Basic demographic data are presented in from participants with valid IH data. These data from 38 countries illustrate the ns for each country (ranging from 88 in Macedonia to over 45 000 in Germany), median age (ranging from 24 in Moldova to 36 in Switzerland and the UK), per cent reporting living in a city >500 000 population (ranging from 1.1% in Malta to 87.9% in Turkey), per cent with tertiary education (ranging from 31.2% in Austria to 84.6% in Turkey), per cent employed (ranging from 54.8% in Serbia to 85.0% in Malta) and per cent now in a relationship with another man (ranging from 22.0% in Bosnia-Herzegovina to 53.5%). IH scores ranged from 1.22 in the Netherlands and 1.23 in Sweden to 2.58 in Bulgaria and 2.56 in Bosnia-Herzegovina.
Data from the 38 countries clustered into three groups using (1) measures of legal climate supporting LGB rights, (2) proportion experiencing verbal discrimination and (3) physical violence because of assumed homosexuality. The three clusters of countries () characterised a group of ‘liberal’ Scandinavian countries (Denmark, Finland, Norway, Sweden) and Western European countries (Belgium, Ireland, the Netherlands, the UK and Spain); a group of ‘moderate’ Central and Mediterranean countries (France, Portugal, Germany, the Czech Republic, Switzerland, Italy, Austria, Slovenia, Hungary, Croatia, Bosnia-Herzegovina, Romania, Macedonia, Greece, Turkey and Estonia) and a group of ‘conservative’ Southeastern, Northeastern and Eastern European countries (Poland, Slovakia, Belarus, Lithuania, Latvia, Russia, Ukraine, Moldova, Bulgaria and Cyprus), countries characterised by the highest levels of discrimination (note that IH was not part of the equation for this clustering process). Clustering countries on the basis of legal and self-reported personal discrimination against MSM provided both a potential validation of the measure of IH and a means of conceptualising geographic subsets of levels of discrimination (). IH was closely related to the three discrimination-based clusters, with the highest IH in the ‘conservative’ countries and the lowest IH in the ‘liberal’ cluster of countries.
Using the measures of LGB legal climate (the strongest predictor), the Gini coefficient and the size of place of residence all predicted IH (, and ). IH, in turn, was associated with outness and age. The HIV-associated behaviour most closely associated with IH were (1) ever being tested for HIV (mediated by outness) and (2) a perception of having no control over sexual risk-taking. Sexual diversity had a smaller impact. HIV testing was predicted, following outness as the major component, by the proportion of gay friends, highest educational attainment and age.
A second linear regression limited to the demographics, HIV testing, ‘outness’ and perceived control over sexual risk-taking onto IH indicated that those most closely associated with IH were lack of control over sexual risk-taking and not being tested for HIV.
Bivariate relationships between IH and country cluster, Gini coefficient septiles and LGB legal climate () show a relationship between these variables and IH. Sexual diversity illustrates () an increase in sexual diversity with decreasing IH and a more limited range of sexual activity with higher IH.
illustrates bivariate associations with strong effect sizes predicting ever having had an HIV test, specifically being ‘out’ and the proportion of MSM friends, followed by education and the size of settlement.
ANOVA of IH score by the relative frequency of condom use with non-steady partners, with covariates, the number of non-steady partners that they had unprotected anal intercourse within the past year and perceived control over sexual risk-taking, demonstrated a small-to-moderate effect size (η2=0.03). An accelerating relationship between IH and the relative frequency of condom use (covariates’ perceived control over sexual risk and the number of casual partners in the past year) with non-steady male partners was apparent (). The strong relationship of perceived control over sexual risk-taking () with condom use led to an additional analysis of the predictors of this perceived control (). The highest stepwise predictors were the number of non-steady partners one had anal intercourse within the past 12 months, IH, Gini coefficient and LGB legal climate.