Association of discrimination-related trauma with sexual risk among HIV-positive African American men who have sex with men.

Publisher: American Public Health Association Country of Publication: United States NLM ID: 1254074 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1541-0048 (Electronic) Linking ISSN: 00900036 NLM ISO Abbreviation: Am J Public Health Subsets: MEDLINE

Publication: Washington, DC : American Public Health Association
Original Publication: New York [etc.]

Black or African American/*psychology ; HIV Seropositivity/*ethnology ; Homosexuality, Male/*psychology ; Prejudice/*psychology ; Stress Disorders, Traumatic/*ethnology ; Violence/*psychology; Adult ; Aged ; Comorbidity ; Depressive Disorder, Major/diagnosis ; Depressive Disorder, Major/ethnology ; HIV Seropositivity/psychology ; Homosexuality, Male/ethnology ; Homosexuality, Male/statistics & numerical data ; Humans ; Interviews as Topic ; Los Angeles/epidemiology ; Male ; Middle Aged ; Prejudice/ethnology ; Prejudice/statistics & numerical data ; Prisoners/statistics & numerical data ; Stress Disorders, Traumatic/etiology ; Stress Disorders, Traumatic/psychology ; Substance-Related Disorders/ethnology ; Unsafe Sex/ethnology ; Unsafe Sex/psychology ; Unsafe Sex/statistics & numerical data ; Violence/ethnology ; Violence/statistics & numerical data ; Young Adult

Objectives: We investigated whether 1 form of traumatic stress, discrimination-related trauma (e.g., physical assault because of race), was associated with unprotected anal intercourse, especially when compared with non-discrimination-related trauma, among African American men who have sex with men.
Methods: A convenience sample of 131 HIV-positive African American men who have sex with men receiving antiretroviral treatment completed audio computer-assisted self-interviews that covered unprotected anal intercourse, interpersonal trauma, and whether trauma was because of discrimination on the basis of race/ethnicity, HIV serostatus, or sexual orientation.
Results: Sixty percent reported at least 1 interpersonal trauma; they attributed at least 1 trauma to being gay (47%), African American (17%), or HIV positive (9%). In a multivariate regression, experiencing discrimination-related trauma was significantly associated with unprotected anal intercourse (adjusted odds ratio [AOR] = 2.4; 95% confidence interval [CI] = 1.0, 5.7; P = .04), whereas experiencing non-discrimination-related trauma was not (AOR = 1.3; 95% CI = 0.6, 3.1; P = .53).
Conclusions: HIV-positive African American men who have sex with men experience high levels of discrimination-related trauma, a stressor associated with greater risk taking. HIV prevention interventions should consider the potential damaging effects of discrimination in the context of trauma.

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R01 MH072351 United States MH NIMH NIH HHS; R01 MH72351 United States MH NIMH NIH HHS

Date Created: 20130316 Date Completed: 20130611 Latest Revision: 20231106

20231106

PMC3625518

10.2105/AJPH.2012.300951

23488499