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

Peterson, John L. PhD*; Bakeman, Roger PhD*; Sullivan, Patrick DVM, MPH; Millett, Gregorio A. MPH; Rosenberg, Eli PhD; Salazar, Laura PhD§; DiClemente, Ralph J. PhD, MPH; Cooper, Hannah MD, SM; Kelley, Colleen F. MD, MPH; Mulligan, Mark J. MD; Frew, Paula PhD, MA, MPH‖,¶; del Rio, Carlos MD

JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000203
Epidemiology and Prevention
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.

Author Information

*Department of Psychology, Georgia State University, Atlanta, GA;

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA;

National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA;

§Division of Health Promotion and Behavior, School of Public Health, Georgia State University, Atlanta, GA;

Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA; and

Department of Medicine, School of Medicine, Emory University, Atlanta, GA.

Correspondence to: John L. Peterson, PhD, Department of Psychology, Georgia State University, P. O. Box 5010, Atlanta, GA 30302 (e-mail: jpeterson@gsu.edu).

Supported by National Institutes of Health (R01MH085600, RC1MD004370, UL1TR000454) and the Emory Center for AIDS Research (P30AI050409).

The authors have no conflicts of interest to disclose.

Received April 25, 2014

Accepted April 29, 2014

© 2014 by Lippincott Williams & Wilkins