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. Author manuscript; available in PMC: 2022 May 8.
Published in final edited form as: Aggress Behav. 2016 Feb 26;42(6):542–554. doi: 10.1002/ab.21649

The Association Between AIDS-Related Stigma and Aggression Toward Gay Men and Lesbians

Wilson Vincent 1, John L Peterson 2, Dominic J Parrott 2
PMCID: PMC9080452  NIHMSID: NIHMS1803051  PMID: 26918697

Abstract

This study examined whether self-identified race and prior contact with a gay man or lesbian moderate the association between AIDS-related stigma and aggression toward gay men and lesbians when controlling for sexual prejudice. A regional, community-recruited sample of 194 heterosexual men (50% Black, 50% White) completed measures of AIDS-related stigma, sexual prejudice, and prior contact with gay men and lesbians. Regression analyses showed that AIDS-related stigma was positively associated with aggression toward gay men and lesbians among White men who reported no prior contact, but not among White men who endorsed prior contact and Black men regardless of prior contact. Findings suggest that intergroup contact may be a key component to reducing the effects of AIDS-related stigma towards stigmatized groups. Implications for aggression theory and intervention are discussed.

Keywords: Aggression, Prejudice, Intergroup Contact, HIV, AIDS

Violence toward gay men and lesbians is a documented public health concern (National Coalition of Anti-Violence Programs [NCAVP], 2009). For example, a national probability poll found that half of sexual-minority individuals in the United States have been victims of verbal abuse, and one in ten have experienced physical abuse (Herek, 2009a). One understood factor in antigay aggression is public perception that gay people, particularly gay men, have or spread HIV (Herek, Widaman, & Capitanio, 2005; Parker and Aggleton, 2003). Historically, individuals perceived to be diagnosed with HIV or AIDS have been targets for physical assault (Nardi & Bolton, 1991). However, contemporary research has failed to directly examine the influence of heterosexuals’ AIDS/HIV-related attitudes on their perpetration of aggression toward gay men and lesbians. Thus, the links between perpetrators’ AIDS-related stigma and their aggression toward gay men and lesbians merit further study.

AIDS-Related Stigma and Aggression Toward Gay Men and Lesbians

Stigma may be broadly understood as the extent to which the public harbors negative beliefs about a particular group, such as people living with HIV (PLWH), and these negative attitudes may affect how members of the devalued group are treated (Goffman, 1963; Herek, Saha, & Burack, 2013; Parker & Aggleton, 2003). This conceptualization of stigma highlights the role of factors outside of the control of those stigmatized, such as the hierarchical power structure between different groups in society and negative treatment toward members of stigmatized groups (Neufeld, Sikkema, Lee, Kochman, & Hansen, 2012; Persons, Kershaw, Sikkema, & Hansen, 2010). The stigma associated with HIV/AIDS, or AIDS-related stigma, has been defined as “all stigma directed at persons perceived to be infected with HIV” whether or not they are actually infected with the HIV virus (Herek & Glunt, 1988, p. 886). For example, HIV status may be stigmatized in that actual or assumed PLWH may be further assumed to be morally inferior and have deviant values (Parker & Aggleton, 2003). AIDS-related stigma reinforces and reproduces pre-existing social inequalities, including those based on sexual orientation (Herek, 1999; Parker & Aggleton, 2003). For example, Parker and Aggleton (2003) noted that stigma is strategic in that the use of words, images, and practices converge to promote the interests of dominant groups in society (e.g., heterosexuals). In regard to HIV/AIDS and gay people, AIDS-related stigma may reinforce beliefs about negative qualities ascribed to gay people (e.g., beliefs that gay people are immoral vectors of disease who deserve infection with HIV).

Since the 1980s, the general public has associated HIV/AIDS with gay people, including lesbians (Herek & Capitanio, 1999; Herek, Capitanio, & Widaman, 2002; Herek & Glunt, 1988; Herek, Mitnick, Burris, Chesney, Fullilove, Gunther et al., 1998; Wright, Mulick, & Kincaid, 2007). This “stigma by association” may be understood as “courtesy” AIDS-related stigma (Goffman, 1963; Herek, 1999; Prior, Reeder, & Monroe, 2012) describes the type of process by which, even though lesbians are technically at very low risk of HIV, they are stigmatized “by association” because they fall under the umbrella of sexual minorities or homosexuality.

In addition, numerous studies show that people (1) categorize themselves and others into in-groups (e.g., heterosexual) and out-groups (e.g., non-heterosexual; gay and lesbian), (2) ascribe positive or negative attributes to their own in-group and members of out-groups, and (3) may have views and motivations that justify existing social hierarchies and the enactment of stigma toward potential out-groups like gay men and lesbians (e.g., social categorization; Bodenhausen, Kang, & Peery, 2012; system justification theory in tandem with social identification and social dominance theories; Costa-Lopes, Dovidio, Pereira, & Jost, 2013; Jost, 2011; sexual and AIDS-related stigma; Herek, 2009b; interpersonal threats and automatic motives; Park & Buunk, 2011). Although heterosexual men may hold differential attitudes toward lesbians versus gay men or may have sexualized views of gender-conforming lesbians (Worthen, 2013), sexually conservative opinions about, and perceived threats to, sexual morality and gender- and sexual orientation-based social hierarchies adhered to by some heterosexual men may be more critical when lesbians are collectively categorized with gay men as a homosexual out-group (Collier, Bos, & Sandfort, 2012; Crawford, Inbar, & Maloney, 2014). Taken together, the stigma literature suggests that a patriarchal view of potentially gender-conforming lesbians who may be perceived as posing little or no threat to existing gender- and sexual orientation-based social hierarchies is a separate issue from the idea of “gay men and lesbians” or “gay people” categorized together as threats to existing social hierarchies (e.g., fighting to uphold gay marriage). Aggregating attitudes toward gay men and lesbians may be as informative about the role and robustness of AIDS-related stigma or other stigmas as disaggregating these attitudes, and research is needed to examine this further.

Sexual prejudice, a form of sexual stigma, has been defined as “a negative attitude toward an individual based on her or his membership in a group defined by its members’ sexual attractions, behaviors, or orientation” (Herek & McLemore, 2013, p. 19). Survey studies have established an association between AIDS-related stigma and prejudice toward gay men as well as lesbians (e.g., Herek, 1997; Herek, Widaman, & Capitanio, 2005; Pryor, Reed, Vinacco, 1989; Pryor, Reed, Vinacco, & Kott, 1999; Waldner, Sikka, & Baig, 1999; Wright, Mulick, & Kincaid, 2007). Whereas AIDS-related stigma is associated with prejudice toward gay men and lesbians, sexual prejudice is, in turn, associated with aggression toward gay men and lesbians according to survey- and laboratory-based research (Bernat, Calhoun, Adams, & Zeichner, 2001; Franklin, 2000; Parrott, Peterson, & Bakeman, 2011; Parrott & Zeichner, 2005; Parrott, Zeichner, & Hoover, 2006; Patel, Long, McCammon, & Wuensch, 1995; Roderick, McCammon, Long, & Allred, 1998; Vincent, Parrott, & Peterson, 2011).

Research has yet to examine whether perpetrators’ AIDS-related stigma is directly associated with their aggression toward groups who are stigmatized. The unique role of AIDS-related stigma above and beyond sexual prejudice remains surprisingly neglected in the literature. In addition, should an association between AIDS-related stigma and aggression toward gay men and lesbians be demonstrated, research is needed to determine for whom the association occurs and what factors might mitigate this association.

Potential Moderators

Based on intergroup contact theory (Allport, 1954; Dovidio, Eller, & Hewstone, 2011), positive contact with gay men and lesbians among heterosexual men should decrease their likelihood of aggression toward gay men and lesbians (Vincent, Parrott, & Peterson, 2014). Allport (1954) outlined four, optimal conditions under which contact between social groups (e.g., heterosexuals, gay men and lesbians) would reduce intergroup prejudice: (1) contact sanctioned by a recognized authority; (2) contact involving intergroup cooperation, or mutual interdependence; (3) contact based on common goals; and (4) contact in which equal status exists between groups in the contact situation. However, two separate meta-analyses have shown that intergroup contact reduces prejudice even when these four conditions are not met (Pettigrew & Tropp, 2006; Smith, Axelton, & Saucier, 2009). As such, a history of prior contact with gay men and lesbians, broadly defined, should decrease the association between AIDS-related stigma and aggression toward gay men and lesbians among heterosexual men.

