Minority Stressors and HIV Communication Among Taiwanese Sexual Minority Men: The Moderating Role of Sexual Position Identity

Abstract

Minority stressors and sexual position identity (e.g. bottom, top, versatile) have been linked to HIV communication among sexual minority men (SMM), yet remain understudied in Taiwan. This study examined associations between minority stressors and HIV communication among Taiwanese SMM, with sexual position identity explored as a potential moderator. Between April and May 2023, 198 HIV-negative or unknown status Taiwanese SMM who used dating apps to find sexual partners completed an online survey assessing sexual position identity, HIV communication behaviors (partner status inquiry and self-disclosure), and three forms of stigma: enacted, anticipated, and internalized. Logistic regression analyses showed that higher internalized stigma was associated with greater odds of partner status inquiry. Moderation analyses identified interactions in which enacted stigma was associated with higher odds of partner status inquiry among bottom-identified SMM compared to versatile-identified SMM, while anticipated stigma was associated with lower odds of partner status inquiry and self-disclosure among bottom-identified SMM. These findings suggest that sexual position identity may shape how minority stressors relate to HIV communication. Interventions that account for both sexual position identity and specific forms of stigma could be relevant for supporting HIV-related communication and informed decision-making among Taiwanese SMM.