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Stigma Toward Men Who Have Sex with Men Among Future Healthcare Providers in Malaysia: Would More Interpersonal Contact Reduce Prejudice?

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Abstract

Men who have sex with men (MSM) living in countries with strong stigma toward MSM are vulnerable to HIV and experience significant barriers to HIV care. Research is needed to inform interventions to reduce stigma toward MSM in these countries, particularly among healthcare providers. A cross-sectional survey of 1158 medical and dental students was conducted at seven Malaysian universities in 2012. Multivariate analyses of variance suggest that students who had interpersonal contact with MSM were less prejudiced toward and had lower intentions to discriminate against MSM. Path analyses with bootstrapping suggest stereotypes and fear mediate associations between contact with prejudice and discrimination. Intervention strategies to reduce MSM stigma among healthcare providers in Malaysia and other countries with strong stigma toward MSM may include facilitating opportunities for direct, in-person or indirect, media-based prosocial contact between medical and dental students with MSM.

Resumen

Los hombres que tienen sexo con hombres (HSH) y viven en países en los cuales el estigma contra los HSH es marcado son vulnerables a la infección por el VIH y encuentran barreras importantes a la hora de recibir atención para esta infección. Se necesitan investigaciones que inspiren intervenciones para reducir el estigma contra los HSH en estos países, en particular entre los profesionales de la salud. En 2012 se realizó en siete universidades de Malasia un estudio transversal en el que participaron 1158 estudiantes de medicina y odontología. Los análisis multivariantes de la varianza indican que los estudiantes que tenían contacto interpersonal con HSH albergaban menos prejuicios contra ellos y tenían menos intenciones de discriminarlos. Los análisis de cadenas causales con el método de bootstrapping (remuestreo aleatorio con reemplazo) indican que los estereotipos y el temor actúan como intermediarios en las asociaciones entre el contacto en condiciones de prejuicio y la discriminación. Entre las estrategias de intervención para reducir el estigma contra los HSH entre los profesionales de la salud de Malasia y de otros países en los que dicho estigma es marcado se podrían facilitar oportunidades para que haya contacto prosocial directo (en persona) o indirecto (a través de medios de comunicación) entre los estudiantes de medicina y odontología y los HSH.

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Acknowledgments

This work was supported by the Agency for Healthcare Research and Quality (K12 HS022986 for VAE); the Downs International Health Student Travel Fellowship (for HJ); the Ministry of Higher Education, Malaysia’s High Impact Research Grant (E000001-200001 for AK, UM.C/625/1/HIR/MOHE/DENT/07 for JJ); and the National Institute on Drug Abuse (R01 DA025943 for JAW, AK, FLA; K24 DA017072 for FLA; K01 DA038529 for JAW; NIDA-International AIDS Society Award for SHL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. The authors would like to thank Drs. Petrick Periyasamy, Samsul Draman, Lela Hj Suut, Lahari Telang, Tan Su Keng, and Azirrawani Ariffin for coordinating participant recruitment at their respective universities.

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Authors and Affiliations

  1. Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, Boston, MA, 02115, USA

    Valerie A. Earnshaw

  2. Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA

    Valerie A. Earnshaw

  3. ICON Clinical Research, 456 Montgomery Street, Suite 2200, San Francisco, CA, 94104, USA

    Harry Jin

  4. AIDS Program, Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510, USA

    Jeffrey A. Wickersham, Adeeba Kamarulzaman & Frederick L. Altice

  5. Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia

    Jeffrey A. Wickersham, Adeeba Kamarulzaman, Sin How Lim & Frederick L. Altice

  6. Faculty of Medicine, University of Malaya, Lembah Pantai, 59100, Kuala Lumpur, Malaysia

    Adeeba Kamarulzaman

  7. Department of Diagnostic and Integrated Dental Practice, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia

    Jacob John

  8. Yale School of Public Health, New Haven, CT, USA

    Frederick L. Altice

  9. Center for Interdisciplinary Research on AIDS, New Haven, CT, USA

    Frederick L. Altice

Authors
  1. Valerie A. Earnshaw
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  2. Harry Jin
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  3. Jeffrey A. Wickersham
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  4. Adeeba Kamarulzaman
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  5. Jacob John
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  6. Sin How Lim
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  7. Frederick L. Altice
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Correspondence to Valerie A. Earnshaw.

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Earnshaw, V.A., Jin, H., Wickersham, J.A. et al. Stigma Toward Men Who Have Sex with Men Among Future Healthcare Providers in Malaysia: Would More Interpersonal Contact Reduce Prejudice?. AIDS Behav 20, 98–106 (2016). https://doi.org/10.1007/s10461-015-1168-x

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  • DOI: https://doi.org/10.1007/s10461-015-1168-x

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