Due to prior contact, Blacks may generally be less likely than Whites to show an association between AIDS-related stigma and aggression toward gay men and lesbians. Blacks, in general, have been disproportionately affected by HIV/AIDS (e.g., CDC, 2011a; 2011b; CDC 2012). Thus, Black heterosexuals are more likely than White heterosexuals to know both heterosexual and non-heterosexual persons diagnosed with HIV infection and AIDS (Gerbert, Sumser, & Baguire, 1991; Hardy & Biddlecom, 1991; Herek & Capitanio, 1997). In contrast, similar contact experiences related to either HIV or AIDS may be less likely among White heterosexuals. Additionally, Waldner and colleagues (1999) found in a sample of undergraduate students that correlations (a) between knowledge of HIV transmission and sexual prejudice, and (b) between fear of AIDS and sexual prejudice, were weaker among Blacks than among Whites. In concert with intergroup contact theory, this literature suggests that AIDS-related stigma would be less strongly associated with prejudice-based aggression toward gay men and lesbians among Black men than among White men.

The Present Study

Given the identified gaps in the literature, the purpose of this study was (1) to examine the association between AIDS-related stigma and aggression toward gay men and lesbians and (2) to examine two theoretically-based moderators (race, prior contact) of this association while controlling for sexual prejudice. Specifically, the association between AIDS-related stigma and aggression toward gay men and lesbians was expected to be significantly more positive among White men with no prior contact with gay men and lesbians than among White men who have had prior contact with gay men and lesbians and Black men regardless of prior contact. Posthoc analyses were conducted to determine if this interaction held when attitudes toward gay men were accounted for separately from attitudes toward lesbians.

Method

Participants

Participants were 241 men who were recruited from the local community in a major metropolitan area in the southeastern United States via newspaper and Internet advertisements. The advertisements read, “Males ages 18–30 needed for 1.5 to 2 hour study on drinking behavior and social attitudes. Earn $25.” The target population of men of ages 18 to 30 generally found for heterosexual perpetrators of antigay aggression (Harry, 1990; NCAVP, 2009). We screened for heterosexual men because the present study focused on intergroup stigma and aggression rather than internalized or within-group stigma and aggression. Stigma enacted by non-heterosexual men toward gay men and lesbians may be motivated by internalized AIDS-related (Lee, Kochman, & Sikkema, 2002) or sexual (Herek, Gillis, & Cogan, 2009) stigma turned inward and directed at other non-heterosexuals. Also, women were excluded because, compared to men, they report lower levels of sexual prejudice and are less likely to engage in anti-gay and lesbian aggression (Baker & Fishbein, 1998; Lim, 2002; NCAVP, 2009; Polimeni, Hardie, & Buzwell, 2000; Whitley & Kite, 1995). Given that one of the aims of the study was to compare responses of Black and White participants, advertisements were placed in venues and media outlets that were predominantly frequented or used, respectively, by Black and White men. Six participants who did not identify as such were excluded from further analyses.

For all participants, a heterosexual orientation was confirmed based on their responses to the Kinsey Heterosexuality-Homosexuality Rating Scales (KRS; Kinsey, Pomeroy, & Martin, 1948). Consequently, 37 participants were removed from subsequent analyses because they did not endorse exclusive sexual arousal to females and sexual experiences that occurred mostly or exclusively with females. An additional three participants were excluded because they were found to be older than 30 years of age upon arrival to the laboratory. One of the remaining 195 respondents was excluded because he did not complete all pertinent measures used in the final analyses. The final sample consisted of 194 participants and was evenly split between Blacks (n = 97) and Whites (n = 97) (see Table 1). On average, participants were in their mid-twenties, had about 14 years of formal education, and earned an income in the mid-$20,000s. As detailed in Table 1, on average, Blacks were approximately two years older than Whites and had about one year less formal education than Whites in the sample. Blacks earned about $12,000 less than Whites.

Table 1.

Sample Means (SD) and Percentages for Age, Years of Formal Education, Race, and Relationship Status, AIDS-related Stigma, Sexual Prejudice, and Anti-sexual-minority Aggression; and Demographic Differences Based on Self-identified Racial Membership.

Variable Total Sample
(N = 194)		 Blacks
(n = 97)		 Whites
(n = 97)		 p-value
Age (years) 24.2 (3.3) 25.2 (3.0) 23.05 (3.2) 0.000
Years of formal education 14.3 (2.5) 13.8 (2.3) 14.8 (2.6) 0.004
Income level $26,637 ($20,351) $20,561 ($15,334) $32,758 ($22,795) 0.000
Relationship status 0.279
   Single, never married 80.4 76 81
   Married 7.7 11 4
   Not married but living with intimate partner 9.3 8 10
   Divorced/separated 2.6 3 2
Prior Contact 0.055
   Yes 83.0 77.3 88.7
   No 17.0 22.7 11.3
AIDS-related Stigma 1.22 (1.589) 1.28 (1.40) 1.16 (1.77) 0.181
Sexual Prejudice 81.59 (39.45) 96.74 (37.26) 65.97 (35.41) 0.000
Attitudes Toward Gay Men 45.85 (22.48) 53.80 (20.93) 37.81 (21.19) 0.000
Attitudes Toward Lesbians 35.59 (19.34) 42.95 (19.00) 28.15 (16.72) 0.000
Antigay Aggression 11.18 (3.26) 11.19 (3.17) 11.15 (3.36) 0.923
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Note. Values of p = 0.000 reflect p < 0.0005. Differences between means were tested using t-tests, and differences in proportions were tested using Cramer’s V statistic.

Computer-Administered Questionnaires

Participants first completed self-report measures adapted for computer administration via MediaLab 2000 (Jarvis, 2006). Each item and set of instructions was presented sequentially on the computer screen for all self-report measures.

Demographic items.

This self-report form obtained information such as age, years of education, income, self-identified race (e.g., African American or Black; Caucasian or White), relationship status, and self-identified sexual orientation (i.e., Heterosexual; Homosexual; Bisexual; Other).

Kinsey Heterosexual-Homosexual Rating Scale (KRS; Kinsey et al., 1948).

A modified version of this instrument was used to assess prior sexual arousal and experiences. This 7-point scale asks participants to rate their sexual arousal and behavioral experiences from 1 (“exclusively heterosexual”) to 7 (“exclusively homosexual”). Only participants who reported exclusive sexual arousal to females and behavioral experiences that were mostly or exclusively with females were included in the analyses (Savin-Williams, 2006).

Prior contact.

Prior contact with a gay person was assessed using an item worded as follows: “Do you have a friend, colleague, or family member who is gay?” Response options were coded 0 for No and 1 for Yes. The excluded participant who did not answer all pertinent measures was the only participant who responded with the only other option, Don’t Know/Refuse to Answer.. Although single-item measures are not ideal, they are the most common type of self-report measure in studies of intergroup contact that are not focused specifically on race- or ethnicity-based contact (Pettigrew & Tropp, 2006). Further, they have been used most often and successfully in studies to detect effects associated with prior contact (Pettigrew & Tropp, 2006).

Attitudes Toward Gay Men and Lesbians Scale (ATGLS; Herek, 1988).

This 20-item, Likert-type scale assessed sexual prejudice toward gay men and lesbians. Scores range from 20 to 180, and higher scores indicate higher levels of sexual prejudice. Sample items include, “I think male homosexuals are disgusting” and “Female homosexuality is an inferior form of sexuality.” Internal consistency for the ATGLS typically approaches or exceeds .90 (e.g., Herek, 1988; Siebert, Chonody, Siebert, & Rutledge, 2014), which was consistent with the present study (α = .93). Internal consistency values were .90 and .86 for Attitudes Toward Gay Men and Attitudes Toward Lesbians subscales, respectively.

Self-Report of Behavior Scale – Revised (SBS-R; Roderick et al., 1998).

This 20-item Likert-type measure assesses the frequency of respondents’ avoidant and aggressive behaviors toward gay men and lesbians. Participants are asked to rate each item on a scale from 1 (“never”) to 5 (“always”), with higher scores indicating more frequent engagement in avoidant or aggressive behaviors toward gay men and lesbians. While the SBS-R is comprised of separate Avoidance and Aggression subscales, prior research has adopted a revised 8-item aggression subscale that includes only those items that clearly reflect aggressive behaviors (Parrott & Peterson, 2008). Items from this subscale include physical aggression (e.g., “I have physically hit or pushed someone I thought was gay because he or she brushed his or her body against mine when passing by”) and verbal aggression (e.g., “I have been with a group in which one (or more) person(s) yelled insulting comments to a gay person or group of gay people”). While participants completed the full SBS-R, only the revised Aggression subscale representing aggression toward gay men and lesbians was analyzed. An internal consistency coefficient of .73 was obtained in the present sample, which is consistent with prior research (α = .70; Parrott & Peterson, 2008).

