Classes of Sexual Identity, Homophobia, and Sexual Risk among Black Sexual Minorities in HPTN 061

ABSTRACT

Homophobia is associated with sexual risk among sexual minorities, including Black sexual minority men, though experienced homophobia may differ across sexual identities. We conducted latent class analysis of sexual identities and experienced homophobia associated with sexual risk, and tested mediators of this association. We used longitudinal data from the HIV Prevention Trials Network Study 061 (n = 1,553). We generated rate ratios between baseline latent classes of experienced homophobia and sexual identity and 12-month outcomes: Condomless receptive anal intercourse (CRAI), number of partners, and transactional sex. Mediators included 6-month internalized homophobia, depression, social support, and substance use. We selected the following 7-class model: “Bisexual, rare homophobia” (reference), “Mixed identities, mixed homophobia”, “Bisexual, frequent homophobia”, “Heterosexual/Same-gender loving, frequent homophobia”, “Gay, frequent homophobia”, “ Gay/Same-gender loving, frequent homophobia,” and “Gay, rare homophobia.” All other classes had greater CRAI than the reference. For bisexual/mixed/heterosexual classes, approximately 20% of this association was positively mediated through our mediators (p < .05). The Heterosexual/Same-gender loving class had the largest proportion mediated through internalized homophobia. For gay-identifying classes, mediation was marginally significant (.05 < p < .10). Classes of sexual identity and experienced homophobia were associated with CRAI among Black sexual minority men, partially mediated through internalized homophobia, depression, social support, and substance use.

Disclosure Statement

None of the named authors have any conflicts of interest to disclose, financial or otherwise.

Data Availability Statement

Access to HPTN 061 study data can be requested here: https://www.hptn.org/research/studies/hptn061/accesstostudydata

Supplemental Material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

Overall support for the HPTN and the HPTN Scholars Program is provided by the National Institute of Allergy and Infectious Diseases (NIAID), National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH) under award number UM1AI068619. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Turpin and Dr. Dyer are supported by the University of Maryland Prevention Research Center, cooperative agreement #U48 DP006382 from the Centers for Disease Control and Prevention (CDC). Any interpretations and opinions expressed herein are solely those of the authors and may not reflect those of the CDC.