Characterizing Metrics of Sexual Behavior Stigmas among Cisgender Men Who Have Sex With Men in Nine Cities across the United States.

Men who have sex with men (MSM) in the United States (US) are stigmatized for same-sex practices, which can lead to risky sexual behavior, potentiating risk for HIV infection. Improved measurement is necessary for accurately reporting and mitigating sexual behavior stigma. We added 13 sexual behavior stigma items to the local surveys of 9 sites of the Centers for Disease Control and Prevention 2017 National HIV Behavioral Surveillance system, which used venue-based, time-sampling procedures to survey cisgender MSM in US metropolitan statistical areas. We performed exploratory factor analytic procedures on site-specific (Baltimore, Maryland; Denver, Colorado; Detroit, Michigan; Houston, Texas; Nassau-Suffolk, New York; Portland, Oregon; Los Angeles, California; San Diego, California; Virginia Beach-Norfolk, Virginia) and pooled responses to the items. A three-factor solution - "stigma from family" (α = 0.70), "anticipated health-care stigma" (α = 0.75), "general social stigma" (α = 0.66) - best fit the pooled data and was the best-fitting solution across sites. Findings demonstrate that MSM across the US experience sexual behavior stigma similarly. The results reflect the programmatic utility of enhanced stigma measurement, including tracking stigma trends over time, making regional comparisons of stigma burden, and supporting evaluation of stigma-mitigation interventions among MSM across the US.