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Stress and Coping with Racism and Their Role in Sexual Risk for HIV Among African American, Asian/Pacific Islander, and Latino Men Who Have Sex with Men

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Abstract

The deleterious effects of racism on a wide range of health outcomes, including HIV risk, are well documented among racial/ethnic minority groups in the United States. However, little is known about how men of color who have sex with men (MSM) cope with stress from racism and whether the coping strategies they employ buffer against the impact of racism on sexual risk for HIV transmission. We examined associations of stress and coping with racism with unprotected anal intercourse (UAI) in a sample of African American (N = 403), Asian/Pacific Islander (N = 393), and Latino (N = 400) MSM recruited in Los Angeles County, CA during 2008–2009. Almost two-thirds (65 %) of the sample reported being stressed as a consequence of racism experienced within the gay community. Overall, 51 % of the sample reported having UAI in the prior 6 months. After controlling for race/ethnicity, age, nativity, marital status, sexual orientation, education, HIV serostatus, and lifetime history of incarceration, the multivariate analysis found statistically significant main effects of stress from racism and avoidance coping on UAI; no statistically significant main effects of dismissal, education/confrontation, and social-support seeking were observed. None of the interactions of stress with the four coping measures were statistically significant. Although stress from racism within the gay community increased the likelihood of engaging in UAI among MSM of color, we found little evidence that coping responses to racism buffered stress from racism. Instead, avoidance coping appears to suggest an increase in UAI.

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References

  • Aldwin, C. M., & Park, C. L. (2004). Coping and physical health outcomes: An overview. Psychology and Health, 19, 277–281.

    Article  Google Scholar 

  • Ayala, G., Bingham, T., Kim, J., Wheeler, D. P., & Millett, G. A. (2012). Modeling the impact of social discrimination and financial hardship on the sexual risk of HIV among Latino and Black men who have sex with men. American Journal of Public Health, 102, S242–S249.

    Article  PubMed Central  PubMed  Google Scholar 

  • Balsam, K. F., Molina, Y., Beadnell, B., Simoni, J., & Walters, K. (2011). Measuring multiple minority stress: The LGBT People of Color Microaggressions scale. Cultural Diversity and Ethnic Minority Psychology, 17, 163–174.

    Article  PubMed Central  PubMed  Google Scholar 

  • Barnes, P. W., & Lightsey, O. R. (2005). Perceived racist discrimination, coping, stress, and life satisfaction. Journal of Multicultural Counseling and Development, 33, 48–60.

    Article  Google Scholar 

  • Billings, A. G., & Moos, R. H. (1984a). The role of coping responses and social resources in attenuating the stress of life events. Journal of Behavioral Medicine, 4, 139–157.

    Article  Google Scholar 

  • Billings, A. G., & Moos, R. H. (1984b). Coping, stress, and social resources among adults with unipolar depression. Journal of Personality and Social Psychology, 46, 877–891.

    Article  PubMed  Google Scholar 

  • Brondolo, E., Gallo, L. C., & Myers, H. F. (2009). Race, racism and health: Disparities, mechanisms, and interventions. Journal of Behavioral Medicine, 32, 1–8.

    Article  PubMed  Google Scholar 

  • Calzavara, L. M., Burchell, A. N., Lebovic, G., Myers, T., Remis, R. S., Raboud, J., et al. (2012). The impact of stressful life events on unprotected anal intercourse among gay and bisexual men. AIDS and Behavior, 16, 633–643.

    Article  PubMed  Google Scholar 

  • Chae, D. H., & Yoshikawa, H. (2008). Perceived group devaluation, depression, and HIV-risk behavior among Asian gay men. Health Psychology, 27, 140–148.

    Article  PubMed  Google Scholar 

  • Chang, E. M., Daly, J., Hancock, K. M., Bidewell, J. W., Johnson, A., Lambert, V. A., et al. (2006). The relationship among workplace stressors, coping methods, demographic characteristics, and health in Australian nurses. Journal of Professional Nursing, 22, 30–38.

