Social Discrimination and Resiliency Are Not Associated With Differences in Prevalent HIV Infection in Black and White Men Who Have Sex With Men

• Type of Material: Article
• Authors: John L. Peterson, Georgia State University; Roger Bakeman, Georgia State University; Patrick Sullivan, Emory University; Gregorio Millett, Centers for Disease Control and Prevention; Eli Rosenberg, Emory University; Laura Salazar, Georgia State University; Ralph Diclemente, Emory University; Hannah Cooper, Emory University; Colleen Kelley, Emory University; Mark Mulligan, Emory University; Paula Frew, Emory University; Carlos Del Rio, Emory University
• Language: English
• Date: 2014-08-15
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 by Lippincott Williams & Wilkins.
• Final Published Version (URL): http://dx.doi.org/10.1097/QAI.0000000000000203
• Title of Journal or Parent Work: Journal of Acquired Immune Deficiency Syndromes
• ISSN: 1525-4135
• Volume: 66
• Issue: 5
• Start Page: 538
• End Page: 543
• Grant/Funding Information: This research was supported by National Institutes of Health (R01MH085600, RC1MD004370, UL1TR000454) and the Emory Center for AIDS Research (P30AI050409).
• Keywords: HEALTH OUTCOMES; PARTNER CHARACTERISTICS; Infectious Diseases; BISEXUAL MEN; YOUNG BLACK; black and white MSM; HIV infection; DISPARITIES; UNITED-STATES; homophobia; CONCEPTUAL ISSUES; resiliency; RISK BEHAVIORS; racism; Life Sciences & Biomedicine; Science & Technology; RACIAL-DIFFERENCES; GAY; Immunology
• Research Categories: Health Sciences, Public Health; Sociology, Ethnic and Racial Studies; Health Sciences, Epidemiology

Abstract

OBJECTIVES: To examine the associations of homophobia, racism, and resiliency with differences in prevalent HIV infection in black and white men who have sex with men (MSM). METHODS: The Involve[ment]t study is a cohort of black and white MSM aged 18-39 years in Atlanta, GA, designed to evaluate individual, dyadic, and community level factors that might explain racial disparities in HIV prevalence. Participants were recruited irrespective of HIV serostatus from community-based venues and from Internet advertisements and were tested for HIV. We assessed respondents' demographics, whether they had engaged in unprotected anal intercourse (UAI) within the past 6 months, and attitudes about perceived homophobia, perceived racism, and personal resiliency. RESULTS: Compared with white MSM, black MSM were less likely to report UAI in the past 6 months [odds ratio (OR): 0.59, confidence interval (CI): 0.44 to 0.80], more likely to be HIV positive (OR: 5.05, CI: 3.52 to 7.25), and - among those HIV positive - more likely to report not being aware of their HIV infection (OR: 2.58, CI: 1.18 to 5.65). Greater perceived racism was associated with UAI in the black sample (partial odds ratio: 1.48, CI: 1.10 to 1.99). Overall, perceived homophobia, perceived racism, and resilience were not associated with prevalent HIV infection in our samples. Greater resilience was associated with less perceived homophobia in both black and white samples (Spearman r = -0.27, P < 0.001, for both). CONCLUSION: Future studies of social discrimination at the institutional and network level, than at the individual level, may explain differences in HIV infection in black and white MSM.