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Sexual Orientation- and Race-Based Discrimination and Sexual HIV Risk Behavior Among Urban MSM

Abstract

Understanding what social factors are associated with risk of HIV acquisition and transmission among gay, bisexual and other men who have sex with men (MSM) is a critical public health goal. Experiencing discrimination may increase risk of HIV infection among MSM. This analysis assessed relations between experiences of sexual orientation- and race-based discrimination and sexual HIV risk behavior among MSM in New York City. 1,369 MSM completed a self-administered computerized assessment of past 3-month sexual behavior, experience of social discrimination and other covariates. Regression models assessed relations between recent experience of discrimination and sexual HIV risk behavior. Mean age was 32 years; 32 % were white; 32 % Latino/Hispanic; 25 % African American/Black. Of MSM who self-reported HIV-positive or unknown status (377), 7 % (N = 27) reported having unprotected insertive anal intercourse with an HIV-negative or unknown status partner (“HIV transmission risk”). Of MSM who self-reported HIV-negative status (992), 11 % (110) reported unprotected receptive anal intercourse with an HIV-positive or unknown status partner (“HIV acquisition risk”). HIV acquisition risk was positively associated with sexual orientation-based discrimination in home or social neighborhoods, but not race-based discrimination. We observed that sexual orientation-based discrimination was associated with sexual HIV risk behavior among urban-dwelling MSM. Addressing environmental sources of this form of discrimination, as well as the psychological distress that may result, should be prioritized in HIV prevention efforts.

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Acknowledgments

The authors acknowledge the assistance of Krista Goodman, DaShawn Usher, Travis Cronin, Jermaine McCrossin, John Bonelli, Geneva Ortiz, Kiwan Stewart, Kimberly Morales, Evelyn Rivera, Blaz Bush, Heriberto Oquendo, Jr., Michael Hernandez, and Damon Jacobs. We also thank the individuals who gave their time and efforts to participate in this study. This study was supported by National Institute of Child Health and Human Development R01 HD059729 to Dr. Beryl Koblin of the New York Blood Center. Dr. Victoria Frye’s work was also supported through a National Institute on Drug Abuse mentored career development award (K01 DA-020774).

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Correspondence to Victoria Frye.

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Frye, V., Nandi, V., Egan, J. et al. Sexual Orientation- and Race-Based Discrimination and Sexual HIV Risk Behavior Among Urban MSM. AIDS Behav 19, 257–269 (2015). https://doi.org/10.1007/s10461-014-0937-2

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  • DOI: https://doi.org/10.1007/s10461-014-0937-2

Keywords

  • HIV prevention
  • Social discrimination
  • Sexual behavior
  • MSM