discrimination	8.12	0,048
No social support and no discrimination	1.63	0,667
Yes social support and yes discrimination	2.66	0,379

[1] Correspondence Luis Ortiz-Hernández. Calzada del Hueso 1100, Col. Villa Quietud, Coyoacán, México, 04960.

Brasil

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Experiences of homophobia and adherence to antiretroviral treatment (ART) in men who have sex with men (MSM)

Abstract