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Abstract
Gay and bisexual men may experience stress due to their social minority status, which is caused by the manifestations of sexual stigma. Stress, in turn, promotes depression and physical health impairments, two major issues in the context of HIV infection. Thus, the relationships between the manifestations of sexual orientation stigma (enacted sexual stigma, the expectations of discrimination from one's family, and internalized homophobia) with depression and HIV-progression biomarkers (CD4+ cell counts and viral load) have been tested. The participants (N = 120) were gay and bisexual HIV-positive Italian men recruited via the Internet. The results of our analyses confirmed that enacted sexual stigma (e.g., homophobic physical aggression) correlated with depression and viral load. Internalized homophobia was associated with a greater level of depression and lower CD4+ cell counts, whereas the expectations of discrimination indirectly corresponded to lower CD4+ cell counts through internalized homophobia. In conclusion, the manifestations of sexual stigma are linked to poorer mental and physical health in HIV-positive gay and bisexual men. Minority stress, then, is an important concept that needs to be further addressed in the contexts of HIV care.