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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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Acknowledgments

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

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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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  • DOI: https://doi.org/10.1007/s10508-014-0331-1

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