    Article  PubMed  Google Scholar 

  • Choi, K., Han, C., Paul, J., & Ayala, G. (2011). Strategies for managing racism and homophobia among U.S. ethnic minority men who have sex with men. AIDS Education and Prevention, 23, 145–158.

    Article  PubMed Central  PubMed  Google Scholar 

  • Choi, K., Paul, J., Ayala, G. Boylan R., & Gregorich S. E. (2013). Experiences of discrimination and their impact on mental health among African American, Asian and Pacific Islander, and Latino men who have sex with men. American Journal of Public Health, 103, 868–874.

  • Clark, R., Anderson, N., Clark, V. R., & Williams, D. R. (1999). Racism as a stressor for African Americans: A biopsychosocial model. American Psychologist, 54, 805–816.

    Article  PubMed  Google Scholar 

  • Collins, P. H. (2008). Black feminist thought: Knowledge, consciousness and the politics of empowerment. New York: Routledge.

    Google Scholar 

  • Czopp, A. M., & Monteith, M. J. (2004). Confronting prejudice (literally): Reactions to confrontations of racial and gender bias. Personality and Social Psychology Bulletin, 29, 532–544.

    Article  Google Scholar 

  • de Graaf, H., & Sandfort, T. G. (2004). Gender differences in affective responses to sexual rejection. Archives of Sexual Behavior, 33, 395–403.

    Article  PubMed  Google Scholar 

  • Diaz, R. M., Ayala, G., & Bein, E. (2004). Sexual risk as an outcome of social oppression: Data from a probability sample of Latino gay men in three U.S. cities. Cultural Diversity and Ethnic Minority Psychology, 10, 255–267.

  • Diaz, R. M., Ayala, G., Bein, E., Henne, J., & Marin, B. V. (2001). The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: Findings from 3 US cities. American Journal of Public Health, 91, 927–932.

    Article  PubMed Central  PubMed  Google Scholar 

  • Dion, K. L. (2002). The social psychology of perceived prejudice and discrimination. Canadian Psychology, 43, 1–10.

    Article  Google Scholar 

  • Elligan, D., & Utsey, S. (1999). Utility of an African-centered support group for African American men confronting societal racism and oppression. Cultural Diversity and Ethnic Minority Psychology, 5, 156–165.

    Article  PubMed  Google Scholar 

  • Folkman, S., & Lazarus, R. S. (1985). If it changes it must be a process: Study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology, 48, 150–170.

  • Friedman, E. M., Williams, D. R., Singer, B. H., & Ryff, C. D. (2009). Chronic discrimination predicts higher circulating levels of E-selection in a national sample: The MIDUS study. Brain, Behavior, and Immunity, 23, 684–692.

  • Gee, G. C., & Ford, C. L. (2011). Structural racism and health inequities: Old issues, new directions. Du Bois Review, 8, 115–132.

    Article  PubMed Central  PubMed  Google Scholar 

  • Giwa, S., & Greensmith, C. (2012). Race relations and racism in the LGBTQ community in Toronto: Perceptions of gay and queer social service providers of color. Journal of Homosexuality, 59, 149–185.

    Article  PubMed  Google Scholar 

  • Han, C. (2008). A qualitative study of the relationship between racism and unsafe sex among Asian and Pacific Islander gay men. Archives of Sexual Behavior, 37, 827–837.

    Article  PubMed  Google Scholar 

  • Han, C. (2009). Asian girls are prettier: Gendered presentations as stigma management among gay Asian men. Symbolic Interaction, 32, 106–122.

    Article  Google Scholar 

  • Harrell, S. P. (2000). A multidimensional conceptualization of racism-related stress: Implications for the well-being of people of color. American Journal of Orthopsychiatry, 70, 42–57.

    Article  PubMed  Google Scholar 

  • Herman-Stahl, M. A., Stemmler, M., & Peterson, A. C. (1995). Approach and avoidant coping: Implications for adolescent mental health. Journal of Youth and Adolescence, 24, 649–665.

    Article  Google Scholar 

  • Huynh, Q., Devos, T., & Dunbar, C. M. (2012). The psychological costs of painless but recurring experiences of racial discrimination. Culture Diversity and Ethnic Minority Psychology, 18, 26–34.

