Barriers to the right to HIV prevention health care for men who have sex with men (MSM) in Barbados: an examination of anti-gay prejudice

Abstract

Purpose A consensus in the literature is that anti-gay prejudice has a negative impact on HIV programming for men who have sex with men (MSM). This paper aims to analyse the prevalence and predictors of anti-gay prejudice in Barbados, an island in the Caribbean, and possible impacts on the full recognition of the right to health care. Design/methodology/approach The study used nationally representative data obtained from the Caribbean Development Research Services capturing anti-gay prejudice in Barbados in 2004, 2013 and 2019. The data were analysed using logit models and ordinary least squares regression. Findings The share of persons who expressed feelings of hatred towards gays and lesbians did not change significantly over the period. Social distance attitudes improved between 2004 and 2013 but have not changed since. Men generally expressed more prejudice than women and male sexual prejudice could be localised to three groups – men without tertiary education, men under 51 and members of non-Christian religions. Meanwhile, there was little consistency in the predictors of women’s attitudes over the period. Originality/value This study provides insights into the trends in attitudes towards sexual minorities in a developing country. The main conclusion is that although health care is provided as a universal right to all Barbadians, a strictly medical approach to HIV prevention among MSM in countries with high levels of anti-gay prejudice is insufficient.