Soc Sci Med. 2026 May 14;403:119401. doi: 10.1016/j.socscimed.2026.119401. Online ahead of print.
ABSTRACT
BACKGROUND: South Asian gay, bisexual, and queer men (SA GBQM) living in Canada report that racism and heterosexism negatively impact their sexual health. There is a paucity of research examining associations between these forms of stigma, migration status, and sexually transmitted infection (STI) testing for this population.
METHODS: We conducted a pooled analysis of Sex Now 2019 and 2021 – online, national, cross-sectional surveys of GBQM. We used modified Poisson regression models (adjusted for age, income, education, disability, and pre-exposure prophylaxis use for HIV) to examine the effects of migration status (born in Canada versus not) and past-year discrimination (racism and heterosexism) on recent STI testing. Using causal mediation decomposition, we estimated the pure direct, pure indirect, mediated interaction, and total effects.
RESULTS: Among 197 SA GBQM, 59% were migrants and 62% were recently tested for STIs. Past-year experiences of racism and heterosexism were self-reported by 64% and 34% of participants, respectively. Recent STI testing was higher among non-migrants compared to migrants [unadjusted prevalence ratio: 1.65 (95% confidence interval: 1.10-2.49)]. Past-year racism was higher among migrants compared to non-migrants (1.32; 1.05-1.66). However, there was no statistically significant difference in experiencing past-year heterosexism between these two groups. Only the pure direct effect estimate for the multivariable racism models was statistically significant (1.80; 1.15-3.37), indicating non-migrant SA GBQM who did not experience racism were more likely to be recently tested than migrants.
CONCLUSIONS: Addressing intersectional stigma and barriers to sexual health services experienced by migrant SA GBQM may improve testing over time.
PMID:42150226 | DOI:10.1016/j.socscimed.2026.119401
