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Police Harassment and Psychiatric, Sexual, and Substance Use Risk Among Black Sexual Minority Men and Black Transgender Women in the HIV Prevention Trials 061 Cohort

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Abstract

Background

Black sexual minority men and Black transgender women (BSMM/BTW) experience disproportionate levels of HIV/STI-related risk factors as well as police harassment (PH). PH is linked to psychiatric risk and could play a role in substance use, sexual risk behavior, and HIV/STI risk.

Methods

We used data from the HIV Prevention Trials Network 061(HPTN 061) study to examine associations between PH and HIV/STI-related outcomes. Using PH exposure measured at baseline and 6-month study visits, we examined an ordinal exposure (PH reported at both visits, PH reported at either visit, versus PH reported at neither baseline nor 6 months) and a binary exposure of persistent PH reported at both visits (yes versus no). We estimate risk ratios (RR) for associations between PH and depression, use of alcohol and methamphetamine, multiple partnerships, condomless sex, and syphilis.

Results

Persistent PH (binary) was associated with a 20% or greater increase in the risk of depression (RR, 1.26 (1.07, 1.47)) and multiple partnerships (RR, 1.20 (1.05, 1.39)). There was evidence that ordinal PH was associated with elevated risk of alcohol use (RR, 1.17 (1.00, 1.36)); the point estimate for the association between persistent PH and alcohol use was similar but the imprecision was greater (RR, 1.16 (0.95, 1.42)).

Conclusion

PH may influence not only mental health but also behavioral risks that contribute to HIV/STI among BSMM/BTW, highlighting the potential wide-ranging and downstream effects of PH on health. Further research is required to confirm associations and elucidate pathways through which PH may influence HIV/STI among BSMM/BTW.

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Data Availability

Access to the data can be provided through an approved Data Use Agreement between our institution (New York University School of Medicine) and the institution with which the user is affiliated. Persons wanting to access the data should communicate with the NYU IRB to initiate a Data Use Agreement (gro.enognaluyn@ofni-bri).

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Acknowledgements

We are thankful to the following groups who made possible the HPTN 061 study: HPTN 061 study participants; HPTN 061 Protocol co-chairs, Beryl Koblin, PhD, Kenneth Mayer, MD, and Darrell Wheeler, PhD, MPH; HPTN061 Protocol team members; HPTN Black Caucus; HPTN Network Laboratory, Johns Hopkins University School of Medicine; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center; Statistical and Data Management Center, Statistical Center for HIV/AIDS Research and Prevention; HPTN CORE Operating Center, Family Health International (FHI) 360; Black Gay Research Group; and clinical research sites, staff, and Community Advisory Boards at Emory University, Fenway Institute, GWU School of Public Health and Health Services, Harlem Prevention Center, New York Blood Center, San Francisco Department of Public Health, the University of California, Los Angeles, Center for Behavioral and Addiction Medicine, and Cornelius Baker, FHI 360. We are thankful to Sam Griffith, Senior Clinical Research Manager, FHI 360, and Lynda Emel, Associate Director, HPTN Statistical and Data Management Center, Fred Hutchinson Cancer Research Center, for their considerable assistance with HPTN 061 data acquisition and documentation.

Funding

This research was supported by the National Institute on Drug Abuse grant “Stop-and-Frisk, Arrest, and Incarceration and STI/HIV Risk in Minority MSM” (Principal Investigator: MRK; R01DA044037). The National Institute of Allergy and Infectious Disease (NIAID), National Institute on Drug Abuse (NIDA), and National Institute of Mental Health (NIMH): Cooperative Agreements UM1 AI068619, UM1 AI068617, and UM1 AI068613. Additional site funding included Fenway Institute Clinical Research Site (CRS): Harvard University CFAR (P30 AI060354) and CTU for HIV Prevention and Microbicide Research (UM1 AI069480); George Washington University CRS: District of Columbia Developmental CFAR (P30 AI087714); Harlem Prevention Center CRS And NY Blood Center/Union Square CRS: Columbia University CTU (5U01 AI069466) and ARRA funding (3U01 AI069466-03S1); Hope Clinic of the Emory Vaccine Center CRS and The Ponce de Leon Center CRS: Emory University HIV/AIDS CTU (5U01 AI069418), CFAR (P30 AI050409) and CTSA (UL1 RR025008); San Francisco Vaccine and Prevention CRS: ARRA funding (3U01 AI069496-03S1, 3U01 AI069496-03S2); UCLA Vine Street CRS: UCLA Department of Medicine, Division of Infectious Diseases CTU(U01AI069424); NIDAP30DA027828-08S1; University of Maryland Prevention Research Center (U48 DP006382); New York University Center for Drug Use and HIV Research (P30 DA011041); New York University-City University of New York (NYU-CUNY) Prevention Research Center (U48 DP005008); and Project DISRUPT (R01 DA-028766).

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MK and JF proposed the original research question, MM conducted analysis; JF and NA wrote the initial draft of the manuscript; JF, MM, and CC assisted with statistical analysis including imputation and propensity score modeling; JF, DD, NI, JS, TD, RT, RB, CHO, CC, KM, and MK provided guidance and expertise on subject matter related to the study sample and design, and all authors reviewed the final manuscript prior to submission.

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Correspondence to Jonathan Feelemyer.

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Feelemyer, J., Duncan, D.T., Akhidenor, N. et al. Police Harassment and Psychiatric, Sexual, and Substance Use Risk Among Black Sexual Minority Men and Black Transgender Women in the HIV Prevention Trials 061 Cohort. J. Racial and Ethnic Health Disparities (2024). https://doi.org/10.1007/s40615-024-01909-1

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