Structured Interview

Following the computer-administered questionnaires, participants completed a structured interview that included Herek’s AIDS and Stigma Survey (HASS; Herek & Capitanio, 1993; Herek, Capitanio, & Widaman, 2002). The HASS consists of 34 items that assess stigma in responses to persons who “have AIDS” (i.e., living with HIV or AIDS). Herek and associates (2002) identified nine items to form a “stigma index” (p. 375). These items represent participants’ stigmatizing responses regarding (a) behavioral intentions to avoid persons living with AIDS, (b) negative feelings toward persons living with AIDS, (c) coercive attitudes about quarantine and publicizing the names of persons living with AIDS, and (d) blaming persons living with AIDS for getting “what they deserve.” Internal consistency for this measure typically exceeds .75 (HASS; Herek & Capitanio, 1993; Herek, Capitanio, & Widaman, 2002). Internal consistency for the present sample was .70.

Procedure

Upon arrival to the laboratory, all participants provided informed consent to a male research assistant. The computer-administered questionnaires (i.e., demographics form, KRS, ATGLS) were then administered. Next, the research assistant conducted the structured interview (i.e., HASS). The same male researcher interviewed all participants and was trained to administer the measures in a consistent, dispassionate manner. Other measures were administered via computer and during the structured interview, but they are unrelated to the present study and are not reported here. At the conclusion of their participation in the study, participants were debriefed, compensated with $25, and thanked.

Results

Preliminary Analyses

Table 1 displays percentages and counts for prior contact with gay men and lesbians and the means and standard deviations for continuous study variables. Of the total sample, most participants endorsed having some contact with gay men and lesbians. However, Whites (88.7%) did not differ from Blacks (77.6%) in the number who reported prior contact with gay men and lesbians (χ2[1] = 4.42, p = 0.055). Thus, even though, overall, more people in the sample reported prior contact than not, this difference did not depend on their race. Thus, race and prior contact were independent of each other in the present sample. Although a marginally significant p-value indicated that that there could be a difference, the sample (N = 194) was sufficiently powered for this two-by-two chi-square test. Although Black men reported more sexual prejudice than White men, they did not differ in their endorsement of AIDS-related stigma or aggression toward gay men and lesbians. Over 93% of aggression enacted by participants was verbal aggression (e.g., yelled an insult; verbally threatened). Less than seven percent of the sample perpetrated any given act of physical aggression. Blacks and Whites did not differ in regard to proportion of verbal aggression relative to physical aggression.

Overview of Primary Analyses

This study examined (1) whether there was an association between AIDS-related stigma and aggression toward gay men and lesbians and (2) whether prior contact with gay men and lesbians and racial membership moderated this association when controlling for sexual prejudice. Specifically, the association was expected to be stronger among White men who reported having had no prior contact with gay men and lesbians than among White men who reported having had contact with gay men and lesbians and Black men regardless of their prior contact with gay men and lesbians.

Commensurate with the continuous nature of the criterion variable, the data were analyzed using linear regression analyses. Skew and kurtosis statistics and their respective standard errors (SEs) in parentheses were as follows: AIDS-Related Stigma Index (skew [SE] = 1.47 [0.17], kurtosis [SE] = 1.71 [0.34]; ), Attitudes Toward Lesbians & Gay Men, or Sexual Prejudice (SP; 0.29 [0.17], −0.91 [0.34] ), Attitudes Toward Gay Men (ATG; 0.23 [0.17], −1.01 [0.34]), Attitudes Toward Lesbians (ATL; 0.50 [0.17], −0.66 [0.34]), Aggression Toward Gay Men and Lesbians (1.89 [0.17], 6.084 [0.34] ). Respective standard errors for skew and kurtosis are the same because they are functions of sample size, not the value of the statistic. Per the recommendations of Field (2005), the skew and kurtosis statistics of each continuous were divided by their respective standard errors to obtain z-scores for skew and kurtosis. For the continuous variables, the z-scores for skew or kurtosis were greater than 1.96, indicating a level skew or kurtosis significantly different from zero. Thus, they required log transformations. Mean age, years of formal education, and income based on race, these variables were included as covariates in all regression analyses.

Hypotheses were tested with a two-step process using two separate hierarchical regression models. In Step 1, the main effects for AIDS-related stigma, race, prior contact, and covariates, including SP, were entered. This step allowed for the evaluation of the hypothesis that AIDS-related stigma is positive associated with aggression toward gay men and lesbians. In Step 2, the two-way interaction terms (i.e., AIDS-Related Stigma x Race, AIDS-related Stigma x Prior Contact, Race x Prior Contact), and the three-way interaction term (i.e., AIDS-Related Stigma x Race x Prior Contact) were entered into the model. This step allowed for the evaluation of the hypothesis that race and prior contact with gay men and lesbians moderated the association of AIDS-related stigma with aggression toward gay men and lesbians. Analyses were repeated with interactions that included combinations of SP and all other predictor variables. However, none of the interaction terms involving SP were significant, thereby justifying the current analytic approach excluding the interactive effects of SP. Although the current sample is relatively small given the number of variables, including interaction terms, the SP interactions were very small in size (Cohen, 1992). Significant interaction terms were interpreted by plotting the effect and testing whether the slopes of the simple regression lines differed significantly from zero for high and low values of the moderator variables (i.e., race; prior contact) (Aiken & West, 1991).

Raw scores for the predictor and moderator variables were grand-mean centered prior to creating product terms for moderation analyses. Interaction terms were then calculated by obtaining cross-products of pertinent, centered first-order variables. This technique reduces multicollinearity between interaction terms and their component lower-order terms (Aiken & West, 1991). Indeed, it was determined that multicollinearity was generally not an issue in these data (i.e., variance inflation factor < 10; tolerance > .1). Regression coefficients for interaction terms are reported as unstandardized bs with SE terms, and partial r values were provided as indicators of effect size. Adjusted R2 values were reported, as the non-adjusted R2 value tends to overestimate the R2 value of the population (Cohen, Cohen, West, & Aiken, 2003).

AIDS-related Stigma and Aggression Toward Gay Men and Lesbians

The first model representing the association between AIDS-related stigma and aggression toward gay men and lesbians, while holding SP and other covariates constant, was significant, adjusted R2 = .19, F(5, 188) = 9.98, p < .0005. In this model, a significant effect small-to-moderate size of AIDS-related stigma (b = .09, SE = .03, rpartial = .23, p = .001) was found, indicating that participants who reported more AIDS-related stigma also reported more aggression toward gay men and lesbians.

The second model was significant at the first step, adjusted R2 = .20, F(7, 186) = 7.86, p < .0005, and the second step (i.e., addition of interaction terms), adjusted R2 = .25, F(11, 182) = 6.75, p < .0005. The three-way AIDS-Related Stigma x Race (Black) x Prior Contact (No) interaction (b = −.27, SE = .12, rpartial = −.16, p = .026) was significant. Thus, higher scores for AIDS-related stigma were associated with higher scores on aggression toward gay men and lesbians contingent upon participants’ self-identified race and ethnicity. Although the effect size small to moderate, it was sufficient to be detected with the current sample. SP was significant with a medium effect size (b= .15, SE = .03, rpartial = .31, p < .0005). Participants who reported more SP also reported more aggression toward gay men and lesbians.

Explication of the 3-way interaction indicated that AIDS-related stigma was significantly and positively associated with aggression toward gay men and lesbians among White men who reported no prior contact with a gay man or lesbian (b = .29, SE = .08, rpartial = .27, p < .0005), a medium effect size, but not among White men who reported prior contact (b = .02, SE = .04, rpartial = .04, p = .633) and Black men either with prior contact (b = .05, SE = .04, rpartial = .09, p = .234) or without prior contact (b = .08, SE = .08, rpartial .08, p = .288) (see Figure 1). Thus, self-identified White men in the present sample reporting no prior contact with gay men and lesbians and greater AIDS-related stigma also reported more aggression toward gay men and lesbians. However, this was not the case among self-identified White men who reported prior contact and Black men regardless of their prior contact. Effect sizes less than .10 tended to show no statistically significant difference, although some of these effects would be significant with a more highly powered sample. Table 2 shows the two-step regression model with White men reporting no prior contact with gay men or lesbians serving as the reference group. In sum, the magnitude of the effect of AIDS-related stigma on aggression toward gay men and lesbians was greatest among White men who reported no prior contact with gay men and lesbians.

