Background: Intersectional stigma (ISS) remains a fundamental driver of HIV and sexual health disparities in the United States. Among Latino men who have sex with men (LMSM), ISS can manifest as enacted, anticipated, and internalized mechanisms in relation to Latino ethnicity, sexuality, and ‘traditional’ masculinity norms. We hypothesize that how ISS manifests to affect behavioral health is context dependent, requiring measurement approaches that are responsive to LMSM’s social, sociopolitical, and intrapersonal experiences.

Methods: NEXUS is a longitudinal cohort study that used social network analysis and theory to more rigorously measure ISS among LMSM. From 2021-2024, 448 LMSM were enrolled in San Diego, CA. We operationalized intersectional stigma as a multilevel latent variable comprised of observed measures of anticipated and enacted stigma experienced towards a participant’s ethnic, sexual, and masculine identities from different types of social network members (i.e., alters).

Results: In the family context, exposure to stereotypes related to one’s ethnicity explain limited variance, where sexuality and masculinity stigma present as distinct but interrelated constructs with masculinity stereotypes uniquely and directly affecting sexuality stereotypes (RMSEA=0.105, CFI=0.947, TLI=0.930, SRMR=0.032).

Conclusions: ISS can be rigorously measured with social network methodology, and doing so incorporates the knowledge that ISS is context dependent. In this study, there was heterogeneity in ISS by alter type. Future ISS interventions should consider the source of ISS and how this differentially affects HIV prevention efforts.