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Perceived Discrimination and Physical Health Among HIV-Positive Black and Latino Men Who Have Sex with Men

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Abstract

We conducted the first study to examine health correlates of discrimination due to race/ethnicity, HIV-status, and sexual orientation among 348 HIV-positive Black (n = 181) and Latino (n = 167) men who have sex with men. Participants completed audio computer-assisted self-interviews. In multivariate analyses, Black participants who experienced greater racial discrimination were less likely to have a high CD4 cell count [OR = 0.7, 95 % CI = (0.5, 0.9), p = 0.02], and an undetectable viral load [OR = 0.8, 95 % CI = (0.6, 1.0), p = 0.03], and were more likely to visit the emergency department [OR = 1.3, 95 % CI = (1.0, 1.7), p = 0.04]; the combined three types of discrimination predicted greater AIDS symptoms [F (3,176) = 3.8, p < 0.01]. Among Latinos, the combined three types of discrimination predicted greater medication side effect severity [F (3,163) = 4.6, p < 0.01] and AIDS symptoms [F (3,163) = 3.1, p < 0.05]. Findings suggest that the stress of multiple types of discrimination plays a role in health outcomes.

Resumen

Hemos realizado el primer estudio que examina los factores de la salud correlacionados con la discriminación por motivos de raza/origen étnico, estado del VIH, y la orientación sexual entre 348 hombres VIH-positivos Afro-Americanos (n = 181) y Latinos (n = 167) que tienen sexo con hombres. Los participantes completaron una auto-entrevista auditiva con ayuda de una computadora. En los análisis multivariantes, participantes Afro-Americanos que experimentaron mayor discriminación racial tenían menos probabilidades de tener un alto recuento de células CD4 [razón de momios (RM) = 0.7, IC = (0.5, 0.9), p = 0.02], y una carga viral indetectable [RM = 0.8, IC = (0.6,1.0), p = 0.03], y eran más propensos a visitar la sala de emergencia [RM = 1.3, IC = (1.0,1.7), p = 0.04]; el combinado de los tres tipos de discriminación predijo mayores síntomas del SIDA [F (3,176) = 3.8, p < 0.01]. Entre los Latinos, el combinado de los tres tipos de discriminación predijo mayor severidad en los efectos de los medicamentos [F (3,163) = 4.6, p < 0.01] y mayores síntomas del SIDA [F (3,163) = 3.1, p < 0.05]. Los resultados sugieren que el estrés debido a múltiples tipos de discriminación juega un papel en los resultados de salud.

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Acknowledgments

This research was supported by R01 MH072351 and R01 MH072351-S1. None of the authors have any conflicts of interest to report. We thank Charisma Acey, Gustavo Arguelles, Denedria Banks, Elizabeth Schink, E. Michael Speltie, Kellii Trombacco, and Silvia Valerio for research assistance; and Charles Hilliard, PhD, and staff and clients of Bienestar Human Services, Inc., SPECTRUM Community Services and OASIS clinic of Charles Drew University of Medicine and Science, AIDS Project Los Angeles, and Minority AIDS Project for results interpretation, recruitment assistance, and interview space.

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Authors and Affiliations

  1. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Laura M. Bogart

  2. Center for Health Disparities Research, East Carolina University, Greenville, NC, USA

    Hope Landrine

  3. Bienestar Human Services, Inc., Los Angeles, CA, USA

    Frank H. Galvan

  4. RAND Corporation, Santa Monica, CA, USA

    Glenn J. Wagner

  5. Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA

    Laura M. Bogart & David J. Klein

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Correspondence to Laura M. Bogart.

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Bogart, L.M., Landrine, H., Galvan, F.H. et al. Perceived Discrimination and Physical Health Among HIV-Positive Black and Latino Men Who Have Sex with Men. AIDS Behav 17, 1431–1441 (2013). https://doi.org/10.1007/s10461-012-0397-5

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