Figure 1.

Figure 1.

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Plot of regression lines depicting the interactive effects between AIDS-related stigma, race, and prior contact with gay men and lesbians on aggression toward gay men and lesbians when controlling for sexual prejudice (i.e., attitudes toward both gay men and lesbians combined). N = 194.

Table 2.

Summary of Two-Step Linear Regression Analyses Used to Examine Main and Interaction Effects in a Model Predicting Frequency of Past Aggression Toward Gay Men and Lesbians While Controlling for Sexual Prejudice.


Variable		 b SE rpartial p
Step 1
  Age .000 .000 −.02 .770
  Education level .000 .000 −.11 .124
  Income .000 .000 .06 .406
  Sexual prejudice .15 .03 .31 .000
  AIDS-related stigma .08 .03 .20 .007
  Race (White) −.03 .02 −.14 .051
  Prior contact (No) −.02 .02 −.07 .366
Step 2
  Age .000 .000 −.02 .841
  Education level −.01 .000 −.12 .099
  Income .000 .000 .11 .126
  Sexual prejudice .15 .03 .31 .000
  AIDS-related stigma .29 .08 .27 .000
  Race (White) −.07 .04 −.13 .082
  Prior contact (No) −.04 .03 −.09 .237
  AR Stigma X Race −.21 .11 −.14 .053
  AR Stigma X Prior Contact −.27 .09 −.23 .002
  Race X Prior Contact .05 .04 .01 .179
  AR Stigma X Race X Prior Contact .27 .12 .16 .026
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Note. N = 194. Values of 0.000 are less than 0.0005. AR Stigma = AIDS-related stigma. Prior Contact = prior contact with gay men and lesbians. Results of Model 2, which included all possible interaction terms involving the covariate sexual prejudice, were omitted because sexual prejudice was not a significant moderator. Whites were coded as the reference group for race. No, as opposed to yes, for prior contact with gay men and lesbians was coded as the reference group for prior contact. Thus, in regards to the present sample, this model refers to White men with no prior contact with gay men or lesbians.

Posthoc analyses: Controlling separately for attitudes toward gay men and attitudes toward lesbians.

In order to determine if associations with attitudes toward gay men and lesbians combined (i.e., SP) were the same when attitudes towards gay men and lesbians were disaggregated, we repeated these analyses, controlling separately for ATG and ATL. Given that the SBS-R combines aggression toward gay men and lesbians, aggression directed toward these two distinct targets could not be disaggregated (See Measures subsection above; Parrott & Peterson, 2008).

The overall pattern was essentially the same. When controlling for ATG (see Table 3; Figure 2), the pattern of results was similar as when controlling for SP, with the slope of aggression toward gay men and lesbians regressed onto AIDS-related stigma (i.e., increase in scores for aggression toward gay men and lesbians for each unit increase in scores for AIDS-related stigma) being steeper among white men with no prior contact with gay men or lesbians (b = .22, SE = .08, rpartial = .21, p = .005) than it was among White men with prior contact (b = .01, SE = .04, rpartial = .03, p = .739) and Black men without prior contact (b = .07, SE = .07, rpartial = .07, p = .36). The association was marginally significant among self-identified Black men who reported prior contact with gay men and lesbians (b = .08, SE = .04, rpartial = .14, p = .063). These associations must be interpreted with caution, however, as the three-way interaction fell short of statistical significance in the present sample (b = −.22, SE = .12, rpartial = −.14, p = .063). When controlling for ATL (see Table 4; Figure 3), AIDS-related stigma was again significantly and positively associated with aggression toward gay men and lesbians among White men who reported no prior contact with a gay man or lesbian (b = .34, SE = .08, rpartial = .31, p < .0005), but not among White men with prior contact (b = .04, SE = .04, rpartial = .08, p .285) and Black men without prior contact (b = .09, SE = .08, rpartial = .09, p = .236). The association was marginally significant among Black men with prior contact (b = .09, SE = .04, rpartial = .15, p = .045).

Table 3.

Summary of Two-Step Linear Regression Analyses Used to Examine Main and Interaction Effects in a Model Predicting Frequency of Past Aggression Toward Gay Men and Lesbians While Controlling for Attitudes Toward Gay Men.


Variable		 b SE rpartial p
Step 1
  Age .000 .000 −.03 .714
  Education level .000 .000 −.11 .141
  Income .000 .000 .06 .404
  Attitudes toward gay men .000 .000 .40 .000
  AIDS-related stigma .06 .03 .16 .027
  Race (White) −.03 .02 −.16 .026
  Prior contact (No) −.01 .02 −.05 .526
Step 2
  Age .000 .000 −.02 .743
  Education level .000 .000 −.12 .120
  Income .000 .000 .11 .151
  Attitudes toward gay men .000 .000 .37 .000
  AIDS-related stigma .22 .08 .21 .005
  Race (White) −.06 .04 −.13 .085
  Prior contact (No) −.03 .03 −.08 .292
  AR Stigma X Race −.16 .11 −.11 .141
  AR Stigma X Prior Contact −.21 .08 −.18 .013
  Race X Prior Contact .05 .04 .09 .223
  AR Stigma X Race X Prior Contact .22 .12 .14 .063
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Note. N = 194. Values of 0.000 are less than 0.0005. AR Stigma = AIDS-related stigma. Prior Contact = prior contact with gay men and lesbians. Results of Model 2, which included all possible interaction terms involving the covariate attitudes toward gay men, were omitted because attitudes toward gay men was not a significant moderator. Whites were coded as the reference group for race. No, as opposed to yes, for prior contact with gay men and lesbians was coded as the reference group for prior contact. Thus, in regards to the present sample, this model refers to White men with no prior contact with gay men or lesbians.

Figure 2.

Figure 2.

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Plot of regression lines depicting the interactive effects between AIDS-related stigma, race, and prior contact with gay men and lesbians on aggression toward gay men and lesbians when controlling for attitudes toward gay men. N = 194.

Table 4.

Summary of Two-Step Linear Regression Analyses Used to Examine Main and Interaction Effects in a Model Predicting Frequency of Past Aggression Toward Gay Men and Lesbians While Controlling for Attitudes Toward Lesbians.


Variable		 b SE rpartial p
Step 1
  Age .000 .000 −.05 .520
  Education level .000 .000 −.11 .121
  Income .000 .000 .07 .332
  Attitudes toward lesbians .03 .01 .17 .017
  AIDS-related stigma .10 .03 .26 .000
  Race (White) −.02 .02 −.08 .267
  Prior contact (No) −.02 .02 −.09 .223
Step 2
  Age .000 .000 −.03 .649
  Education level .000 .000 −.13 .080
  Income .000 .000 .13 .089
  Attitudes toward lesbians .04 .01 .21 .004
  AIDS-related stigma .343 .08 .31 .000
  Race (White) −.06 .04 −.12 .103
  Prior contact (No) −.02 .02 −.11 .528
  AR Stigma X Race −.25 .11 −.17 .023
  AR Stigma X Prior Contact −.30 .09 −.25 .001
  Race X Prior Contact .06 .04 .11 .125
  AR Stigma X Race X Prior Contact .30 .12 .17 .018
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Note. N = 194. Values of 0.000 are less than 0.0005. AR Stigma = AIDS-related stigma. Prior Contact = prior contact with gay men and lesbians. Results of Model 2, which included all possible interaction terms involving the covariate attitudes toward lesbians, were omitted because attitudes toward lesbians was not a significant moderator. Whites were coded as the reference group for race. No, as opposed to yes, for prior contact with gay men and lesbians was coded as the reference group for prior contact. Thus, in regards to the present sample, this model refers to White men with no prior contact with gay men or lesbians.

Figure 3.

Figure 3.

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Plot of regression lines depicting the interactive effects between AIDS-related stigma, race, and prior contact with gay men and lesbians on aggression toward gay men and lesbians when controlling for attitudes toward lesbians. N = 194.

