Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
AIDS and Behavior
Published in: AIDS and Behavior 2/2015

01-02-2015 | Original Paper

Sexual Orientation- and Race-Based Discrimination and Sexual HIV Risk Behavior Among Urban MSM

Authors: Victoria Frye, Vijay Nandi, James Egan, Magdalena Cerda, Emily Greene, Hong Van Tieu, Danielle C. Ompad, Donald R. Hoover, Debbie Lucy, Eduardo Baez, Beryl A. Koblin

Published in: AIDS and Behavior | Issue 2/2015

Login to get access

Abstract

Understanding what social factors are associated with risk of HIV acquisition and transmission among gay, bisexual and other men who have sex with men (MSM) is a critical public health goal. Experiencing discrimination may increase risk of HIV infection among MSM. This analysis assessed relations between experiences of sexual orientation- and race-based discrimination and sexual HIV risk behavior among MSM in New York City. 1,369 MSM completed a self-administered computerized assessment of past 3-month sexual behavior, experience of social discrimination and other covariates. Regression models assessed relations between recent experience of discrimination and sexual HIV risk behavior. Mean age was 32 years; 32 % were white; 32 % Latino/Hispanic; 25 % African American/Black. Of MSM who self-reported HIV-positive or unknown status (377), 7 % (N = 27) reported having unprotected insertive anal intercourse with an HIV-negative or unknown status partner (“HIV transmission risk”). Of MSM who self-reported HIV-negative status (992), 11 % (110) reported unprotected receptive anal intercourse with an HIV-positive or unknown status partner (“HIV acquisition risk”). HIV acquisition risk was positively associated with sexual orientation-based discrimination in home or social neighborhoods, but not race-based discrimination. We observed that sexual orientation-based discrimination was associated with sexual HIV risk behavior among urban-dwelling MSM. Addressing environmental sources of this form of discrimination, as well as the psychological distress that may result, should be prioritized in HIV prevention efforts.
Literature
1.
Centers for Disease Control and Prevention. HIV Surveillance Report, 2009; vol. 21. 2011
2.
Prejean J, Song R, Hernandez A, Ziebell R, Green T, Walker F, et al. Estimated HIV incidence in the United States, 2006–2009. PLoS One. 2011;6(8):e17502.CrossRefPubMedCentralPubMed
3.
New York City Deparment of Health. HIV Epidemiology and Field Services Semiannual Report. 2012; 7(1).
4.
Millett GA, Flores SA, Peterson JL, Bakeman R. Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. AIDS. 2007;21(15):2083–91.CrossRefPubMed
5.
Harawa NT, Greenland S, Bingham TA, Johnson DF, Cochran SD, Cunningham WE, et al. Associations of race/ethnicity with HIV prevalence and HIV-related behaviors among young men who have sex with men in 7 urban centers in the United States. J Acquir Immune Defic Syndr. 2004;35(5):526–36.CrossRefPubMed
6.
Koblin BA, Husnik MJ, Colfax G, Huang Y, Madison M, Mayer K, et al. Risk factors for HIV infection among men who have sex with men. AIDS. 2006;20(5):731–9.CrossRefPubMed
7.
Koblin BA, Mayer KH, Eshleman SH, Wang L, Mannheimer S, del Rio C, et al. Correlates of HIV acquisition in a cohort of black men who have sex with men in the United States: HIV prevention trials network (HPTN) 061. PLoS One. 2013;8(7):e70413.CrossRefPubMedCentralPubMed
8.
9.
Egan JE, Frye V, Kurtz SP, Latkin C, Chen M, Tobin K, et al. Migration, neighborhoods, and networks: approaches to understanding how urban environmental conditions affect syndemic adverse health outcomes among gay, bisexual and other men who have sex with men. AIDS Behav. 2011;15(Suppl 1):S35–50.CrossRefPubMedCentralPubMed
10.
Frye V, Koblin B, Chin J, Beard J, Blaney S, Halkitis P, et al. Neighbourhood-level correlates of consistent condom use among men who have sex with men: a multi-level analysis. AIDS Behav. 2010;14(4):974–85.CrossRefPubMedCentralPubMed
11.
Kelly BC, Carpiano RM, Easterbrook A, Parsons JT. Sex and the community: the implications of neighbourhoods and social networks for sexual risk behaviours among urban gay men. Sociol Health Illn. 2012;34(7):1085–102.CrossRefPubMed
