nach oben

AIDS and Behavior

Erschienen in:

01.05.2013 | Original Paper

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

verfasst von: Laura M. Bogart, Hope Landrine, Frank H. Galvan, Glenn J. Wagner, David J. Klein

Erschienen in: AIDS and Behavior | Ausgabe 4/2013

Einloggen, um Zugang zu erhalten

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.

Centers for Disease Control and Prevention. HIV Surveillance Report, 2009. Atlanta: Department of Health and Human Services; 2011.

Giordano TP, White AC, Sajja P, et al. Factors associated with the use of highly active antiretroviral therapy in patients newly entering care in an urban clinic. J Acquir Immune Defic Syndr. 2003;32(4):399–405.PubMedCrossRef

Knowlton AR, Hoover DR, Chung SE, Celentano DD, Vlahov D, Latkin CA. Access to medical care and service utilization among injection drug users with HIV/AIDS. Drug Alcohol Depend. 2001;64(1):55–62.PubMedCrossRef

Stone VE. Optimizing the care of minority patients with HIV/AIDS. Clin Infect Dis. 2004;38(3):400–4.PubMedCrossRef

Gebo KA, Fleishman JA, Conviser R, et al. Racial and gender disparities in receipt of highly active antiretroviral therapy persist in a multistate sample of HIV patients in 2001. J Acquir Immune Defic Syndr. 2005;38(1):96–103.PubMedCrossRef

Shapiro MF, Morton SC, McCaffrey DF, et al. Variations in the care of HIV-infected adults in the United States: results from the HIV Cost and Services Utilization Study. JAMA. 1999;281(24):2305–15.PubMedCrossRef

Losina E, Schackman BR, Sadownik SN, et al. Racial and sex disparities in life expectancy losses among HIV-infected persons in the United States: impact of risk behavior, late initiation, and early discontinuation of antiretroviral therapy. Clin Infect Dis. 2009;49(10):1570–8.PubMedCrossRef

Sabin CA, Smith CJ, Gumley H, et al. Late presenters in the era of highly active antiretroviral therapy: uptake of and responses to antiretroviral therapy. AIDS. 2004;18(16):2145–51.PubMedCrossRef

Mugavero MJ, Lin HY, Allison JJ, et al. Failure to establish HIV care: characterizing the “no show” phenomenon. Clin Infect Dis. 2007;45(1):127–30.PubMedCrossRef

10.

Johnson MO, Catz SL, Remien RH, et al. Theory-guided empirically supported avenues for intervention on HIV medication nonadherence: findings from the Healthy Living Project. AIDS Patient Care STDS. 2003;17(12):645–56.PubMedCrossRef

11.

Centers for Disease Control and Prevention. HIV in the United States: The stages of care. Atlanta: Centers for Disease Control and Prevention; 2012.

12.

Chen NE, Gallant JE, Page KR. A systematic review of HIV/AIDS survival and delayed diagnosis among Hispanics in the United States. J Immigr Minor Health. 2012;14(1):65–81.PubMedCrossRef

13.

Turner BJ, Cunningham WE, Duan N, et al. Delayed medical care after diagnosis in a US national probability sample of persons infected with human immunodeficiency virus. Arch Intern Med. 2000;160(17):2614–22.PubMedCrossRef

14.

Crystal S, Sambamoorthi U, Moynihan PJ, McSpiritt E. Initiation and continuation of newer antiretroviral treatments among medicaid recipients with AIDS. J Gen Intern Med. 2001;16(12):850–9.PubMedCrossRef

15.

Torian LV, Wiewel EW, Liu KL, Sackoff JE, Frieden TR. Risk factors for delayed initiation of medical care after diagnosis of human immunodeficiency virus. Arch Intern Med. 2008;168(11):1181–7.PubMedCrossRef

16.

Duran D, Usman HR, Beltrami J, Alvarez ME, Valleroy L, Lyles CM. HIV counseling and testing among Hispanics at CDC-funded sites in the United States, 2007. Am J Public Health. 2010;100(suppl 1):S152–8.PubMedCrossRef

17.