In sum, these results suggest that self-identified White men reporting prior contact with gay men and lesbians who endorsed more AIDS-related stigma also reported more aggression toward gay men and lesbians. As with the primary analyses, this was not the case for the other groups. However, there was a trend suggesting that self-identified Black men reporting prior contact with gay men and lesbians who reported higher AIDS-related stigma also reported more aggression toward gay men and lesbians. Nonetheless, as shown in Figures 1 through 3, the pattern of effects for the association between AIDS-related stigma and aggression toward gay men and lesbians is consistent across primary and posthoc analyses, with the steepest slope among White men with no prior contact with gay men and lesbians, the flattest slope (i.e., most practically nonsignificant) among White men with prior contact, and a mildly positive slop among Black men with and without prior contact. The three-way interaction was significant (b = .295, SE = .12, rpartial = .17, p = .018). None of the interaction terms that included ATG or ATL were significant.

Other findings.

Tables 2–4 show that, as covariates, SP, ATG, ATL in steps 1 and 2 are all statistically significant for the analyses conducted with the present sample. Higher scores on all three of these forms of SP were associated with higher scores on aggression toward gay men and lesbians when controlling for all other variables in the models in the present sample. The associations between ATL (rpartials = .17, .21) and aggression toward gay men and lesbians was small to medium, whereas the associations for SP (rpartial = .31 for both steps) and ATG (rpartials = .37, .40) were medium to large. There was a small association between race and aggression toward gay men and lesbians that was marginally significant when controlling for SP (b = −.03, SE = .02, rpartial = −.14, p = .051) and significant when controlling for ATG (b = −.03, SE = −.16, rpartial = −.16, p = .026), but not when controlling for ATL (b = −.02, SE = .02, rpartial = −.08, p = .267). This suggests that the White men who comprised the reference group in this model may have been more likely to engage in aggression toward gay men and lesbians than Black men when accounting for SP and ATG, but not when accounting for their ATL for the present sample.

Discussion

To our knowledge, this is the first study to empirically test whether AIDS-related stigma is uniquely associated with heterosexual men’s aggression, including physical aggression, toward gay men and lesbians. In the sample as a whole, AIDS-related stigma was associated with aggression toward gay men and lesbians even when controlling for SP. Stigma associated with HIV/AIDS may be directly related to adverse consequences, even victimization in the form of physical aggression, among groups that are stigmatized by this medical condition. The present study suggests that this may be the case for gay men and lesbians (CDC, 2006).

The present study also suggests that intergroup contact (Allport, 1954; Dovidio et al., 2011) nullifies the association between AIDS-related stigma and aggression toward gay men and lesbians. Specifically, AIDS-related stigma was significantly associated with aggression toward gay men and lesbians among White men with no prior contact with gay men and lesbians, but not among White men who had prior contact with gay men and lesbians and Black men with or without prior contact. These results are consistent with pertinent theory (e.g., intergroup contact; Dovidio et al., 2011; social categorization; Bodenhausen et al., 2012; interpersonal threats and automatic motives; Park & Buunk, 2011). Specifically, intergroup contact theory suggests that prior contact with gay men or lesbians would diminish the association between AIDS-related stigma and aggression toward gay men and lesbians, who may be perceived as HIV-positive or somehow associated with AIDS (e.g., Herek, 1997; Herek, Widaman, & Capitanio, 2005). As noted previously, Blacks are disproportionately affected by HIV and AIDS, and, thus, may have a greater awareness about persons, whether heterosexual or not, at high risk of HIV/AIDS (e.g., Herek & Capitanio, 1997). As such, AIDS-related stigma may not be as strongly associated with gay men and lesbians among Black heterosexuals as among White heterosexuals. Overall, the results suggest that, to the extent that AIDS-related stigma is linked to prejudice-based aggression toward groups stigmatized by HIV/AIDS, intergroup contact may mitigate this association.

Whether controlling for ATG and ATL collectively or respectively, these covariates were significant in the model even though their interactions were not significant. The significant associations between all three, respective forms of SP and aggression toward gay men and lesbians indicated that higher scores on these covariates were linked to reports of more frequent prejudice-based aggression in this study, regardless of the gender of the actual target of SP. Although ATG and ATL should be analyzed separately (Worthen, 2013), the present study shows the value of analyzing these variables together to determine the extent to which target characteristics (e.g., gender of the gay person) matters in the specific model. Further, SP showed relatively robust associations, suggesting that, although its associations may not be moderated in the present analyses, SP may be mediated by other factors (e.g., antigay anger; Parrott & Peterson, 2008). In contrast, the link between AIDS-related stigma and aggression toward gay men and lesbians appears to be strengthened in some instances and weakened in others, such as when prior contact is reported. Additionally, the nonsignificant interactions may have been due, in part, to both the relatively small sample size as well as the effects sizes that were less than small (i.e., rpartial < .01).

Results indicated that, to a small degree, White men were more likely to report aggression toward gay men and lesbians when controlling for SP and ATG, but not ATL. This finding indicates that ATL contributes to this difference, and that the difference is lessened when the variance in aggression toward gay men and lesbians, due to SP directed at lesbians, is held constant. Although Black men scored higher than White men in SP, ATG, and ATL, these mean differences may not be responsible for differences in association with aggression toward gay men and lesbians in the regression models when accounting for all other variables. It is possible that ATL among White men in the present sample more likely contributes to aggression toward gay men and lesbians than ATL among Black men. Also, Black men reporting prior contact with gay men and lesbians showed a trend toward reporting more frequent aggression toward gay men and lesbians if they also reported greater AIDS-related stigma, when accounting for ATL. This finding appears to contradict intergroup contact theory (Allport, 2014; Dovidio et al., 2011). This outcome may be clarified with modified replication studies in which prior contact and aggression toward gay men and lesbians, respectively, are disaggregated. Additional research is needed, as these novel results lack sufficient examples in the literature on which to draw conclusions.

Most of the aggression perpetrated by heterosexual men in the present sample involved verbal behaviors. This is not considered a limitation by any means, as the effects of stigma enacted toward gay men and lesbians are detrimental regardless of the form in which it is delivered. For example, among lesbian, gay, and bisexual youth, experiences of both verbal and physical abuse are associated with substance abuse, difficulties at school, running away, prostitution, and suicide (Savin-Williams, 1994). Meyer’s (2003) model of minority stress posits that stigma enacted by heterosexuals and experienced by gay men and lesbians, whether verbal or physical, is associated with both debilitating psychological and physiological consequences on sexual-minority health. Further, gay men and lesbians’ awareness that stigma is enacted toward their group and, as a result, that they can be the target of prejudice-based violence is associated with psychological distress even if they have not been victimized (Herek & Garnets, 2007; Herek, Gillis, & Cogan, 2009). Collectively, these data show that enacted stigma, whether verbal or physical, has deleterious effects on gay and lesbian health (Herek, Gillis, & Cogan, 2009; Meyer, 2003).

Limitations

Although the present findings advance our understanding of the outcomes of AIDS-related stigma, there are several caveats regarding the study’s conclusions. First, the correlational, cross-sectional design of the study cannot determine causal and temporal relations among the variables. As such, any definitive, causal explanations regarding the associations between the variables examined in this study cannot be made. Similarly, the lack of probability sampling limits the generalizability of these results. Second, SP and aggression were assessed in response to gay men and lesbians, collectively. Thus, it is possible that AIDS-related stigma may be differentially associated with aggression toward gay men versus aggression toward lesbians. This could not be determined from our data, as the established measure of aggression toward gay men and lesbians does not distinguish between male and female targets. However, we did control separately for SP, ATG, and ATL, and the pattern of results was the same for all three.

Third, the majority of participants and Black and White men, respectively, reported having had prior contact with a gay man or lesbian, indicating that the dataset was unbalanced with respect to prior contact. Although the cell size representing White men with no prior contact was the smallest (n = 11), it yielded the largest effect size for the association between AIDS-related stigma and aggression (b = .29, SE = .08, rpartial = .27, p < .0005) toward gay men and lesbians than any other cell (rpartial values less than .10). The results robust findings showing a stronger, positive association between AIDS-related stigma and aggression toward gay men or lesbians among White men with no prior contact with gay men or lesbians compared to White men who did report prior contact are theoretically consistent with existing literature (e.g., Allport, 1954; Dovidio, Eller, & Hewstone, 2011). Prior contact appeared to attenuate the association with prejudice-based aggression. Further, the percentages of people who reported having had prior contact versus no prior contact with gay men or lesbians are consistent with a CBS national probability poll conducted in the last few years showing that the majority of Americans, 77%, reported that they knew a gay man or lesbian (Montopoli, 2010). Future studies should purposefully oversample people who report no prior contact with gay men or lesbians, although the feasibility of such an approach may be challenging in regions in which there are relatively large numbers of openly gay people.

