Housing insecurity, migration and HIV among sexual minority men in the U.S.

Sexual minority individuals in the U.S. experience disproportionate levels of housing insecurity, shaped by structural inequalities, stigma and health related vulnerabilities. Drawing on minority stress theory and the sexual and gender minority health disparities framework, we investigate how housing insecurity among sexual minority men is associated with HIV status and domestic interstate migration, and how these relationships vary across space using data from four cycles of the American Men’s Internet Survey (2018–2021). Among 42,401 sexual minority men in the study, a sample prevalence of 8.2% reported housing insecurity in the past year with significant state level variation. Pooled logistic regression models revealed HIV status was significantly associated with housing insecurity. Migrant status showed no independent association with housing insecurity after adjusting for education, as migrants were more likely to be highly educated, and more education was associated with lower risk of housing insecurity. Within the AMIS sample, respondents identifying as racial and ethnic minorities experienced elevated levels of housing insecurity. State-stratified models revealed geographic differences in the association between HIV status and housing insecurity, with the strongest effects observed in Utah, Colorado, Nevada, Texas, Georgia, Indiana and New Jersey, highlighting the critical need for tailored policies to address housing stability, particularly in geographic contexts represented within the AMIS sample.