The impact of social connections and discrimination to HIV risk among Asian gay and bisexual men in Australia
Curtis Chan
A * , Limin Mao B , Benjamin R. Bavinton A , Martin Holt B , Sujith Kumar Prankumar A B , Kevin Dong C , Timothy Wark D , Timothy Chen D , Hendri Yulius Wijaya E and Horas T. H. Wong B F
A
B
C
D
E
F
Sexual Health - https://doi.org/10.1071/SH23036
Submitted: 17 February 2023 Accepted: 6 September 2023 Published online: 25 September 2023
Abstract
Asian gay, bisexual, and other men who have sex with men (GBMSM) are overrepresented in new HIV diagnoses in Australia. Social engagement with other GBMSM has been associated with HIV testing and pre-exposure prophylaxis (PrEP) uptake. Asian GBMSM may be socially disconnected from LGBTQ+ people, which may increase their HIV risk. This analysis assessed the contribution of social connection on HIV risk among Asian GBMSM.
Using an online cross-sectional survey of Asian GBMSM in Australia, we measured condomless anal intercourse (CLAI) in the last 6 months without PrEP or an undetectable viral load (UVL), i.e. CLAI with a risk of HIV transmission. Bivariable and multivariable logistic regression models were performed to compare demographic characteristics and social engagement of participants who had CLAI without PrEP or UVL to those who had not. Analyses were restricted to participants who reported sex with casual partners in the last 6 months.
Among 509 participants who had casual partners in the last 6 months, 151 (29.7%) reported CLAI without PrEP or UVL. CLAI without PrEP or UVL was negatively associated with full-time employment, and recently being tested for HIV and was positively associated with experiencing discrimination based on sexual orientation. Social engagement with LGBTQ+ people was not associated with CLAI without PrEP or UVL.
CLAI without PrEP or UVL was not related to social connections with LGBTQ+ people but was more likely among Asian men who had experienced sexuality-related discrimination, suggesting that mitigating homophobia and biphobia may assist in improving HIV prevention among Asian GBMSM who live in Australia.
Keywords: discrimination, gay men, HIV/AIDS, HIV prevention, homophobia, men who have sex with men, migrant and mobile populations, pre-exposure prophylaxis, social support.
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