    Article  Google Scholar 

  • Ibanes, G. E., Van Oss Marin, B., Flores, S. A., Millett, G., & Diaz, R. M. (2009). General and gay-related racism experienced by Latino gay men. Cultural Diversity and Ethnic Minority Psychology, 15, 215–222.

    Article  Google Scholar 

  • Icard, L. (1986). Black gay men and conflicting social identities. Journal of Social Work & Human Sexuality, 4, 180–190.

    Article  Google Scholar 

  • Kaiser, C. R., & Miller, C. T. (2001). Stop complaining! The social costs of making attributions to discrimination. Group Process & Intergroup Relations, 6, 227–237.

    Article  Google Scholar 

  • Kaiser, C. R., & Miller, C. T. (2003). Derogating the victim: The interpersonal consequences of blaming events on discrimination. Personality and Social Psychology Bulletin, 27, 254–263.

    Article  Google Scholar 

  • Kaiser, C. R., & Miller, C. T. (2004). A stress and coping perspective on confronting sexism. Psychology of Women Quarterly, 28, 168–178.

    Article  Google Scholar 

  • Kraft, J. M., Beeker, C., Stokes, J. P., & Peterson, J. L. (2000). Finding the “community” in community-level HIV/AIDS interventions: Formative research with young African American men who have sex with men. Health Education & Behavior, 27, 430–441.

    Article  Google Scholar 

  • Lazarus, R. S. (1966). Psychological stress and the coping process. New York: McGraw-Hill.

    Google Scholar 

  • Lazarus, R. S. (1991). Emotion and adaptation. New York: Oxford University Press.

    Google Scholar 

  • Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.

    Google Scholar 

  • Lazarus, R. S., & Folkman, S. (1986). Cognitive theories of stress and the issue of circularity. In M. H. Appley & R. Trumbull (Eds.), Dynamics of stress: Physiological, psychological, and social perspectives (pp. 63–80). New York: Springer.

  • Lyon, B. L. (2012). Stress, coping, and health. In V. H. Rice (Ed.), Handbook of stress, coping, and health: Implications for nursing research, theory, and procedures (pp. 2–20). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Martin, J. I., & Alessi, E. J. (2010). Stressful events, avoidance coping, and unprotected anal sex among gay and bisexual men. American Journal of Orthopsychiatry, 80, 293–301.

    Article  PubMed  Google Scholar 

  • Mays, V. M., Cochran, S. D., & Barnes, N. W. (2007). Race, race-based discrimination, and health outcomes among African Americans. Annual Review of Psychology, 58, 201–225.

    Article  PubMed Central  PubMed  Google Scholar 

  • Mellor, D. (2004). Responses to racism: A taxonomy of coping styles used by aboriginal Australians. American Journal of Orthopsychiatry, 74, 56–71.

    Article  PubMed  Google Scholar 

  • Mendoza-Denton, R., Downey, G., Purdie, V. J., Davis, A., & Pietrzak, J. (2002). Sensitivity to status-based rejection: Implications for African American students’ college experience. Journal of Personality and Social Psychology, 83, 896–918.

    Article  PubMed  Google Scholar 

  • Metts, S., Cupach, W. R., & Imahori, T. T. (1992). Perceptions of sexual compliance: Resisting messages in three types of cross-sex relationships. Western Journal of Communication, 56, 1–17.

    Article  Google Scholar 

  • Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697.

    Article  PubMed Central  PubMed  Google Scholar 

  • Moghaddam, F. M., Taylor, D. M., Ditto, B., Jacobs, K., & Bianchi, E. (2002). Psychological distress and perceived discrimination: A study of women from India. International Journal of Intercultural Relations, 26, 381–390.

  • Noh, S., & Kaspar, V. (2003). Perceived discrimination and depression: Moderating effects of coping, acculturation, and ethnic support. American Journal of Public Health, 93, 232–238.

