The association of externalized HIV stigma and the engagement in risky sexual behaviors among young African Americans in the South

Externalized stigma presents a significant barrier to human immunodeficiency virus (HIV) testing, preventative care, and education. HIV continues to disproportionately impact African Americans, particularly those living in the Southern United States. This study relied on the HIV Stigma Framework developed by Earnshaw and Chaudoir (2009. From conceptualizing to measuring HIV stigma: A review of HIV stigma mechanism measures. <i>AIDS and Behaviour</i>, <i>13</i>(6), 1160-1177) to examine the association between levels of externalized HIV-related stigma and engagement in risky sexual behaviors, among a sample of African American young adults in the South. Findings suggest (95% CI) that individuals with lower-level HIV-related stigma engaged in fewer risky sexual behaviors, including condom usage during anal sex among males (<i>p</i> = 0.005) and overall (<i>p</i> = 0.003), as well as among females during vaginal sex (<i>p</i> = 0.043), discussing HIV status with sex partners (<i>p</i> = 0.033), and prior HIV testing (<i>p</i> = 0.098). These results highlight the need for interventions that address HIV-related stigma as a key factor in reducing HIV transmission. Interventions should consider the unique experiences of young African American adults in the South, which additionally varies by gender, which may influence the effectiveness in reducing stigma and delivering meaningful prevention and education interventions to this population.