The Relationship of Internalized Homonegativity to Sexual Health and Well-Being Among Men in 38 European Countries Who Have Sex With Men

Figures & data

Table 1 Description of the Analytic Sample (N = 144,177)

	n	%
Region of residence^1
West (be, fr, ie, nl, uk)	33,987	23.6
Northwest (dk, fi, no, se)	7,492	5.2
Central-West (at, ch, de, lu)	53,297	37.0
Southwest (gr, es, it, pt)	30,206	21.0
Northeast (ee, It, Iv)	1,478	1.0
Central east (cz, hu, pl, si, sk)	6,349	4.4
Southeast, EU (bg, cy, mt, ro)	2,74	1.9
Southeast, nonEU (ba, hr, mk, rs, tr)	2,817	2.0
East (by, md, ru, ua)	2,811	4.0
Sexual identity
Gay or homosexual	116,448	80.9
Bisexual	17,147	11.9
Straight or heterosexual	580	0.4
Any other term	1,016	0.7
Don't usually use a term	8,672	6.0
Age
<25	32,196	22.3
25-39	71,781	49.8
40+	40,200	27.9
HIV-status
HIV-positive	12,093	8.4
HIV-negative (last test was negative	92,741	64.3
Never received HIV test result	38,635	26.9
Settlement size
≥1 million inhabitants	44,499	31.6
500,000 - 999,999 inhabitants	21,708	15.4
100,000-499,999 inhabitants	30,618	21.7
10,000-99,999 inhabitants	26,913	19.1
≤10,000 inhabitants	17,082	12.1
Education (ISCED^2)
ISCED 6	36,117	25.1
ISCED 5	37,291	25.9
ISCED 4	32,303	22.5
ISCED 3	27,188	18.9
ISCED 2	9,355	6.5
ISCED 1	1,514	1.1
Occupation
Employed full-or part time	104,011	72.3
Unemployed	8,541	5.9
Student	21,689	15.1
Retired	3,488	2.4
Long term sick leave/medically retired	1,825	1.3
Other	4,352	3.0

Note. ¹ Regions: West = Belgium, France, Ireland, Netherlands, United Kingdom; Northwest = Denmark, Finland, Norway, Sweden; Central-West = Austria, Switzerland, Germany, Luxemburg; Southwest = Greece, Spain, Italy, Portugal; Northeast = Estonia, Lithuania, Latvia; Central-East = Czech Republic, Hungary, Poland, Slovenia, Slovakia; Southeast, EU = Bulgaria, Cyprus, Malta, Romania; Southeast, nonEU = Bosnia-Herzegovina, Croatia, Macedonia, Serbia, Turkey; East = Belarus, Moldova, Russia, Ukraine.

² ISCED = International Standardised Classification of Educational Degrees: highest (6) is terminal tertiary education and lowest (1) is primary education.