Reed JB, Hanson D, McNaghten AD, et al. HIV testing factors associated with delayed entry into HIV medical care among HIV-infected persons from eighteen states, United States, 2000–2004. AIDS Patient Care STDS. 2009;23(9):765–73.PubMedCrossRef

18.

Lillie-Blanton M, Stone VE. Snow Jones A, et al. Association of race, substance abuse, and health insurance coverage with use of highly active antiretroviral therapy among HIV-infected women, 2005. Am J Public Health. 2010;100(8):1493–9.PubMedCrossRef

19.

Rajabiun S, Rumptz MH, Felizzola J, et al. The impact of acculturation on Latinos’ perceived barriers to HIV primary care. Ethn Dis. 2008;18(4):403–8.PubMed

20.

Hatzenbuehler ML, Nolen-Hoeksema S, Dovidio J. How does stigma “get under the skin”?: the mediating role of emotion regulation. Psychol Sci. 2009;20(10):1282–9.PubMedCrossRef

21.

Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–97.PubMedCrossRef

22.

Landrine H, Klonoff EA. Cultural diversity and health psychology. In: Baum A, Singer J, Revenson T, editors. Handbook of health psychology. Mahwah: Erlbaum; 2001. p. 855–95.

23.

Paradies Y. A systematic review of empirical research on self-reported racism and health. Int J Epidemiol. 2006;35(4):888–901.PubMedCrossRef

24.

Williams DR, Yu Y, Jackson JS, Anderson NB. Racial differences in physical and mental health: socio-economic status, stress and discrimination. J Health Psychol. 1997;2(3):335–51.PubMedCrossRef

25.

Pascoe EA, Smart Richman L. Perceived discrimination and health: a meta-analytic review. Psychol Bull. 2009;135(4):531–54.PubMedCrossRef

26.

Rintamaki LS, Davis TC, Skripkauskas S, Bennett CL, Wolf MS. Social stigma concerns and HIV medication adherence. AIDS Patient Care STDS. 2006;20(5):359–68.PubMedCrossRef

27.

Sayles JN, Hays RD, Sarkisian CA, Mahajan AP, Spritzer KL, Cunningham WE. Development and psychometric assessment of a multidimensional measure of internalized HIV stigma in a sample of HIV-positive adults. AIDS Behav. 2008;12(5):748–58.PubMedCrossRef

28.

Vanable PA, Carey MP, Blair DC, Littlewood RA. Impact of HIV-related stigma on health behaviors and psychological adjustment among HIV-positive men and women. AIDS Behav. 2006;10(5):473–82.PubMedCrossRef

29.

Ren XS, Amick BC, Williams DR. Racial/ethnic disparities in health: the interplay between discrimination and socioeconomic status. Ethn Dis. 1999;9(2):151–65.PubMed

30.

Thomas KS, Bardwell WA, Ancoli-Israel S, Dimsdale JE. The toll of ethnic discrimination on sleep architecture and fatigue. Health Psychol. 2006;25(5):635–42.PubMedCrossRef

31.

Harris R, Tobias M, Jeffreys M, Waldegrave K, Karlsen S, Nazroo J. Effects of self-reported racial discrimination and deprivation on Maori health and inequalities in New Zealand: cross-sectional study. Lancet. 2006;367(9527):2005–9.PubMedCrossRef

32.

Larson A, Gillies M, Howard PJ, Coffin J. It’s enough to make you sick: the impact of racism on the health of Aboriginal Australians. Aust N Z J Public Health. 2007;31(4):322–9.PubMedCrossRef

33.

Clark R, Anderson NB, Clark VR, Williams DR. Racism as a stressor for African Americans: a biopsychosocial model. Am Psychol. 1999;54(10):805–16.PubMedCrossRef

34.

Williams DR, Mohammed SA. Discrimination and racial disparities in health: evidence and needed research. J Behav Med. 2009;32(1):20–47.PubMedCrossRef

35.

Link BG, Phelan JC. Stigma and its public health implications. Lancet. 2006;367(9509):528–9.PubMedCrossRef

36.

Nyblade L. Measuring HIV stigma: existing knowledge and gaps. Psychol Health Med. 2006;11(3):335–45.PubMedCrossRef

37.