In addition, we did not include women as perpetrators in these analyses, as they report lower levels of SP and frequency of antigay or –lesbian aggression (Baker & Fishbein, 1998; Lim, 2002; Polimeni, Hardie, & Buzwell, 2000; Whitley & Kite, 1995). However, this is certainly a limitation of the study. Women may engage in forms of aggression that were not captured in the current design, and future studies should provide more of a focus on women’s expressions of intergroup aggression. Also, the sample was generally small given the number of variables tested (e.g., interaction terms including a four-way interactions with SP, ATG, and ATL, respectively), and these results could be significant given a larger, more highly powered sample. However, given the present sample size, these smaller effects were deemed statistically non-significant in our model. We noted the effect sizes in our results, which limits an exclusive focus on sample-size dependent p-values. Further, all data were collected in the southeastern United States. Attitudes toward gay people in the South are generally more negative than attitudes in other regions, such as the Northeast, of the United States (Pew Research Center, 2003; Tilcsik, 2011). Replication of this study in other regions or with other populations could yield different results. Additionally, this study examined gay men and lesbians as targets of prejudice and aggression, but not transgender persons, bisexuals, and other stigmatized sexual or gender identities. Further study of these populations is needed.

Finally, with respect to the measures used in this study, all measures were based on self-report, which is vulnerable to recall bias and social desirability. Unfortunately, like this study, prior survey-based studies have not used measures of social desirability (e.g., Herek & Capitanio, 1993; Herek et al., 2005; Parrott et al., 2011). Future studies may need to use different paradigms of studying aggression (e.g., laboratory-based experiments in which aggression or its analogs are directly observed). Further, although we used a simple, one-item measure to assess prior contact, future research may improve upon this approach with the use of a broader prior contact scale to collect more nuanced data about intergroup contact with gay men and lesbians. For instance, relationship type may be assessed as well as the quantity and quality of intergroup contact.

Implications

Overall, the findings of the present study have implications for the design and implementation of interventions to reduce AIDS-related stigma and intergroup aggression. Specifically, intergroup contact theory (Allport, 1954; Dovidio, Eller, & Hewstone, 2011) is useful to better understand stigma toward persons living with or affected by HIV/AIDS. Vincent, Parrott, and Peterson (2014) reviewed a number of interventions that are based on intergroup contact theory and extensions of this theory (e.g., imagined or vicarious contact via media such as books or public service announcements) to reduce SP, stigma, and related, negative behavioral responses (e.g., aggression). Such interventions can be extended to AIDS-related stigma. For example, public service announcements or other types of interventions can incorporate stories or scenes of positive, intergroup contact between heterosexual and gay people. Such intervention studies could be extended to other groups perceived to be living with HIV or AIDS. Further, as noted in prior literature (Dovidio et al., 2011; Pettigrew & Tropp, 2006; Smith et al, 2009; Vincent et al., 2014), interventions based on intergroup contact need not involve actual contact with gay men and lesbians (or persons living with HIV/AIDS); this contact can be imagined or visualized.

Additionally, this study has implications for existing theories of aggression. For example, the Generalized Aggression Model (GAM; Anderson & Bushman, 2002; DeWall, Anderson, & Bushman, 2011) posits that inputs, which include individual (e.g., attitudes; gender of perpetrator) and situational factors (e.g., perceived provocation; frustration), facilitate aggression through three distinct but interrelated routes: cognition (i.e., hostile thoughts), affect (i.e., angry feelings), and arousal (i.e., heightened physiological arousal) routes. These internal processes inform appraisal and decision making processes that may result in an aggressive or non-aggressive action. Although the GAM has been used to explain intergroup aggression (DeWall et al., 2011), the present study suggests that a greater focus on how prospective perpetrators categorize and make attributions about prospective targets is needed (social categorization theory; e.g., Bodenhausen et al., 2012).

Specifically, although gay men are typically associated with HIV disease, lesbians (Marrazzo & Gorgos, 2012) also have been perceived as linked to HIV/AIDS (e.g., Herek, Capitanio, & Widaman, 2002; Wright, Mulick, & Kincaid, 2007). For example, attitudinal factors such as “legitimizing myths” (social dominance theory; Sidanius & Pratto, 2012) about HIV and AIDS that may be implicitly or explicitly used to justify hostility toward gay men should not be associated with aggression toward lesbians. However, this association would be counterintuitive, but is reflected by the consistent associations between AIDS-related stigma and aggression toward gay men and lesbians in this study even when controlling for SP, ATG, and ATL, respectively. Although this study did not disaggregate aggression toward lesbians, specifically, the counterintuitive results of this study are nonetheless interesting. It may be that, when (1) gay men and lesbians are collectively categorized as a homosexual group or (2) when lesbians are categorized in a manner that is not sexualized or heteronormative, legitimizing myths about gay men may apply to lesbians. This recalls the maxim, “Guilty by association.” Clearly, further study is needed to determine the veracity of these tentative conclusions. However, implicit categorizations that have little basis in either objective or social reality might play a more important role in aggressive behavior between groups in society than previously emphasized.

In addition, AIDS-related stigma was shown to be less strongly associated with aggression toward gay men and lesbians among Black men, as compared to White men who reported no prior contact, perhaps due to the disproportionate impact of HIV/AIDS on Blacks. As such, interventions based on intergroup contact theory to reduce AIDS-related stigma and its sequelae (e.g., anti-sexual-minority violence) should be tailored to specific, social groups for whom the enactment of AIDS-related stigma might be an issue for different reasons.

Finally, more research is needed on the assessment of AIDS-related stigma by heterosexual individuals. Indeed, Parker and Aggleton (2003) discussed the inconsistent and sometimes poor understanding of assessment of stigma associated with HIV/AIDS in the literature. Moreover, the present results suggest how AIDS-related stigma may vary based on increased contact with gay men or lesbians in the White heterosexual male population. Phenomena that occur at the cultural/societal or population level, such as the disproportionate impact of HIV/AIDS on different racial/ethnic groups, may alter fundamental beliefs about HIV/AIDS and associated stigma and influence patterns of intergroup aggression.

In conclusion, this study adds to prior research on the impact of the AIDS-epidemic on stigma by showing that AIDS-related stigma is significantly correlated with aggression toward gay men and lesbians when controlling for SP, a robust predictor of this type of prejudice-based aggression. Also, this study is the first to show how contact with gay men and lesbians may mitigate the enactment of AIDS-related stigma among some segments of the male heterosexual population. As the fight against HIV and AIDS rages on, it may be essential to address the link between AIDS-related stigma and violence in pertinent heterosexual populations.

Acknowledgments

This research was supported by grant R01-AA-015445 from the National Institute of Alcohol Abuse and Alcoholism.

Footnotes

Author Note

The informed consent process was explained to all subjects, and each participant provided informed consent. The study protocol was approved by the Institutional Review Board for ethical human research of Georgia State University. This study was conducted in accordance with the Ethical Standards for Research and Publication of the American Psychological Association. The authors of this manuscript have no financial conflicts of interest to report regarding the research presented in this manuscript.

