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<p>Black sexual minority men living with HIV (BSMM+) in the Southern United States encounter multiple forms of discrimination, which are associated with decreased HIV care engagement. We analyzed data from 166 BSMM + in the South to assess direct associations between experiences of racism, heterosexism, and HIV-related discrimination with HIV care engagement. We further investigated indirect associations through three mediators: internalized racism, internalized heterosexism, and internalized HIV stigma. Experienced heterosexism was indirectly associated with HIV care engagement through internalized HIV stigma (<i>b</i><sub>indirect</sub> = −0.039, <i>p</i> = 0.098). HIV discrimination was associated with internalized heterosexism (<i>b</i><sub>direct</sub> = 0.577, <i>p</i> = 0.007) and internalized racism (<i>b</i><sub>direct</sub> = 0.253, <i>p</i> = 0.009). There were significant direct associations between internalized HIV stigma and HIV care engagement (<i>b</i><sub>direct</sub> = −0.040, <i>p</i> = 0.001) and experienced heterosexism and internalized HIV stigma (<i>b</i><sub>direct</sub> = 0.974, <i>p</i> = 0.050). These findings aim to understand the factors affecting HIV care engagement among this population to improve HIV care engagement.</p>

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Untangling Discrimination: The Impact of Internalizing Oppression on HIV Treatment Engagement Among Young Black Sexual Minority Men in the Southern US

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年6月5日

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  • Carrie L. Nacht,
  • Cody Lentz,
  • Wilson Vincent,
  • Daniel Siconolfi,
  • Lance M. Pollack,
  • Susan M. Kegeles,
  • Chadwick K. Campbell,
  • Adedotun Ogunbajo,
  • Erik D. Storholm

摘要

Black sexual minority men living with HIV (BSMM+) in the Southern United States encounter multiple forms of discrimination, which are associated with decreased HIV care engagement. We analyzed data from 166 BSMM + in the South to assess direct associations between experiences of racism, heterosexism, and HIV-related discrimination with HIV care engagement. We further investigated indirect associations through three mediators: internalized racism, internalized heterosexism, and internalized HIV stigma. Experienced heterosexism was indirectly associated with HIV care engagement through internalized HIV stigma (bindirect = −0.039, p = 0.098). HIV discrimination was associated with internalized heterosexism (bdirect = 0.577, p = 0.007) and internalized racism (bdirect = 0.253, p = 0.009). There were significant direct associations between internalized HIV stigma and HIV care engagement (bdirect = −0.040, p = 0.001) and experienced heterosexism and internalized HIV stigma (bdirect = 0.974, p = 0.050). These findings aim to understand the factors affecting HIV care engagement among this population to improve HIV care engagement.