Strange Bedfellows: HIV-Related Stigma Among Gay Men in Australia

  • John B. F. de WitEmail author
  • Dean A. Murphy
  • Philippe C. G. Adam
  • Simon Donohoe


HIV-related stigma and discrimination among gay men has remained largely under-researched. Also, there generally is a lack of research that directly compares the HIV-related stigma experienced by people living with HIV and the stigma expressed by people not living with HIV. This chapter reports on an online community study in Australia, undertaken to investigate and compare HIV-related stigma as experienced by HIV-positive gay men and expressed by non-HIV-positive gay men. From 1 December 2009 to 31 January 2010, the HIV Stigma Barometer Survey recruited 1,258 HIV-positive (17.0 %), HIV-negative (72.6 %), and HIV status unknown (10.4 %) gay men. Participants answered a range of questions regarding stigma-related attributions of responsibility, social distancing, negative emotional reactions, and sexual exclusion. Findings show that HIV-positive men overall experienced low levels of stigma, including attributions of responsibility and social distancing. However, they experienced higher levels of negative emotional reactions and in particular experienced exclusion as sexual or romantic partners. HIV-related stigma expressed by non-HIV-positive men was highly comparable to the experiences of HIV-positive men. These findings provide evidence of HIV-related stigma and a “serostatus divide” in the gay community. Stigma seems located primarily in the domain of sex and relationships, and this possible sexual divide may reflect and drive the adoption of serostatus-based risk reduction strategies. An important contribution of this study is its comparison and cross-validation of reports of experienced as well as expressed stigma in gay men. This was enabled by a new stigma measure that was informed by a conceptual analysis of the stigma concept and draws on existing scales.


Social Distance Implicit Association Test Regular Partner Negative Emotional Reaction Experienced Stigma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Berger, B. E., Estwing Ferrans, C., & Lashley, F. R. (2001). Measuring stigma in people with HIV: Psychometric assessment of the HIV stigma scale. Research in Nursing & Health, 24(6), 518–529.CrossRefGoogle Scholar
  2. Bird, J. D., & Voisin, D. R. (2011). A conceptual model of HIV disclosure in casual sexual encounters among men who have sex with men. Journal of Health Psychology, 16(2), 365–373.CrossRefGoogle Scholar
  3. Brewer, M. (2007). The social psychology of intergroup relations: Social categorization, ingroup bias, and outgroup prejudice. In A. W. Kruglanski & E. T. Higgins (Eds.), Social psychology: Handbook of basic principles (pp. 695–715). New York: Guilford.Google Scholar
  4. Chaudoir, S. R., Fisher, J. D., & Simoni, J. M. (2011). Understanding HIV disclosure: A review and application of the disclosure processes model. Social Science & Medicine, 72(10), 1618–1629.CrossRefGoogle Scholar
  5. Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., et al. (2011). Prevention of HIV-1 infection with early antiretroviral therapy. The New England Journal of Medicine, 365(6), 493–505.CrossRefGoogle Scholar
  6. Courtenay-Quirk, C., Wolitski, R., Parsons, J., & Gomez, C. (2006). Is HIV/AIDS stigma dividing the gay community? Perceptions of HIV-positive men who have sex with men. AIDS Education and Prevention, 18(1), 56–67.CrossRefGoogle Scholar
  7. Elford, J., Bolding, G., Davis, M., Sherr, L., & Hart, G. (2004). Web-based behavioral surveillance among men who have sex with men: A comparison of online and offline samples in London, UK. Journal of Acquired Immune Deficiency Syndromes, 35(4), 421–426.CrossRefGoogle Scholar
  8. Evans, A. R., Wiggins, R. D., Mercer, C. H., Bolding, G. J., & Elford, J. (2007). Men who have sex with men in Great Britain: Comparison of a self-selected internet sample with a national probability sample. Sexually Transmitted Infections, 83(3), 200–205.CrossRefGoogle Scholar
  9. Fife, B. L., & Wright, E. R. (2000). The dimensionality of stigma: A comparison of its impact on the self of persons with HIV/AIDS and cancer. Journal of Health and Social Behavior, 41(1), 50–67.CrossRefGoogle Scholar