Reidpath DD, Chan KY. A method for the quantitative analysis of the layering of HIV-related stigma. AIDS Care. 2005;17(4):425–32.PubMedCrossRef

38.

Earnshaw VA, Chaudoir SR. From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures. AIDS Behav. 2009;13(6):1160–77.PubMedCrossRef

39.

Boarts JM, Bogart LM, Tabak MA, Armelie AP, Delahanty DL. Relationship of race-, sexual orientation-, and HIV-related discrimination with adherence to HIV treatment: a pilot study. J Behav Med. 2008;31(5):445–51.PubMedCrossRef

40.

Bogart LM, Wagner GJ, Galvan FH, Klein DJ. Longitudinal relationships between antiretroviral treatment adherence and discrimination due to HIV-serostatus, race, and sexual orientation among African-American men with HIV. Ann Behav Med. 2010;40(2):184–90.PubMedCrossRef

41.

Zamboni BD, Crawford I. Minority stress and sexual problems among African-American gay and bisexual men. Arch Sex Behav. 2007;36(4):569–78.PubMedCrossRef

42.

Diaz RM, Ayala G, Bein E, Henne J, Marin BV. The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: findings from 3 US cities. Am J Public Health. 2001;91(6):927–32.PubMedCrossRef

43.

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 U.S. cities. Cultur Divers Ethnic Minor Psychol. 2004;10(3):255–67.PubMedCrossRef

44.

Weiner B, Perry RP, Magnusson J. An attributional analysis of reactions to stigmas. J Pers Soc Psychol. 1988;55(5):738–48.PubMedCrossRef

45.

Malebranche DJ, Peterson JL, Fullilove RE, Stackhouse RW. Race and sexual identity: perceptions about medical culture and healthcare among black men who have sex with men. J Natl Med Assoc. 2004;96(1):97–107.PubMed

46.

Bogart LM, Wagner G, Galvan FH, Banks D. Conspiracy beliefs about HIV are related to antiretroviral treatment nonadherence among African American men with HIV. J Acquir Immune Defic Syndr. 2010;53(5):648–55.PubMed

47.

Bogart LM, Galvan FH, Wagner G, Klein DJ. Longitudinal association of HIV conspiracy beliefs with sexual risk among Black males living with HIV. AIDS Behav. 2011;15(6):1180–6.PubMedCrossRef

48.

Bogart LM, Wagner GJ, Galvan FH, Landrine H, Klein DJ, Sticklor LA. Perceived discrimination and mental health symptoms among Black men with HIV. Cultur Divers Ethnic Minor Psychol. 2011;17(3):295–302.PubMedCrossRef

49.

Wagner GJ, Bogart LM, Galvan FH, Banks D, Klein DJ. Discrimination as a key mediator of the relationship between posttraumatic stress and HIV treatment adherence among African American men. J Behav Med. 2011;35(1):8–18.PubMedCrossRef

50.

Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health. 2001;24(6):518–29.PubMedCrossRef

51.

Krieger N, Sidney S. Prevalence and health implications of anti-gay discrimination: a study of black and white women and men in the CARDIA cohort. Coronary Artery Risk Development in Young Adults. Int J Health Serv. 1997;27(1):157–76.PubMedCrossRef

52.

Krieger N. Discrimination and health. In: Berkman LF, Kawachi I, editors. Social epidemiology. Oxford: Oxford University Press; 2000. p. 36–75.

53.

Sue DW, Capodilupo CM, Torino GC, et al. Racial microaggressions in everyday life: implications for clinical practice. Am Psychol. 2007;62(4):271–86.PubMedCrossRef

54.

Brondolo E, Kelly KP, Coakley V, et al. The perceived ethnic discrimination questionnaire: development and preliminary validation of a community version. J Appl Soc Psychol. 2005;35(2):335–65.CrossRef

55.

Landrine H, Klonoff EA. The schedule of racist events: a measure of racial discrimination and a study of its negative physical and mental health consequences. J Black Psychol. 1996;22(2):144–68.CrossRef

56.

McKirnan DJ, Peterson PL. Stress, expectancies, and vulnerability to substance abuse: a test of a model among homosexual men. J Abnorm Psychol. 1988;97(4):461–6.PubMedCrossRef

57.