Table 2 Domain-specific Multiple Regression on Internalized Homonegativity

Variables	B (SE)	β	95% CI
Domain 1: Sociodemographics (adjR^2 =.27)
Age	−.01 (.00)	−.10	−.01, −.01
Identify as gay	−.43 (.01)	−.14	−.44, −.41
Closeted about being attracted to men	.92 (.01)	.33	.91,  .94
Currently in steady relationship with a man	−.18 (.01)	−.07	−.19,−.17
Visited gay social place in last 6 mo	−.41 (.01)	−.15	−.42,−.39
Diagnosed HIV positive	.06 (.01)	.01	.08,  .04
High education (ISCED 5−6)	.17 (.01)	.07	.16,  .18
Domain 2: Mental health and cognitions (adjR^2 =.07)
Find it easy to say ‘no’ to unwanted sex	−.23 (.01)	−.05	−.26,−.21
Sometimes feel lonely	.26 (.01)	.10	.24,  .27
Happy with sex life	−.42 (.01)	−.17	−.44,−.41
Knowledge about HIV and HIV testing	−.36 (.01)	−.12	−.38,−.35
Domain 3: Sexual health and behaviours (adjR^2 =.06)
STI test in past 12 mo	−.13 (.01)	−.05	−.15,−.12
HIV test in past 12 mo	−.13 (.01)	−.05	−.14,−.11
Diagnosed with an STI in the past 12 mo	.04 (.01)	.01	.02,  .07
Age ≥18 when first sexual experience with man	.18 (.01)	.08	.17,  .20
Ever anal intercourse with men	−.39 (.02)	−.06	−.43,−.36
Sex abroad (with non−steady male partner)	−.14 (.01)	−.05	−.16,−.13
UAI with steady male partner in past 12 mo	−.18 (.01)	−.07	−.19,  .16
UAI with non−steady male partner in past 12 mo	.04 (.01)	.02	.02,  .05
Unprotected intercourse with female partner in past 12 mo	.80 (.02)	.14	.77,  .83
Domain 4: Substance use (adjR^2 =.02)
Used party drugs in past 12 mo	−.20 (.01)	−.06	−.22,−.18
Used cannabis in past 4 weeks	−.06 (.01)	−.02	−.08,−.04
Used poppers in past 4 weeks	−.32 (.01)	−.10	−.34,−.30
Drank alcohol in past 24 hours	−.15 (.01)	−.06	−.17,−.14

all p ≤.001. mo = months

Table 3 Multiple Regression on Internalized Homonegativity, Final Model (adjR² =.29)

Variables	B (SE)	β	95% CI
Age	−.01 (.00)	−.10	−.01, −.01	***
Identify as gay	−.44 (.01)	−.14	−.46, −.42	***
Closeted about being attracted to men	.87 (.01)	.31	.85,   .88	***
Currently in steady relationship with a man	−.05 (.01)	−.02	−.06, −.03	***
Visited gay social place in last 6 mo	−.36 (.01)	−.14	−.37, −.34	***
Diagnosed HIV positive	−.05 (.01)	−.01	−.06, −.02	p =.001
High education (ISCED 5−6)	.16 (.01)	.07	.15,   .17	***
Find it easy to say ‘no’ to unwanted sex	−.21 (.01)	−.05	−.24, −.19	***
Sometimes feel lonely	.17 (.01)	.07	.16,   .19	***
Happy with sex life	−.27 (.01)	−.11	−.28, −.25	***
Knowledge about HIV and HIV testing	−.12 (.01)	−.04	−.14, −.10	***
STI test in past 12 mo	−.02 (.01)	−.01	−.03, −.00	p =.06
HIV test in past 12 mo	−.02 (.01)	−.01	−.03, −.00	p =.02
Diagnosed with an STI in the past 12 mo	.07 (.01)	.02	.05,   .09	***
Age ≥18 when first sexual experience with man	.11 (.01)	.04	.09,   .12	***
Ever anal intercourse with men	−.02 (.02)	.00	−.05,   .01	p =.14
Sex abroad (with non–steady male partner)	.01 (.01)	.00	−.01,   .02	p =.28
UAI with non–steady male partner in past 12 mo	.02 (.01)	.01	.01,   .03	p =.004
UAI with steady male partner in past 12 mo	−.01 (.01)	.00	−.03,   .00	p =.11
Unprotected intercourse with female partner in past 12 mo	.00 (.01)	.00	−.03,   .03	p =.88
Used party drugs in past 12 mo	−.04 (.01)	−.01	−.06, −.02	***
Used cannabis in past 4 weeks	−.03 (.01)	−.01	−.05, −.01	p =.005
Used poppers in past 4 weeks	−.04 (.01)	−.01	−.06, −.03	***
Drank alcohol in past 24 hours	−.06 (.01)	−.02	−.07, −.05	***

***p <.001. ISCED = International Standardised Classification of Education. mo = months. UAI = Unprotected anal intercourse.