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Int J STD AIDS. 2018 Jan;29(1):80-88. doi: 10.1177/0956462417717652. Epub 2017 Jul 1.

Social-ecological factors associated with HIV infection among men who have sex with men in Jamaica.

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1 Factor-Inwentash Faculty of Social Work, 7938 University of Toronto , Toronto, Canada.
2 Women's College Research Institute, Women's College Hospital, 7938 University of Toronto , Toronto, Canada.
3 Gillings School of Global Public Health, 2331 University of North Carolina at Chapel Hill , Chapel Hill, NC, USA.
4 Jamaica AIDS Support for Life, Kingston, Jamaica.
5 Institute for Gender and Development Studies, 62707 University of the West Indies , Mona Campus, Jamaica.


In Jamaica, where homosexuality is criminalized, scant research has examined associations between sexual stigma and HIV infection. The study objective was to examine correlates of HIV infection among men who have sex with men (MSM) in Jamaica. We conducted a cross-sectional tablet-based survey with MSM in Jamaica using chain referral sampling. We assessed socio-demographic, individual, social, and structural factors associated with HIV infection. A logit-link model, fit using backwards-stepwise regression, was used to estimate a final multivariable model. Among 498 participants (median age: 24, interquartile range: 22-28), 67 (13.5%) were HIV-positive. In the multivariable model, HIV infection was associated with increased odds of socio-demographic (older age, odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.00-1.10]; residing in Kingston versus Ocho Rios [OR: 6.99, 95% CI 2.54-19.26]), individual (poor/fair versus excellent/good self-rated health [OR: 4.55, 95% CI: 1.81-11.42], sexually transmitted infection [STI] history [OR: 3.67, 95% CI: 1.61-8.38]), and structural (enacted sexual stigma [OR: 1.08, 95% CI: 1.01-1.15], having a health care provider [OR: 2.23, 95% CI: 1.06-4.66]) factors. This is among the first studies to demonstrate associations between sexual stigma and HIV infection in Jamaica. Findings underscore the need to integrate STI testing in the HIV care continuum and to address stigma and regional differences among MSM in Jamaica.


HIV; Jamaica; health disparities; men who have sex with men

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