  10. Flowers, P., Duncan, B., & Frankis, J. (2000). Community, responsibility and culpability: HIV risk-management amongst Scottish gay men. Journal of Community and Applied Social Psychology, 10(4), 285–300.CrossRefGoogle Scholar
  11. Fortenberry, J., McFarlane, M., Bleakley, A., Bull, S., Fishbein, M., Grimley, D., Malotte, C. K., & Stoner, B. P. (2002). Relationships of stigma and shame to gonorrhea and HIV screening. American Journal of Public Health, 92(3), 378–381.CrossRefGoogle Scholar
  12. Genberg, B. L., Kawichai, S., Chingono, A., Sendah, M., Chariyalertsak, S., Konda, K. A., & Celentano, D. D. (2008). Assessing HIV/AIDS stigma and discrimination in developing countries. AIDS and Behavior, 12(5), 772–780.CrossRefGoogle Scholar
  13. Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs: Prentice-Hall.Google Scholar
  14. Gosling, S. D., Vazire, S., Srivastava, S., & John, O. P. (2004). Should we trust web-based studies? A comparative analysis of six preconceptions about internet questionnaires. American Psychologist, 59(2), 93–104.CrossRefGoogle Scholar
  15. Greenwald, A. G., Poehlman, T. A., Uhlmann, E. L., & Banaji, M. R. (2009). Understanding and using the implicit association test: III. Meta-analysis of predictive validity. Journal of Personality and Social Psychology, 97(1), 17–41.CrossRefGoogle Scholar
  16. Herek, G., Capitanio, J. P., & Widaman, K. (2002). HIV-related stigma and knowledge in the United States: Prevalence and trends, 1991–1999. American Journal of Public Health, 92(3), 371–377.CrossRefGoogle Scholar
  17. Higgins, E. T. (1987). Self-discrepancy; A theory relating self and affect. Psychological Review, 94(3), 319–340.CrossRefGoogle Scholar
  18. Holzemer, W. L., Uys, L. R., Chirwa, M. L., Greeff, M., Makoae, L. N., Kohi, T. W., et al. (2007). Validation of the HIV/AIDS stigma instrument – PLWA (HASI-P). AIDS Care, 19(8), 1002–1012.CrossRefGoogle Scholar
  19. Kalichman, S. C., Simbayi, L. C., Jooste, S., Toefy, Y., Cain, D., Cherry, C., & Kagee, A. (2005). Development of a brief scale to measure AIDS-related stigma in South Africa. AIDS and Behavior, 9(2), 135–143.CrossRefGoogle Scholar
  20. Kalichman, S. C., Simbayi, L. C., Cloete, A., Mthembu, P., Mkhonta, R. N., & Ginindza, T. (2009). Measuring AIDS stigmas in people living with HIV/AIDS: The internalized AIDS-related stigma scale. AIDS Care, 21(1), 87–93.CrossRefGoogle Scholar
  21. Ki-moon, B. (2008, August 6). The stigma factor. The Washington Times. Retrieved September 6, 2011, from
  22. Lee, R. S., Kochman, A., & Sikkema, K. J. (2002). Internalized stigma among people living with HIV-AIDS. AIDS and Behavior, 6(4), 309–319.CrossRefGoogle Scholar
  23. Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363–385.CrossRefGoogle Scholar
  24. Logie, C., & Gadalla, T. M. (2009). Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS Care, 21(6), 742–753.CrossRefGoogle Scholar
  25. Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Sawires, S. R., Ortiz, D. J., et al. (2008). Stigma in the HIV/AIDS epidemic: A review of the literature and recommendations for the way forward. AIDS, 22(Suppl 2), S67–S79.CrossRefGoogle Scholar
  26. Major, B., & O’Brien, L. T. (2005). The social psychology of stigma. Annual Review of Sociology, 56, 393–421.Google Scholar
  27. Markus, H., & Nurius, P. (1986). Possible selves. American Psychologist, 41(9), 954–969.CrossRefGoogle Scholar
  28. Miller, C. T., Grover, K. W., Bunn, J. Y., & Solomon, S. E. (2011). Community norms about suppression of AIDS-related prejudice and perceptions of stigma by people with HIV or AIDS. Psychological Science, 22(5), 579–583.CrossRefGoogle Scholar
  29. Molero, F., Fuster, M. J., Jetten, J., & Moriano, J. A. (2011). Living with HIV/AIDS: A psychosocial perspective on coping with prejudice and discrimination. Journal of Applied Social Psychology, 41(3), 609–626.CrossRefGoogle Scholar
  30. Nyblade, L. C. (2006). Measuring HIV stigma: Existing knowledge and gaps. Psychology, Health & Medicine, 11(3), 335–345.CrossRefGoogle Scholar
  31. Parker, R., & Aggleton, P. (2003). HIV and AIDS-related stigma and discrimination: A conceptual framework and implications for action. Social Science & Medicine, 57(1), 13–24.CrossRefGoogle Scholar