Reference

  1. Aiken LS, & West SG (1991). Multiple regression: Testing and interpreting interactions Newbury Park, CA: Sage. [Google Scholar]
  2. Allport GW (1954). The nature of prejudice Reading, MA: Addison Wesley. [Google Scholar]
  3. Anderson CA, & Bushman BJ (2002). Human aggression. Annual Review of Psychology, 53, 27–51. [DOI] [PubMed] [Google Scholar]
  4. Baker JG, & Fishbein HD (1998). The development of prejudice toward gays and lesbians by adolescents. Journal of Homosexuality, 36, 89–100. doi: 10.1300/J082v36n01_06 [DOI] [PubMed] [Google Scholar]
  5. Bernat JA, Calhoun KS, Adams HE, & Zeichner A (2001). Homophobia and physical aggression toward homosexual and heterosexual individuals. Journal of Abnormal Psychology, 110, 179–187. doi: 10.1037/0021-843X.110.1.179 [DOI] [PubMed] [Google Scholar]
  6. Bodenhausen GV, Kang SK, & Peery D (2012). Social categorization and the perception of social groups. In Fiske ST & MacRae CN (Eds.), The Sage Handbook of Social Cognition (pp. 318–336). Thousand Oaks, CA: SAGE Publications, Inc. [Google Scholar]
  7. Centers for Disease Control and Prevention (2011a, February 4). HIV surveillance -- United States, 1981–2008. Morbidity and Mortality Weekly Report, 35, 655–658. Retrieved from http://origin.glb.cdc.gov/mmwr/pdf/wk/mm6021.pdf [Google Scholar]
  8. Centers for Disease Control and Prevention (2011b, June 3). Disparities in diagnosis of HIV infection between Blacks/African Americans and other racial/ethnic populations – 37 states, 2005–2008. Morbidity and Mortality Weekly Report, 60, 689–693. Retrieved from http://www.cdc.gov/mmwr/pdf/wk/mm6004.pdf [PubMed] [Google Scholar]
  9. Centers for Disease Control and Prevention. (2012). HIV Surveillance Report, 2010 (Vol. 22). Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/hiv/surveillance/resources/reports/2010report/pdf/2010_HIV_Surveillance_Report_vol_22.pdf [Google Scholar]
  10. Centers for Disease Control and Prevention (2013, July 1). HIV among gay and bisexual men Retrieved from http://www.cdc.gov/hiv/risk/gender/msm/facts/index.html#refa [Google Scholar]
  11. Cohen J A power primer. Psychological Bulletin, 112, 155–159. [DOI] [PubMed] [Google Scholar]
  12. Cohen J, Cohen P, West SG, & Aiken LS (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Lawrence Earlbaum Associates: Mahwah, NJ. [Google Scholar]
  13. Collier KL, Bos HMW, & Sandfort TGM (2012). Intergroup contact, attitudes toward homosexuality, and the role of acceptance of gender non-conformity in young adolescents. Journal of Adolescence, 35, 899–907. doi: 10.1016/j.adolescence.2011.12.010 [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Costa-Lopes R, Dovidio JF, Pereira CR, & Jost JT (2013). Social psychological perspectives on the legitimation of social inequality: Past, present and future. European Journal of Social Psychology, 43, 229–237. doi: 10.1002/ejsp.1966 [DOI] [Google Scholar]
  15. Crawford JT, Inbar Y, & Maloney V (2014). Disgust sensitivity selectively predicts attitudes toward groups that threat (or uphold) traditional sexual morality. Personality and Individual Differences, 70, 218–223. doi: 10.1016/j.paid.2014.07.001 [DOI] [Google Scholar]
  16. DeWall CN, Anderson CA, & Bushman BJ (2011). The General Aggression Model: Theoretical extentions to violence. Psychology of Violence, 1, 245–258. doi: 10.1037/a0023842 [DOI] [Google Scholar]
  17. Dovidio JF, Eller A, & Hewstone M (2011). Improving intergroup relations through direct, extended, and other forms of indirect contact. Group Processes & Intergroup Relations, 13, 147–160. doi: 10.1177/1368430210390555 [DOI] [Google Scholar]
  18. Field A (2005). Discovering statistics using SPSS SAGE Publications, Inc.: Thousand Oaks, CA. [Google Scholar]
  19. Franklin K (2000). Antigay behaviors among young adults. Journal of Interpersonal Violence, 15, 339–362. doi: 10.1177/088626000015004001 [DOI] [Google Scholar]
  20. Gerbert B, Sumser J, & Maguire BT (1991). The impact of who you know and where you live on opinions about aids and health care. Social Science & Medicine, 32, 677–681. doi: 10.1016/0277-9536(91)90146- [DOI] [PubMed] [Google Scholar]
  21. Goffman E (1963). Stigma: Notes on the management of spoiled identity New York: Simon and Shuster. [Google Scholar]
  22. Harry J (1990). Conceptualizing antigay violence. Journal of Interpersonal Violence, 5, 350–358. [Google Scholar]
  23. Hardy AM, & Biddlecom AE (1991). AIDS knowledge and attitudes of Black Americans: United States, 1990. Advance Data from Vital and Health Statistics, 206, 1–24. Retrieved from http://stacks.cdc.gov/view/cdc/5519/ [PubMed] [Google Scholar]
  24. Herek GM (1988). Heterosexuals’ attitudes toward lesbians and gay men: Correlates and gender differences. Journal of Sex Research, 25, 451–477. doi: 10.1080/00224498809551476 [DOI] [Google Scholar]
  25. Herek GM (1997). The HIV epidemic and public attitudes toward lesbians and gay men. In Levine MP, Nardi P, & Gagnon J (Eds.) In changing times: Gay men and lesbians encounter HIV/AIDS (pp. 191–218). Chicago: University of Chicago Press. [Google Scholar]
  26. Herek GM (2009a). Hate crimes and stigma-related experiences among sexual minority adults in the United States: Prevalence estimates from a national probability sample. Journal of Interpersonal Violence, 24, 54–74. doi: 10.1177/0886260508316477 [DOI] [PubMed] [Google Scholar]
  27. Herek GM (2009b). Sexual stigma and sexual prejudice in the United States: A conceptual framework. In Contemporary perspectives on lesbian, gay, and bisexual identities (pp. 65–111). Springer New York. doi: 10.1007/978-0-387-09556-1_4 [DOI] [PubMed] [Google Scholar]
  28. Herek GM, & Capitanio JP (1993). Public reactions to AIDS in the United States: A second decade of stigma. American Journal of Public Health, 83, 574–577. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1694493/ [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Herek GM, & Capitanio JP (1997). AIDS stigma and contact with persons with AIDS: Effects of direct and vicarious contact. Journal of Applied Social Psychology, 27, 1–36. doi: 10.1111/j.1559-1816.1997.tb00621.x [DOI] [Google Scholar]
  30. Herek GM, & Capitanio JP (1999). AIDS stigma and sexual prejudice. American Behavioral Scientist, 42, 1126–1143. doi: 10.1177/0002764299042007006 [DOI] [Google Scholar]
  31. Herek GM, Capitanio JP, & Widaman KF (2002). HIV-related stigma and knowledge in the United States: Prevalence and trends, 1991–1999. American Journal of Public Health, 92, 371–377. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11867313 [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Herek GM, & Garnets LD (2007). Sexual orientation and mental health. Annual Review of Clinical Psychology, 3, 353–375. doi: 10.1146/annurev.clinpsy.3.022806.091510 [DOI] [PubMed] [Google Scholar]
  33. Herek GM, Gillis JR, & Cogan JC (2009). Internalized stigma among sexual minority adults: Insights from a social psychological perspective. Journal of Counseling Psychology, 56, 32–43. doi: 10.1037/a0014672 [DOI] [Google Scholar]
  34. Herek GM, & Glunt EK (1988). An epidemic of stigma: Public reactions to AIDS. American Psychologist, 43, 886–891. doi: 10.1037/0003-066X.43.11.886 [DOI] [PubMed] [Google Scholar]
  35. Herek GM, & McLemore KA (2013). Sexual prejudice. Annual Review of Psychology, 64. doi: 10.1146/annurev-psych-113011-143826 [DOI] [PubMed] [Google Scholar]
  36. Herek GM, Mitnick L, Burris S, Chesney M, Devine P, Fullilove MT, Fullilove R, Gunther H, C., Levi J, Michaels S, Novick A, Pryor J, Snyder M, & Sweeney T (1998). AIDS and stigma: A conceptual framework and research agenda. AIDS and Public Policy Journal, 13(1), 36–47. [PubMed] [Google Scholar]
  37. Herek GM, Saha S, & Burack J (2013). Stigma and psychological distress in people with HIV/AIDS. Basic and Applied Social Psychology, 35, 41–54. doi: 10.1080/01973533.2012.746606 [DOI] [Google Scholar]
  38. Herek GM, Widaman KF, & Capitanio JP (2005). When sex equals AIDS: Symbolic stigma and heterosexual adults’ inaccurate beliefs about sexual transmission of AIDS. Social Problems, 52, 15–37. doi: 10.1525/sp.2005.52.1.15 [DOI] [Google Scholar]
  39. Jarvis BG (2006). MediaLab (Version 2006.1.41) [Computer Software] New York, NY: Empirisoft Corporation. [Google Scholar]