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.PubMedCrossRef

58.

Landrine H, Klonoff EA, Corral I, Fernandez S, Roesch S. Conceptualizing and measuring ethnic discrimination in health research. J Behav Med. 2006;29(1):79–94.PubMedCrossRef

59.

Williams DR, Neighbors HW, Jackson JS. Racial/ethnic discrimination and health: findings from community studies. Am J Public Health. 2003;93(2):200–8.PubMedCrossRef

60.

Tabatchnik BG, Fidell LS. Using multivariate statisitcs. 5th ed. Boston: Pearson Education, Inc., Allyn & Bacon; 2007.

61.

Cattell RB. The scree test for the number of factors. Multivar Behav Res. 1966;1(2):245–76.CrossRef

62.

Costello AB, Osborne JW. Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Assess Res Eval. 2005;10(7):173–8.

63.

Kalichman SC, Simbayi LC, Cloete A, Mthembu PP, Mkhonta RN, Ginindza T. Measuring AIDS stigmas in people living with HIV/AIDS: the internalized AIDS-related stigma scale. AIDS Care. 2009;21(1):87–93.PubMedCrossRef

64.

Herek GM, Gillis JR, Cogan JC. Internalized stigma among sexual minority adults: insights from a social psychological perspective. J Couns Psychol. 2009;56(1):32–43.CrossRef

65.

Cunningham WE, Rana HM, Shapiro MF, Hays RD. Reliability and validity of self-report CD4 counts-in persons hospitalized with HIV disease. J Clin Epidemiol. 1997;50(7):829–35.PubMedCrossRef

66.

Catz SL, Kelly JA, Bogart LM, Benotsch EG, McAuliffe TL. Patterns, correlates, and barriers to medication adherence among persons prescribed new treatments for HIV disease. Health Psychol. 2000;19(2):124–33.PubMedCrossRef

67.

Kalichman SC, Ramachandran B, Catz S. Adherence to combination antiretroviral therapies in HIV patients of low health literacy. J Gen Intern Med. 1999;14(5):267–73.PubMedCrossRef

68.

Mathews WC, McCutchan JA, Asch S, et al. National estimates of HIV-related symptom prevalence from the HIV Cost and Services Utilization Study. Med Care. 2000;38(7):750–62.PubMedCrossRef

69.

Nawar EW, Niska RW, Xu J. National Hospital Ambulatory Medical Care Survey: 2005 emergency department summary. Adv Data. 2007;386:1–32.PubMed

70.

Armstrong K, McMurphy S, Dean LT, et al. Differences in the patterns of health care system distrust between blacks and whites. J Gen Intern Med. 2008;23(6):827–33.PubMedCrossRef

71.

Brandon DT, Isaac LA, LaVeist TA. The legacy of Tuskegee and trust in medical care: is Tuskegee responsible for race differences in mistrust of medical care? J Natl Med Assoc. 2005;97(7):951–6.PubMed

72.

Chen FM, Fryer GEJ, Phillips RLJ, Wilson E, Pathman DE. Patients’ beliefs about racism, preferences for physician race, and satisfaction with care. Ann Fam Med. 2005;3(2):138–43.PubMedCrossRef

73.

Hausmann LR, Jeong K, Bost JE, Ibrahim SA. Perceived discrimination in health care and health status in a racially diverse sample. Med Care. 2008;46(9):905–14.PubMedCrossRef

74.

LaVeist TA, Nickerson KJ, Bowie JV. Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients. Med Care Res Rev. 2000;57(suppl 1):146–61.PubMed

75.

Lillie-Blanton M, Brodie M, Rowland D, Altman D, McIntosh M. Race, ethnicity, and the health care system: public perceptions and experiences. Med Care Res Rev. 2000;57(suppl 1):218–35.PubMed

76.

Schrimshaw EW, Siegel K, Lekas HM. Changes in attitudes toward antiviral medication: a comparison of women living with HIV/AIDS in the pre-HAART and HAART eras. AIDS Behav. 2005;9(3):267–79.PubMedCrossRef

77.

