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Socio-structural Factors Associated with Mental Health, Substance Use, and HIV Risk Among Black Sexual and Gender Minorities in the House and Ball Community

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Abstract

The House and Ball Community (HBC), a tight-knit social and cultural network comprised primarily of Black sexual and gender minorities (SGM), offers unique opportunities for HIV prevention that leverage naturally occurring social support networks. However, experiences of socioeconomic marginalization, stigma, violence, and trauma may impede HIV prevention efforts. This study analyzed data from 551 Black SGM recruited at HBC events in 2 cities over 24 months. Logistic regression with generalized estimating equations examined associations between socio-structural stressors, mental health, substance use, and sexual behavior among HBC participants. Findings indicated high prevalence of depressive symptoms, history of trauma, intimate partner violence, and substance use, and significant associations between socioeconomic marginalization and depressive symptoms, substance use, and condomless anal sex. Future research is needed to better elucidate the temporal relationships between socioeconomic marginalization, mental health and substance use, and HIV transmission dynamics. Results highlight a need for integration of mental health services, substance use treatment, and HIV prevention for this community.

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Author information

Authors and Affiliations

  1. Department of Medicine, University of Chicago, Chicago, IL, USA

    Anna L. Hotton

  2. Department of Psychiatry, Stroger Hospital of Cook County, Chicago, IL, USA

    Christopher Balthazar & Sybil G. Hosek

  3. Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA

    Laura Jadwin-Cakmak & Gary W. Harper

  4. The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Bevin Gwiazdowski & Marne Castillo

  5. Section of Infectious Diseases and Global Health & Chicago Center for HIV Elimination (CCHE), The University of Chicago Medicine, 5837 S. Maryland Ave, Chicago, IL, L-03860637, USA

    Anna L. Hotton

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  1. Anna L. Hotton
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  2. Christopher Balthazar
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  4. Bevin Gwiazdowski
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  5. Marne Castillo
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  7. Sybil G. Hosek
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Correspondence to Anna L. Hotton.

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Hotton, A.L., Balthazar, C., Jadwin-Cakmak, L. et al. Socio-structural Factors Associated with Mental Health, Substance Use, and HIV Risk Among Black Sexual and Gender Minorities in the House and Ball Community. AIDS Behav 24, 2319–2326 (2020). https://doi.org/10.1007/s10461-020-02791-8

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  • DOI: https://doi.org/10.1007/s10461-020-02791-8

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