  40. Jost J (2011). System justification theory as compliment, complement, and corrective to theories of social identification and social dominance. In Dunning D (Ed.), Social Motivation New York: Taylor & Francis Group. [Google Scholar]
  41. Kinsey AC, Pomeroy WB, & Martin CE (1948). Sexual behavior in the human male Philadelphia, PA: W.B. Saunders. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Lee RS, Kochman A, & Sikkema KJ (2002). Internalized stigma among people living with HIV-AIDS. AIDS and Behavior, 6(4), 309–319. doi: 10.1023/A:1021144511957 [DOI] [Google Scholar]
  43. Lim VK (2002). Gender differences and attitudes towards homosexuality. Journal of Homosexuality, 43, 85–97. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12521244 [DOI] [PubMed] [Google Scholar]
  44. Marrazzo JM, & Gorgos LM (2012). Emerging sexual health issues among women who have sex with women. Current Infectious Disease Reports, 14, 204–2011. doi 10.1007/s11908-012-0244-x [DOI] [PubMed] [Google Scholar]
  45. Meyer IH (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697. doi: 10.1037/0033-2909.129.5.674 [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Montopoli B (2010, June 9). Poll: With higher visibility, less disapproval for gays. CBS News Retrieved from http://www.cbsnews.com/news/poll-with-higher-visibility-less-disapproval-for-gays/ [Google Scholar]
  47. Nardi PM, & Bolton R (1991). Gay-bashing: Violence and aggression against gay men and lesbians. In Baenninger R (Ed.) Targets of violence and aggression (pp. 349–400). New York: Elsevier. [Google Scholar]
  48. National Coalition of Anti-Violence Programs (2009). Hate Violence against Lesbian, Gay, Bisexual, and Transgender People in the United States: 2008 New York: NCAVP. [Google Scholar]
  49. Neufeld SAS, Sikkema KJ, Lee RS, Kochman A, & Hansen NB (2012). The Development and Psychometric Properties of the HIV and Abuse Related Shame Inventory (HARSI). AIDS and Behavior, 16, 1063–1074. doi: 10.1007/s10461-011-0086-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Park JH, & Buunk AP (2011). Interpersonal threat and automatic motives. In Dunning D (Ed.), Social Motivation New York: Taylor & Francis Group. [Google Scholar]
  51. Parker R, & Aggleton P (2003). HIV and AIDS-related stigma and discrimination: A conceptual framework and implications for action. Social Science & Medicine, 57, 13–24. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12753813 [DOI] [PubMed] [Google Scholar]
  52. Parrott DJ, & Peterson JL (2008). What motivates hate crimes based on sexual orientation?: Mediating effects of anger on antigay aggression. Aggressive Behavior, 34, 306–318. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18161792 [DOI] [PubMed] [Google Scholar]
  53. Parrott DJ, Peterson JL, & Bakeman R (2011). Determinants of aggression toward sexual minorities in a community sample. Psychology of Violence, 1, 41–52. doi: 10.1037/a0021581 [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Parrott DJ, & Zeichner A (2005). Effects of sexual prejudice and anger on physical aggression toward gay and heterosexual men. Psychology of Men and Masculinity, 6, 3–17. doi: 10.1037/1524-9220.6.1.3 [DOI] [Google Scholar]
  55. Parrott DJ, Zeichner A, & Hoover R (2006). Sexual prejudice and anger network activation: The mediating role of negative affect. Aggressive Behavior, 32, 7–16. doi: 10.1002/ab.20101 [DOI] [Google Scholar]
  56. Patel S, Long TE, McCammon SL, & Wuensch KL (1995). Personality and emotional correlates of self-reported antigay behaviors. Journal of Interpersonal Violence, 10, 354–366. doi: 10.1177/088626095010003008 [DOI] [Google Scholar]
  57. Persons E, Kershaw T, Sikkema KJ, & Hansen NB (2010). The impact of shame on health-related quality of life among HIV-positive adults with a history of childhood sexual abuse. AIDS Patient Care and STDs, 24, 571–580. doi: 10.1089/apc.2009.0209 [DOI] [PMC free article] [PubMed] [Google Scholar]
  58. Pettigrew TF, & Tropp LR (2006). A meta-analytic test of intergroup contact theory. Journal of Personal and Social Psychology, 90, 751–783. Retrieved from http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=2006-07099-004 [DOI] [PubMed] [Google Scholar]
  59. Pew Research Center. (2003). Religious beliefs underpin opposition to homosexuality Retrieved from http://www.people-press.org/report/197/religious-beliefs-underpin-opposition-to-homosexuality
  60. Polimeni A, Hardie E, & Buzwell S (2000). Homophobia among Australian heterosexuals: The role of sex, gender role ideology, and gender role traits. Current Research in Social Psychology, 5, 47–62. Retrieved from http://psycnet.apa.org/index.cfm?fa=search.displayRecord&UID=2001-03129-001 [Google Scholar]
  61. Pryor JB, Reeder GD, Landau S, (1999). A social-psychological analysis of HIV-related stigma: A two-factor theory. American Behavioral Scientist, 42, 1193–1211. doi: 10.1177/0002764299042007010 [DOI] [Google Scholar]
  62. Pryor JB, Reeder GD, & Monroe AE (2012). The infection of bad company: Stigma by association. Journal of Personality and Social Psychology, 102, 224–241. [DOI] [PubMed] [Google Scholar]
  63. Pryor JB, Reeder GD, Vinacco R, & Kott TL (1989). The instrumental and symbolic functions of attitudes toward persons with AIDS. Journal of Applied Social Psychology, 19, 377–404. doi: 10.1111/j.1559-1816.1989.tb00062.x [DOI] [Google Scholar]
  64. Roderick T, McCammon SL, Long TE, & Allred LJ (1998). Behavioral aspects of homonegativity. Journal of Homosexuality, 36, 79–88. doi: 10.1300/J082v36n01_05 [DOI] [PubMed] [Google Scholar]
  65. Savin-Williams RC (1994). Verbal and physical abuse as stressors in the lives of lesbian, gay male, and bisexual youths: Associations with school problems, running away, substance abuse, prostitution, and suicide. Journal of Consulting and Clinical Psychology, 62, 261–269. doi: 10.1037/0022-006X.62.2.261‎ [DOI] [PubMed] [Google Scholar]
  66. Savin-Williams RC (2006). Who’s gay? Does it matter? Psychological Science, 15, 40–44. doi: 10.1111/j.0963-7214.2006.00403.x [DOI] [Google Scholar]
  67. Sidanius J, & Pratto F (2012). Social dominance theory. In Van Lange PAM, Kruglanski AW, & Higgins ET (Eds.), Handbook of Theories of Social Psychology (1st ed., Vol. 2, pp. 418–438). Thousand Oaks, CA: SAGE Publications, Inc. [Google Scholar]
  68. Siebert DC, Chonody J, Siebert CF, & Rutledge SE (2014). The importance of confirmatory validation: Short version of the Attitudes Toward Lesbians and Gay Men Scale. Journal of the Society for Social Work and Research, 5, 189–210. [Google Scholar]
  69. Smith SJ, Axelton AM, & Saucier DA (2009). The effects of contact on sexual prejudice: A meta-analysis. Sex Roles, 61, 178–191. doi: 10.1007/s11199-009-9627-3 [DOI] [Google Scholar]
  70. Tilcsik A (2011). Pride and prejudice: Employment discrimination against openly gay men in the United States. American Journal of Sociology, 117, 586–626. doi: 10.1086/661653 [DOI] [PubMed] [Google Scholar]
  71. Vincent W, Parrott DJ, & Peterson JL (2011). Effects of traditional gender role norms and religious fundamentalism on self-identified heterosexual men’s attitudes, anger, and aggression toward gay men and lesbians. Psychology of Men and Masculinity, 12, 383–400. doi: 10.1037/a0023807 [DOI] [PMC free article] [PubMed] [Google Scholar]
  72. Vincent W, Parrott DJ, & Peterson JL (2014). Sexual prejudice. In Bloom M and Gullotta T (Eds), Encyclopedia of Primary Prevention and Health Promotion (2nd Ed), New York: Springer. [Google Scholar]
  73. Waldner LK, Sikka A, & Baig S (1999). Ethnicity and sex differences in university students’ knowledge of AIDS, fear of AIDS, and homophobia. Journal of Homosexuality, 37, 117–133. doi: 10.1300/J082v37n03_07 [DOI] [PubMed] [Google Scholar]
  74. Whitley BE, & Kite ME (1995). Sex differences in attitudes toward homosexuality: A comment on Oliver and Hyde (1993). Psychological Bulletin, 117, 146–154. doi: 10.1177/0146167296224002 [DOI] [PubMed] [Google Scholar]
  75. Worthen MGF (2013). An argument for separate analyses of attitudes toward lesbian, gay bisexual men, bisexual women, MtF and FtM transgender individuals. Sex Roles, 68, 703–723. doi: 10.1007/s11199-012-0155-1 [DOI] [Google Scholar]
  76. Wright LW, Mulick PS, & Kincaid SB (2007). Fear of and discrimination against bisexuals, homosexuals, and individuals with AIDS. Journal of Bisexuality, 6, 71–84. doi: 10.1300/J159v06n04_06 [DOI] [Google Scholar]

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