(671) Italian MSM and Safer Sex Choices: Stigma, Status, and Sexual Health

Introduction Limited research has explored sexual protection choices and behaviours among men who have sex with men (MSM) and potential discrimination experiences that occur as consequences. Such behaviours are not merely preventive choices but expressions of identity, intimacy, and social belonging and they may relate to psychological and sexual well-being. Objective This study aimed to examine how discrimination associated with sexual protection choices-such as condom use, PrEP adherence, and HIV serostatus-influences psychosocial, sexual, and mental health outcomes among MSM. It further investigated intracommunity stigma as a mechanism linking protection behaviours with identity visibility and social recognition. Methods A survey was created and distributed, reaching N = 841 Italian MSM. Validated instruments assessed sexual identity variables (outness, concealment), community participation (perceived MSM status, intraminority stress), sexual functioning, sexual quality of life, anxiety, and depression. Quantitative analyses were performed using SPSS®, including descriptive statistics and independent-sample t-tests comparing those who experienced discrimination to those who did not. An open-ended question further explored narratives of discrimination related to protection choices (e.g., condom use, PrEP, unprotected sex, HIV status, chemsex). Results Participants who reported experiencing discrimination showed higher levels of outness and perceived community status but greater sexual difficulties, particularly in receptive and insertive anal sex, and increased body embarrassment. No significant differences emerged in anxiety, depression, or intraminority stress. Qualitative findings indicated that discrimination most frequently targeted condom use and PrEP adherence, often framed within moral or identity-based judgments. Conclusions Findings highlight that protection choices are embedded in psychosocial and cultural contexts rather than individual risk logics. Discrimination related to these choices primarily undermines sexual rather than mental health, revealing the embodied dimensions of stigma. Prevention programs should integrate stigma reduction, inclusive counselling, and community-level interventions to promote both safety and belonging in MSM sexual health. Disclosure No