Siegel K, Karus D, Schrimshaw EW. Racial differences in attitudes toward protease inhibitors among older HIV-infected men. AIDS Care. 2000;12(4):423–34.PubMedCrossRef

78.

Brown L, Macintyre K, Trujillo L. Interventions to reduce HIV/AIDS stigma: what have we learned? AIDS Educ Prev. 2003;15(1):49–69.PubMedCrossRef

79.

Mahajan AP, Sayles JN, Patel VA, 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.PubMedCrossRef

80.

Uchino BN, Cacioppo JT, Kiecolt-Glaser JK. The relationship between social support and physiological processes: a review with emphasis on underlying mechanisms and implications for health. Psychol Bull. 1996;119(3):488–531.PubMedCrossRef

81.

Cohen S. Psychosocial models of the role of social support in the etiology of physical disease. Health Psychol. 1988;7(3):269–97.PubMedCrossRef

82.

Hatzenbuehler ML. How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychol Bull. 2009;135(5):707–30.PubMedCrossRef

83.

Nolen-Hoeksema S, Wisco BE, Lyubomirsky S. Rethinking rumination. Perspect Psychol Sci. 2008;3(5):400–24.CrossRef

84.

Gross JJ. Emotion regulation in adulthood: timing is everything. Curr Dir Psychol Sci. 2001;10(6):214–9.CrossRef

85.

Gross JJ, John OP. Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J Pers Soc Psychol. 2003;85(2):348–62.PubMedCrossRef

86.

Pettigrew TF, Tropp LR. A meta-analytic test of intergroup contact theory. J Pers Soc Psychol. 2006;90(5):751–83.PubMedCrossRef

87.

Earnshaw V, Bogart LM, Dovidio J, Williams D. Stigma and racial/ethnic HIV disparities: moving towards resilience (under review).

88.

Meyer IH. Prejudice as stress: conceptual and measurement problems. Am J Public Health. 2003;93(2):262.PubMedCrossRef

89.

Darity WA Jr. Employment discrimination, segregation, and health. Am J Public Health. 2003;93(2):226–31.PubMedCrossRef

90.

Brondolo E, Hausmann LR, Jhalani J, et al. Dimensions of perceived racism and self-reported health: examination of racial/ethnic differences and potential mediators. Ann Behav Med. 2011;42(1):14–28.PubMedCrossRef

91.

Corral I, Landrine H. Racial discrimination and health-promoting vs damaging behaviors among African-American adults. J Health Psychol. 2012;17(8):1176–82.PubMedCrossRef

Titel: Perceived Discrimination and Physical Health Among HIV-Positive Black and Latino Men Who Have Sex with Men
verfasst von: Laura M. Bogart
Hope Landrine
Frank H. Galvan
Glenn J. Wagner
David J. Klein
Publikationsdatum: 01.05.2013
Verlag: Springer US
Erschienen in: AIDS and Behavior / Ausgabe 4/2013
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-012-0397-5

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Positiver FIT: Die Ursache liegt nicht immer im Dickdarm

27.05.2024 Blut im Stuhl Nachrichten

Immunchemischer Stuhltest positiv, Koloskopie negativ – in solchen Fällen kann die Blutungsquelle auch weiter proximal sitzen. Ein Forschungsteam hat nachgesehen, wie häufig und in welchen Lokalisationen das der Fall ist.

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

24.05.2024 Diabetische Retinopathie Nachrichten

Möglicherweise hängt es von der Art der Diabetesmedikamente ab, wie hoch das Risiko der Betroffenen ist, dass sich sehkraftgefährdende Komplikationen verschlimmern.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2013

Aggregate Versus Day Level Association Between Methamphetamine Use and HIV Medication Non-adherence Among Gay and Bisexual Men

Homophobia is Associated with Sexual Behavior that Increases Risk of Acquiring and Transmitting HIV Infection Among Black Men Who Have Sex with Men

Prevalence and Correlates of Unprotected Anal Intercourse Among Hong Kong Men Who Have Sex with Men Traveling to Shenzhen, China

Robert M. Malow 1953–2013

Syphilis Among Men Who Have Sex With Men (MSM) in Taiwan: Its Association With HIV Prevalence, Awareness of HIV Status, and Use of Antiretroviral Therapy