12.
13.
Millett GA, Peterson JL, Flores SA, Hart TA, Jeffries WL, Wilson PA, et al. Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis. Lancet. 2012;380(9839):341–8.CrossRefPubMed
14.
15.
Crenshaw K. Mapping the margins: intersectionality, identity politics, and violence against women of color. Stanford Law Rev. 1991;43(6):1241–99.CrossRef
16.
Stall R, Mills TC, Williamson J, Hart T, Greenwood G, Paul J, et al. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J Public Health. 2003;93(6):939–42.CrossRefPubMedCentralPubMed
17.
Singer M. Introduction to syndemics: a critial systems approach to public and community health. San Francisco: Jossey-Bass; 2009.
18.
Westbrook L, Schilt K. Doing gender, determining gender: transgender people, gender panics, and the maintenance of the sex/gender/sexuality system. Gender and Society. 2014;28(1):32–57.CrossRef
19.
Namaste VK. Genderbashing: sexuality gender, and the regulation of public space. In: Stryker S, Whittle S, editors. The transgender studies reader. London: Routledge; 2006.
20.
Wilchins RA. Queer theory, gender theory: an instant primer. Los Angeles: Alyson Publications; 2004.
21.
Massey D, Denton NA. The dimensions of residential segregation. Soc Forces. 1998;67:281–315.CrossRef
22.
23.
Kessler RC, Mickelson KD, Williams DR. The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. J Health Soc Behav. 1999;40(3):208–30.CrossRefPubMed
24.
Meyer IH. Minority stress and mental health in gay men. J Health Soc Behav. 1995;36:38–56.
25.
DeLongis A, Lazarus RS, Folkman S. The impact of daily stress on health and mood: psychological and social resources as mediators. J Pers Soc Psychol. 1988;54(3):486–95.CrossRefPubMed
26.
Lazarus RS, Folkman S. Stress, appraisal. New York: Coping; 1984.
27.
Meyer I. Prejudice, social stress, and mental health in lesbian, gay and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–97.CrossRefPubMedCentralPubMed
28.
Gottheil E. Stress and addiction. New York: Brunner Mazel; 1987.
29.
Chae DH, Krieger N, Bennett GG, Lindsey JC, Stoddard AM, Barbeau EM. Implications of discrimination based on sexuality, gender, and race/ethnicity for psychological distress among working-class sexual minorities: the United for Health Study, 2003–2004. Int J Health Serv. 2010;40(4):589–608.CrossRefPubMed
30.
Wong CF, Weiss G, Ayala G, Kipke MD. Harassment, discrimination, violence, and illicit drug use among young men who have sex with men. AIDS Educ Prev. 2010;22(4):286–98.CrossRefPubMedCentralPubMed
31.
Mizuno Y, Borkowf C, Millett GA, Bingham T, Ayala G, Stueve A. Homophobia and racism experienced by Latino men who have sex with men in the United States: correlates of exposure and associations with HIV risk behaviors. AIDS Behav. 2012;16(3):724–35.CrossRefPubMed
32.
Fields EL, Bogart LM, Galvan FH, Wagner GJ, Klein DJ, Schuster MA. Association of discrimination-related trauma with sexual risk among HIV-positive African American men who have sex with men. Am J Public Health. 2013;103(5):875–80.CrossRefPubMedCentralPubMed
33.
34.
Malebranche DJ, Gvetadze R, Millett GA, Sutton MY. The relationship between gender role conflict and condom use among black MSM. AIDS Behav. 2012;16(7):2051–61.CrossRefPubMed
35.
Jeffries WL, Marks G, Lauby J, Murrill CS, Millett GA. Homophobia is associated with sexual behavior that increases risk of acquiring and transmitting HIV Infection among black men who have sex with men. AIDS Behav. 2012;17(4):1442–53.CrossRef
36.
Karlsen S, Nazroo JY. Relation between racial discrimination, social class, and health among ethnic minority groups. Am J Public Health. 2002;92(4):624–31.CrossRefPubMedCentralPubMed
37.
Nazroo JY. The structuring of ethnic inequalities in health: economic position, racial discrimination, and racism. Am J Public Health. 2003;93(2):277–84.CrossRefPubMedCentralPubMed
38.
Egan JE, Frye V, Kurtz SP, Latkin C, Chen M, Tobin K, et al. Migration, neighborhoods, and networks: approaches to understanding how urban environmental conditions affect syndemic adverse health outcomes among gay, bisexual and other men who have sex with men. AIDS Behav. 2011;15(Suppl 1):S35–50.CrossRefPubMedCentralPubMed
39.
