Migration status, discrimination, and recent sexually transmitted infection testing among South Asian gay, bisexual, and other queer men living in Canada.

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.