  32. Pascoe, E. A., & Smart Richman, L. (2009). Perceived discrimination and health: A meta-analytic review. Psychological Bulletin, 135(4), 531–554.CrossRefGoogle Scholar
  33. Phelan, J. C., Link, B. G., & Dovidio, J. F. (2008). Stigma and prejudice: One animal or two? Social Science & Medicine, 67(3), 358–367.CrossRefGoogle Scholar
  34. Prestage, G., Ferris, J., Grierson, J., Thorpe, R., Zablotska, I., Imrie, J., Smith, A., & Grulich, A. E. (2008). Homosexual men in Australia: Population, distribution and HIV prevalence. Sexual Health, 5(2), 97–102.CrossRefGoogle Scholar
  35. Pryor, J. B., Reeder, G. D., Yeadon, C., & Hesson-McLnnis, M. (2004). A dual-process model of reactions to perceived stigma. Journal of Personality and Social Psychology, 87(4), 436–452.CrossRefGoogle Scholar
  36. Rawstorne, P., Prestage, G., Grierson, J., Song, A., Grulich, A., & Kippax, S. (2005). Trends and predictors of HIV-positive community attachment among PLWHA. AIDS Care, 17(5), 589–600.CrossRefGoogle Scholar
  37. Rintamaki, L. S., Davis, T. C., Skripkauskas, S., Bennett, C. L., & Wolf, M. S. (2006). Social stigma concerns and HIV medication adherence. AIDS Patient Care and STDs, 20(5), 359–368.CrossRefGoogle Scholar
  38. Rosser, S. B. R., West, W., & Weinmeyer, R. (2008). Are gay communities dying or just in transition? Results from an international consultation examining possible structural change in gay communities. AIDS Care, 20(5), 588–595.CrossRefGoogle Scholar
  39. Sayles, J. N., Hays, R. D., Sarkisian, C. A., Mahajan, A. P., Spritzer, K. L., & Cunningham, W. E. (2008). Development and psychometric assessment of a multidimensional measure of internalized HIV stigma in a sample of HIV-positive adults. AIDS and Behavior, 12(5), 748–758.CrossRefGoogle Scholar
  40. Serovich, J. M. (2001). A test of two HIV disclosure theories. AIDS Education and Prevention, 13(4), 355–364.CrossRefGoogle Scholar
  41. Serovich, J. M., Lim, J. Y., & Mason, T. L. (2008). A retest of two HIV disclosure theories: The women’s story. Health and Social Work, 33(1), 23–31.CrossRefGoogle Scholar
  42. Stutterheim, S. E., Pryor, J. B., Bos, A. E., Hoogendijk, R., Muris, P., & Schaalma, H. P. (2009). HIV-related stigma and psychological distress: The harmful effects of specific stigma manifestations in various social settings. AIDS, 23(17), 2353–2357.CrossRefGoogle Scholar
  43. Stutterheim, S. E., Bos, A. E., Pryor, J. B., Brands, R., Liebregts, M., & Schaalma, H. P. (2011). Psychological and social correlates of HIV status disclosure: The significance of stigma visibility. AIDS Education and Prevention, 23(4), 382–392.CrossRefGoogle Scholar
  44. Swendeman, D., Rotheram-Borus, M. J., Comulada, S., Weiss, R., & Ramos, M. E. (2006). Predictors of HIV-related stigma among young people living with HIV. Health Psychology, 25(4), 501–509.CrossRefGoogle Scholar
  45. UNAIDS. (2010). Global report: UNAIDS report on the global AIDS epidemic 2010. Geneve: UNAIDS.Google Scholar
  46. Van Brakel, W. H. (2006). Measuring health-related stigma – A literature review. Psychology, Health & Medicine, 11(3), 307–334.CrossRefGoogle Scholar
  47. Vanable, P., Carey, M., Blair, D., & Littlewood, R. (2006). Impact of HIV-related stigma on health behaviors and psychological adjustment among HIV-positive men and women. AIDS and Behavior, 10(5), 473–482.CrossRefGoogle Scholar
  48. Visser, M. J., Kershaw, T., Makin, J. D., & Forsyth, B. W. (2008). Development of parallel scales to measure HIV-related stigma. AIDS and Behavior, 12(5), 759–771.CrossRefGoogle Scholar
  49. Zablotska, I. B., Holt, M., & Prestage, G. (2011). Changes in gay men’s participation in gay community life: Implications for HIV surveillance and research. AIDS and Behavior [Online publication ahead of print, March 19, 2011].Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • John B. F. de Wit
    • 1
    Email author
  • Dean A. Murphy
    • 1
    • 2
  • Philippe C. G. Adam
    • 1
    • 3
  • Simon Donohoe
    • 2
  1. 1.National Centre in HIV Social ResearchThe University of New South WalesSydneyAustralia
  2. 2.Australian Federation of AIDS OrganisationsNewtownAustralia
  3. 3.Institute for Prevention and Social ResearchVaalsThe Netherlands

Personalised recommendations