Abstract

Background: Men who have sex with men (MSM) widely reported stigmatization for their same-sex practices. Stigma is a multi-dimensional concept that encompasses perceived, enacted, internalized, and anticipated stigma. Despite its complexities, stigma-related research has mostly focused on specific kinds of sexual stigma among MSM, while identification and understanding of perceived and enacted stigma are crucial in many aspects. Thus, the present study aimed to explore the levels of perceived and enacted stigma and their associated factors among MSM in Nepal.
Methods: A nationwide cross-sectional study was conducted online among 842 participants between April and May 2024. A convenient sampling technique was utilized to recruit participants. The Neiland’s Sexual Stigma Scale (NSS-10) was employed to assess perceived and enacted stigma. Bivariate and multivariate linear regression analysis examined the relationship between the independent and outcome variables.
Results: Participant's mean age was 27.6 (SD=7.1) years. The mean score of the perceived and enacted stigma were 9.3 (SD=6.8) and 5.6 (SD=5.1) respectively. Participants who were engaged in anal sex in the past 12 months, [B:1.5, S.E:0.2, ꞵ:0.2, p-value: <0.01], [B:1.5, S.E:0.3, ꞵ:0.2, p-value: <0.01] and had depressive symptoms [B:1.2, S.E:0.1, ꞵ:0.2, p-value: <0.01], [B:1.3, S.E:0.2, ꞵ:0.2, p-value: <0.01] had increased perceived and enacted stigma. Conversely, participants who were involved in sex parties [B: -0.5, S.E:0.2, ꞵ: -0.1, p-value: 0.017], [B: -0.5, S.E:0.2, ꞵ: -0.1, p-value: 0.017] and were engaged in condomless sex in the past 12 months [B: -0.4, S.E:0.2, ꞵ:-0.1, p-value: 0.0579], [B:-0.4, S.E:0.2, ꞵ:-0.1, p-value: 0.059] had reported lower perceived and enacted stigma.
Conclusion: The study showed a high level of perceived and enacted stigma among MSM in Nepal. These findings emphasize the importance of a comprehensive approach to combat such stigmas in Nepal by adopting and upholding anti-discrimination laws that preserve MSM's rights.