A study by Monash Business School has found that Australian gay, bi-sexual and other men who have sex with men (GBM) living in areas who had a high ‘no’ vote in 2017 marriage equality plebiscite have poorer sexual health outcomes than those living in high ‘yes’ vote areas.  

Using demographic data from the 2017 Australian Marriage Law Postal survey and responses to behavioural surveys, researchers mapped the attitudes on marriage equality and determined the levels of social stigma related towards the LGBTQI community across Australian electorates.  

Researchers found Australian GBM living in regions with high levels of anti-LGBTQI stigma and strong opposition to marriage equality, were less likely to seek out HIV/STI testing and receive diagnoses for HIV and STIs. They were also less likely to be taking or aware of crucial bio-medical prevention strategies such as PrEP (pre-exposure prophylaxis).  

According to the study, gay or bisexual men living in an area with the highest reported levels of opposition to marriage equality were 7% less likely to have used PrEP (a preventative medicine people at risk of HIV). HIV-positive men in these areas were also 8% less likely to be on antiretroviral therapy (ART) than someone living in an area with less opposition to marriage equality.  

“This is the first study to provide empirical evidence that structural stigma is associated with reduced use and awareness of HIV-related healthcare among this group,” said Karinna Saxby, lead researcher from the Monash Business School’s Centre for Health Economics.  

She indicated that the study highlighted “the ongoing need to reduce the stigma of sexual minorities”. 

“While health care providers can play a role to promote acceptance of sexuality and gender diverse populations, there may also be scope for more innovative and flexible service models for men living in high stigma regions, such as at-home HIV/STI testing. To reach its goal of eliminating HIV transmission, Australia must improve its uptake of testing and HIV treatment among gay and bisexual men, particularly in high-stigma areas.” 

The study also found that GBM who lived in ‘no’ voting areas had increased barriers to accessing healthcare, with fewer LGBTQI healthcare services and medical practitioners per person than ‘yes’ voting areas.