Diggs M. Surveying the intersection: pathology, secrecy, and the discourses of racial and sexual identity. J Homosex. 1993;26(2–3):1–19.CrossRefPubMed
40.
Diaz RM, Ayala G, Bein E. Sexual risk as an outcome of social oppression: data from a probability sample of Latino gay men in three US cities. Cultur Divers Ethnic Minor Psychol. 2004;10(3):255–67.CrossRefPubMed
41.
Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr. 2005;39(4):446–53.CrossRefPubMed
42.
O’Donnell L, Agronick G, San DA, Duran R, Myint U, Stueve A. Ethnic and gay community attachments and sexual risk behaviors among urban Latino young men who have sex with men. AIDS Educ Prev. 2002;14(6):457–71.CrossRefPubMed
43.
Chng CL, Geliga-Vargas J. Ethnic identity, gay identity, sexual sensation seeking and HIV risk taking among multiethnic men who have sex with men. AIDS Educ Prev. 2000;12(4):326–39.PubMed
44.
Flores SA, Mansergh G, Marks G, Guzman R, Colfax G. Gay identity-related factors and sexual risk among men who have sex with men in San Francisco. AIDS Educ Prev. 2009;21(2):91–103.CrossRefPubMed
45.
Rosario M, Schrimshaw EW, Hunter J. A model of sexual risk behaviors among young gay and bisexual men: longitudinal associations of mental health, substance abuse, sexual abuse, and the coming-out process. AIDS Educ Prev. 2006;18(5):444–60.CrossRefPubMedCentralPubMed
46.
White D, Stephenson R. Identity formation, outness, and sexual risk among gay and bisexual men. Am J Mens Health. 2014;8(2):98–109.CrossRefPubMed
47.
Klein H. Condom use self-efficacy and HIV risk practices among men who use the internet to find male partners for unprotected sex. Am J Mens Health. 2014;8(3):190–204.CrossRefPubMed
48.
Bauermeister JA, Hickok AM, Meadowbrooke C, Veinot T, Loveluck J. Self-efficacy among young men who have sex with men: an exploratory analysis of HIV/AIDS risk behaviors across partner types. AIDS Behav. 2014;18(1):69–77.CrossRefPubMed
49.
Koblin B, Egan JE, Rundle A, Quinn T, Tieu HV, et al. Methods to measure the impact of home, social, and sexual neighborhoods of urban gay, bisexual, and other men who have sex with men. PLoS Med. 2013;8(10):e75878.CrossRef
50.
Mackellar DA, Gallagher KM, Finlayson T, Sanchez T, Lansky A, Sullivan PS. Surveillance of HIV risk and prevention behaviors of men who have sex with men–a national application of venue-based, time-space sampling. Public Health Rep. 2007;122(Suppl 1):39–47.PubMedCentralPubMed
51.
52.
Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.CrossRefPubMed
53.
Ross MW, Rosser BRS, Bauer GR, Bockting WO, Robinson BBE, Rugg DL, et al. Drug use, unsafe sexual behavior, and internalized homonegativity in men who have sex with men. AIDS Behav. 2001;5(1):97–103.CrossRef
54.
Rowen CJ, Malcolm JP. Correlates of internalized homophobia and homosexual identity formation in a sample of gay men. J Homosex. 2002;43(2):77–92.CrossRefPubMed
55.
Phinney J. The multigroup ethnic identity measure: a new scale for use with adolescents and young adults from diverse groups. J Adolesc Res. 1992;7:156–76.CrossRef
56.
Bradford LJ, Beck KH. Development and validation of the condom self-efficacy scale for college students. J Am Coll Health. 1991;39(2):219–25.CrossRef
57.
Choi KH, Han CS, Hudes ES, Kegeles S. Unprotected sex and associated risk factors among young Asian and Pacific Islander men who have sex with men. AIDS Educ Prev. 2002;14(6):472–81.CrossRefPubMed
58.
DiIorio C, Maibach E, O’Leary A, Sanderson CA, Celentano D. Measurement of condom use self-efficacy and outcome expectancies in a geographically diverse group of STD patients. AIDS Educ Prev. 1997;9(1):1–13.PubMed
59.
Jones KT, Johnson WD, Wheeler DP, Gray P, Foust E, Gaiter J. Nonsupportive peer norms and incarceration as HIV risk correlates for young black men who have sex with men. AIDS Behav. 2008;12(1):41–50.CrossRefPubMed
60.
Koblin BA, Bonner S, Powell B, Metralexis P, Egan JE, Patterson J, et al. A randomized trial of a behavioral intervention for black MSM: the DiSH study. AIDS. 2012;26(4):483–8.CrossRefPubMed
61.
Jeffries WL, Marks G, Lauby J, Murrill CS, Millett GA. Homophobia is associated with sexual behavior that increases risk of acquiring and transmitting HIV infection among black men who have sex with men. AIDS Behav. 2013;17(4):1442–53.CrossRefPubMed