    Article  PubMed Central  PubMed  Google Scholar 

  • Paradies, Y. (2006). A systematic review of empirical research on self-reported racism and health. Ethnicity and Health, 35, 888–901.

    Google Scholar 

  • Paul, J. P., Ayala, G., & Choi, K. (2010). Internet sex ads for MSM and partner selection criteria: The potency of race/ethnicity online. Journal of Sex Research, 47, 528–538.

    Article  PubMed Central  PubMed  Google Scholar 

  • Phua, V. C., & Kaufman, G. (2003). The crossroads of race and sexuality: Date selection among men in internet “personal” ads. Journal of Family Issues, 24, 981–994.

    Article  Google Scholar 

  • Plummer, D. L., & Slane, S. (1996). Patterns of coping in racially stressful situations. Journal of Black Psychology, 22, 302–315.

    Article  Google Scholar 

  • Poon, M. K., & Ho, P. T. (2008). Negotiating social stigma among gay Asian men. Sexualities, 11, 245–268.

    Article  Google Scholar 

  • Raymond, H. F., & McFarland, W. (2009). Racial mixing and HIV risk among men who have sex with men. AIDS and Behavior, 13, 630–637.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rubin, D. (1987). Multiple imputation for nonresponse in surveys. New York: Wiley.

    Book  Google Scholar 

  • Schafer, J. L. (1997). Analysis of incomplete multivariate data. London: Chapman & Hall.

    Book  Google Scholar 

  • Seal, D. W., Kelly, J. A., Bloom, F. R., Stevenson, L. Y., Coley, B. I., Broyles, L. A., & the Medical College of Wisconsin City Project Research Team. (2000). HIV prevention with young men who have sex with men: What young men themselves say is needed. AIDS Care, 12, 5–26.

  • Shavers, V. L., & Shavers, B. S. (2006). Racism and health inequity among Americans. Journal of the National Medical Association, 98, 386–396.

    PubMed Central  PubMed  Google Scholar 

  • Smith, E. M. J. (1985). Ethnic minorities: Life stress, social support and mental health issues. The Counseling Psychologist, 13, 537–579.

    Article  Google Scholar 

  • Subramanian, S. V., Acevedo-Garcia, D., & Osypuk, T. L. (2005). Racial residential segregation and geographic heterogeneity in black/white disparity in poor self-rated health in the US: A multilevel statistical analysis. Social Science and Medicine, 60, 1667–1679.

    Article  PubMed  Google Scholar 

  • Suls, J., & Fletcher, B. (1985). The relative efficacy of avoidant and non-avoidant coping strategies: A meta-analysis. Health Psychology, 4, 249–288.

    Article  PubMed  Google Scholar 

  • Szymanski, D. M., & Sung, M. R. (2010). Minority stress and psychological distress among Asian American sexual minority persons. The Counseling Psychologist, 38, 848–872.

    Article  Google Scholar 

  • Thompson, V. L. S. (2002). Racism: Perceptions of distress among African Americans. Community Mental Health Journal, 38, 111–118.

    Article  PubMed  Google Scholar 

  • Utsey, S. O., Ponterotto, J. G., Reynolds, A. L., & Cancelli, A. A. (2000). Racial discrimination, coping, life satisfaction, and self-esteem among African Americans. Journal of Counseling & Development, 78, 72–80.

    Article  Google Scholar 

  • van Buuren, S. (2007). Multiple imputation of discrete and continuous data by fully conditional specification. Statistical Methods in Medical Research, 16, 219–242.

    Article  PubMed  Google Scholar 

  • Wang, J., & Patten, S. B. (2002). The moderating effects of coping strategies on major depression in the general population. Canadian Journal of Psychiatry, 47, 167–173.

    Google Scholar 

  • Wei, M., Heppner, P. P., Ku, T., & Liao, K. Y. (2010). Racial discrimination stress, coping, and depressive symptoms among Asian Americans: A moderation analysis. Asian American Journal of Psychology, 1, 136–150.

    Article  Google Scholar 

  • Wei, M., Ku, T., Russell, D. W., Mallinckrodt, B., & Liao, K. (2008). Moderating effects of three coping strategies and self-esteem on perceived discrimination and depressive symptoms: A minority stress model of Asian international students. Journal of Counseling Psychology, 55, 541–462.

