Journal Article

Association of Discrimination-Related Trauma With Sexual Risk Among HIV-Positive African American Men Who Have Sex With Men

Fields, Errol L., Klein, David J., Galvan, Frank H., Schuster, Mark A., Bogart, Laura M., Wagner, Glenn J.

2013

Overview

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.

• Publisher: American Public Health Association
• Subject: Adult / African Americans / African Americans - psychology / Aged / Anal intercourse / Antiretroviral agents / Antiretroviral therapy / Behavior / Biological and medical sciences / Cocaine / Comorbidity / Depressive Disorder, Major - diagnosis / Depressive Disorder, Major - ethnology / Discrimination / Disease prevention / Domestic violence / Drug use / Ethnicity / General aspects / HIV / HIV Seropositivity - ethnology / HIV Seropositivity - psychology / Homosexuality, Male - ethnology / Homosexuality, Male - psychology / Homosexuality, Male - statistics & numerical data / Human immunodeficiency virus / Human viral diseases / Humans / Infectious diseases / Interviews as Topic / Los Angeles - epidemiology / Male / Males / Medical sciences / Medical treatment / Men who have sex with men / Mens health / Mental depression / Mental health / Middle Aged / Minority & ethnic groups / Miscellaneous / Population / Prejudice - ethnology / Prejudice - psychology / Prejudice - statistics & numerical data / Prevention and actions / Prevention programs / Preventive medicine / Prisoners - statistics & numerical data / Psychological trauma / Public health / Public health. Hygiene / Public health. Hygiene-occupational medicine / Race / Research and Practice / Risk behavior / Risk taking / Sex crimes / Sexual behavior / Sexual intercourse / Sexual orientation / Sexuality / Sexually transmitted diseases / STD / Stress / Stress Disorders, Traumatic - ethnology / Stress Disorders, Traumatic - etiology / Stress Disorders, Traumatic - psychology / Substance-Related Disorders - ethnology / Transgender persons / Trauma / Traumatic stress / Unsafe Sex - ethnology / Unsafe Sex - psychology / Unsafe Sex - statistics & numerical data / Variables / Violence - ethnology / Violence - psychology / Violence - statistics & numerical data / Viral diseases / Viral diseases of the lymphoid tissue and the blood. Aids / Young Adult