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

• 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
• Journal Title: Journal of Acquired Immune Deficiency Syndromes
• Volume: Volume 66, Number 5
• Publisher: Lippincott, Williams & Wilkins | 2014-08-15, Pages 538-543
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1097/QAI.0000000000000203
• Subjects: Health Sciences, Epidemiology; Health Sciences, Public Health; Sociology, Ethnic and Racial Studies
• Keywords: Science & Technology; Life Sciences & Biomedicine; Immunology; Infectious Diseases; HIV infection; black and white MSM; homophobia; racism; resiliency; UNITED-STATES; PARTNER CHARACTERISTICS; RACIAL-DIFFERENCES; CONCEPTUAL ISSUES; HEALTH OUTCOMES; RISK BEHAVIORS; BISEXUAL MEN; YOUNG BLACK; DISPARITIES; GAY

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.