  • West, L. M., Donovan, R. A., & Roemer, L. (2010). Coping with racism: What works and doesn’t work for black women. Journal of Black Psychology, 36, 331–349.

    Article  Google Scholar 

  • Williams, D. R. (2006). Race, socioeconomic status, and health: The added effects of racism and discrimination. Annals of the New York Academy of Sciences, 896, 173–188.

    Article  Google Scholar 

  • Williams, D. R., & Collins, C. (2001). Racial residential segregation: A fundamental cause of racial disparities in health. Public Health Report, 116, 404–416.

    Article  Google Scholar 

  • Williams, E. R., Mohammed, S. A., Leavell, J., & Collins, C. (2010). Race, socioeconomic status, and health: Complexities, ongoing challenges, and research opportunities. Annals of the New York Academy of Sciences, 1186, 69–101.

    Article  PubMed Central  PubMed  Google Scholar 

  • Williams, D. R., Neighbors, H. W., & Jackson, J. S. (2003). Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 93, 200–208.

    Article  PubMed Central  PubMed  Google Scholar 

  • Wilson, P. A., & Yoshikawa, H. (2004). Experiences of and responses to social discrimination among Asian and Pacific Islander gay men: Their relationship to HIV risk. AIDS Education and Prevention, 16, 68–83.

    Article  PubMed  Google Scholar 

  • Woolwine, D. (2000). Community in gay male experience and moral discourse. Journal of Homosexuality, 38, 5–37.

    Article  PubMed  Google Scholar 

  • Yoshikawa, H., Wilson, P. A., Chae, D. H., & Cheng, J. (2004). Do family and friendship networks protect against the influence of discrimination on mental health and HIV risk among Asian and Pacific Islander gay men? AIDS Education and Prevention, 16, 84–100.

    Article  PubMed  Google Scholar 

  • Zamboni, B., & Crawford, I. (2007). Minority stress and sexual problems among African-American gay and bisexual men. Achieves of Sexual Behavior, 36, 569–578.

    Article  Google Scholar 

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Acknowledgments

This research was supported by the National Institute of Mental Health Grant R01 MH069119.

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Authors and Affiliations

  1. Department of Sociology and Anthropology, Middlebury College, Middlebury, VT, 05753, USA

    Chong-suk Han

  2. Global Forum on MSM and HIV, Oakland, CA, USA

    George Ayala

  3. Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA

    Jay P. Paul, Ross Boylan, Steven E. Gregorich & Kyung-Hee Choi

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  1. Chong-suk Han
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Correspondence to Chong-suk Han.

Appendix 1: Eight Survey Questions Used to Create a Stress-from-Racism Measure

Appendix 1: Eight Survey Questions Used to Create a Stress-from-Racism Measure

  1. 1.

    “Sexual partners have wanted me only because of my race or ethnicity; they pay no attention to other personal characteristics.”

  2. 2.

    “I’ve been turned down for sex because of my race or ethnicity.”

  3. 3.

    “I’ve been made to feel unwanted online because of my race or ethnicity.”

  4. 4.

    “I’ve felt white gay men have acted as if they’re better than me because of my race or ethnicity.”

  5. 5.

    “I’ve felt ignored or invisible where white gay men hang out because of my race or ethnicity.”

  6. 6.

    “I’ve felt unwelcome or that I didn’t fit into West Hollywood because of my race or ethnicity.”

  7. 7.

    “I’ve felt that white gay men are uncomfortable around me because of my race or ethnicity.”

  8. 8.

    “Overall, when you have been treated differently based on your race/ethnicity, how stressful have these experiences been for you?”

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Han, Cs., Ayala, G., Paul, J.P. et al. Stress and Coping with Racism and Their Role in Sexual Risk for HIV Among African American, Asian/Pacific Islander, and Latino Men Who Have Sex with Men. Arch Sex Behav 44, 411–420 (2015). https://doi.org/10.1007/s10508-014-0331-1

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