Homophobic attitudes and laws in European nations keep men who have sex with men (MSM) from accessing HIV-prevention services and from discussing their sexuality with health care providers. Publishing their findings in the journal AIDS, researchers examined data from the European MSM Internet Survey, which includes HIV-related information about 174,000 gay and bisexual men in 35 European countries. They compared this data with various countrywide laws, policies and attitudes toward homosexuality.

The researchers found that higher levels of homophobia in a nation was linked with lower HIV knowledge among gay and bi men, and that the men in these countries were also less likely to use condoms.

“Our findings suggest that rather than primarily being the result of personal failure, HIV risk is largely determined by national laws, policies, and attitudes toward homosexuality,” John Pachankis, PhD, an associate professor of epidemiology at Yale, said in a press release. “This study shows that gay and bisexual men in homophobic countries are denied the resources, including psychological resources like open self-expression, that are necessary to stay healthy.”

However, gay and bi men living in nations with pronounced homophobia have fewer sex partners and are less likely to have HIV. The investigators concluded that this was a consequence of the men being more likely to stay in the closet due to an inhospitable environment.

To read a press release about the study, click here.

To read the study abstract, click here.