Associations between Perceived Homophobia, Community Connectedness, and Having a Primary Care Provider among Gay and Bisexual Men
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According to the minority stress model and social evaluation theory, stigma increases negative health outcomes in sexual minorities, and those with greater connection to a community appraise their lives with respect to fellow community members. This study was a secondary analysis of data from the online 2010 Social Justice Sexuality Project and examined associations between perceived homophobia, community connectedness, and having a health care provider among 2281 men who have sex with men (MSM). Approximately 37.9% (n = 840) of the participants were African American/Black, and approximately 68.3% (n = 1559) self-identified as gay. Perceived homophobia was associated with lower odds of having a regular health care provider (AOR = 0.89, 95% CI 0.85–0.96). Income was associated with at least two-fold greater odds of having a regular health care provider, but only for incomes at or above $20,000 (AORs 1.43–2.39, ps < .001). Community connectedness partially mediated and suppressed the negative association between perceived homophobia and having a primary care provider in the overall model (AOR = 0.95, 95% CI 0.90–1.00), and mediated approximately 14.1% of the total effect in the mediation model. Facilitating community connectedness for MSM may reduce the negative association between perceived homophobia and having a primary care provider, and community-based interventions that promote community connectedness may increase long-term engagement in healthcare utilization.
KeywordsHealth care Homophobia Gay men Bisexual men Community connectedness Minority stress Social support
Compliance with Ethical Standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants in the original study from which this article is based.
Conflict of Interest
The authors declare that they have no conflict of interest.
Portions of this manuscript have been accepted for presentation at the 16th Biennial Conference of the Society for Community Research and Action in Ottawa, Ontario, Canada. The data used for this manuscript were obtained from the Social Justice Sexuality Project, 2010 (PI: Juan Battle, PhD; Co-I: Antonio Pastrana Jr., PhD and Jessie Daniels, PhD).
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