62.
Fingerhut AW, Peplau LA, Gable SL. Identity, minority stress and psychological well-being among gay men and lesbians. Psychol Sex. 2010;1(2):101–14.CrossRef
63.
McCabe SE, Bostwick WB, Hughes TL, West BT, Boyd CJ. The relationship between discrimination and substance use disorders among lesbian, gay, and bisexual adults in the United States. Am J Public Health. 2010;100(10):1946–52.CrossRefPubMedCentralPubMed
64.
Morrison MA. Psychological health correlates of perceived discrimination among canadian Gay men and Lesbian women. Can J Commun Ment Health. 2011;30(2):81–98.CrossRef
65.
Feinstein BA, Goldfried MR, Davila J. The relationship between experiences of discrimination and mental health among lesbians and gay men: an examination of internalized homonegativity and rejection sensitivity as potential mechanisms. J Consult Clin Psychol. 2012;80(5):917–27.CrossRefPubMed
66.
Szymanski DM, Ikizler AS. Internalized heterosexism as a mediator in the relationship between gender role conflict, heterosexist discrimination, and depression among sexual minority men. Psychol Men Masc. 2013;14(2):211.CrossRef
67.
Newcomb ME, Mustanski B. Internalized homophobia and internalizing mental health problems: a meta-analytic review. Clin Psychol Rev. 2010;30(8):1019–29.CrossRefPubMed
68.
Warren JC, Fernandez MI, Harper GW, Hidalgo MA, Jamil OB, Torres RS. Predictors of unprotected sex among young sexually active African American, Hispanic, and White MSM: the importance of ethnicity and culture. AIDS Behav. 2008;12(3):459–68.CrossRefPubMedCentralPubMed
69.
Krieger N, Smith K, Naishadham D, Hartman C, Barbeau EM. Experiences of discrimination: validity and reliability of a self-report measure for population health research on racism and health. Soc Sci Med. 2005;61(7):1576–96.CrossRefPubMed
70.
Klein SJ, Karchner WD, O’Connell DA. Interventions to prevent HIV-related stigma and discrimination: findings and recommendations for public health practice. J Public Health Manage Pract. 2002;8(6):44–53.CrossRef
71.
Mahajan AP, Sayles JN, Patel VA, Remien RH, Sawires SR, Ortiz DJ, et al. Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS. 2008;22(Suppl 2):S67–79.CrossRefPubMedCentralPubMed
72.
Herbst JH, Beeker C, Mathew A, McNally T, Passin WF, Kay LS, et al. The effectiveness of individual-, group-, and community-level HIV behavioral risk-reduction interventions for adult men who have sex with men: a systematic review. Am J Prev Med. 2007;32(4 Suppl):S38–67.CrossRefPubMed
Metadata
Title
Sexual Orientation- and Race-Based Discrimination and Sexual HIV Risk Behavior Among Urban MSM
Authors
Victoria Frye
Vijay Nandi
James Egan
Magdalena Cerda
Emily Greene
Hong Van Tieu
Danielle C. Ompad
Donald R. Hoover
Debbie Lucy
Eduardo Baez
Beryl A. Koblin
Publication date
01-02-2015
Publisher
Springer US
Published in
AIDS and Behavior / Issue 2/2015
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-014-0937-2

Other articles of this Issue 2/2015

AIDS and Behavior 2/2015 Go to the issue

Behavioral Surveillance

Men Who Have Sex with Men in Mozambique: Identifying a Hidden Population at High-risk for HIV

Original Paper

“Was it a Mistake to Tell Others That You are Infected with HIV?”: Factors Associated with Regret Following HIV Disclosure Among People Living with HIV in Five Countries (Mali, Morocco, Democratic Republic of the Congo, Ecuador and Romania). Results from a Community-Based Research

Original Paper

Prevalence and Correlates of Knowledge of Male Partner HIV Testing and Serostatus Among African-American Women Living in High Poverty, High HIV Prevalence Communities (HPTN 064)

Original Paper

Using a 2-Stage Strategy with Respondent-Driven Sampling to Recruit a Hard-to-Reach Population for a Placebo Microbicide Gel Clinical Trial in Nellore, Andhra Pradesh (India)

Original Paper

HIV Stigma as a Barrier to Retention in HIV Care at a General Hospital in Lima, Peru: A Case–Control Study

Original Paper

Improving Hospital-Based Quality of Care by Reducing HIV-Related Stigma: Evaluation Results from Vietnam
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits