Associations between Perceived Homophobia, Community Connectedness, and Having a Primary Care Provider among Gay and Bisexual Men

According to the minority stress model and social evaluation theory, stigma increases negative health outcomes in sexual minorities, and those with greater connection to a community appraise their lives with respect to fellow community members. This study was a secondary analysis of data from the online 2010 Social Justice Sexuality Project and examined associations between perceived homophobia, community connectedness, and having a health care provider among 2281 men who have sex with men (MSM). Approximately 37.9% ( n = 840) of the participants were African American/Black, and approximately 68.3% ( n = 1559) self-identified as gay. Perceived homophobia was associated with lower odds of having a regular health care provider (AOR = 0.89, 95% CI 0.85–0.96). Income was associated with at least two-fold greater odds of having a regular health care provider, but only for incomes at or above $20,000 (AORs 1.43–2.39, p s < .001). Community connectedness partially mediated and suppressed the negative association between perceived homophobia and having a primary care provider in the overall model (AOR = 0.95, 95% CI 0.90–1.00), and mediated approximately 14.1% of the total effect in the mediation model. Facilitating community connectedness for MSM may reduce the negative association between perceived homophobia and having a primary care provider, and community-based interventions that promote community connectedness may increase long-term engagement in healthcare utilization.