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.
Similar content being viewed by others
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).
References
Mimiaga MJ, Reisner SL, Fontaine Y-M, et al. Walking the line: stimulant use during sex and HIV risk behavior among Black urban MSM. Drug Alcohol Depend. 2010;110(1–2):30–7.
Millett GA, Peterson JL, Wolitski RJ, Stall R. Greater risk for HIV infection of black men who have sex with men: a critical literature review. Am J Public Health. 2006;96(6):1007–19.
Laganá L, Balian OA, Nakhla MZ, Zizumbo J, Greenberg S. A preliminary model of health regarding sexual and ethnic minority older adults. Cult Health Sex. 2021;23(3):333–48.
Miller RL. Legacy denied: African American gay men, AIDS, and the Black church. Soc Work. 2007;52(1):51–61.
Peterson JL, Jones KT. HIV prevention for black men who have sex with men in the United States. Am J Public Health. 2009;99(6):976–80.
Beymer MR, Harawa NT, Weiss RE, et al. Are partner race and intimate partner violence associated with incident and newly diagnosed HIV infection in African-American men who have sex with men? J Urban Health. 2017;94(5):666–75.
Carbado DW, Crenshaw KW, Mays VM, Tomlinson B. INTERSECTIONALITY: mapping the movements of a theory. Du Bois Rev. 2013;10(2):303–12.
Testa RJ, Michaels MS, Bliss W, Rogers ML, Balsam KF, Joiner T. Suicidal ideation in transgender people: gender minority stress and interpersonal theory factors. J Abnorm Psychol. 2017;126(1):125–36.
Forde AT, Sims M, Muntner P, et al. Discrimination and hypertension risk among African Americans in the Jackson heart study. Hypertension. 2020;76(3):715–23.
Mays VM, Cochran SD, Barnes NW. Race, race-based discrimination, and health outcomes among African Americans. Annu Rev Psychol. 2007;58:201–25.
Bogart LM, Wagner GJ, Galvan FH, Landrine H, Klein DJ, Sticklor LA. Perceived discrimination and mental health symptoms among Black men with HIV. Cultur Divers Ethnic Minor Psychol. 2011;17(3):295–302.
Kwate NOA, Goodman MS. Cross-sectional and longitudinal effects of racism on mental health among residents of Black neighborhoods in New York City. Am J Public Health. 2015;105(4):711–8.
Remch M, Duncan DT, Geller A, et al. Police harassment and psychosocial vulnerability, distress, and depressive symptoms among black men who have sex with men in the U.S.: longitudinal analysis of HPTN 061. SSM Popul Health. 2021;13:100753.
McCabe SE, Bostwick WB, Hughes TL, West BT, Boyd CJ. The relationship between discrimination and substance use disorders among lesbian, gay, and bisexual adults in the United States. Am J Public Health. 2010;100(10):1946–52.
Gibbons FX, Etcheverry PE, Stock ML, et al. Exploring the link between racial discrimination and substance use: what mediates? What buffers? J Pers Soc Psychol. 2010;99(5):785–801.
Tobler AL, Maldonado-Molina MM, Staras SAS, O’Mara RJ, Livingston MD, Komro KA. Perceived racial/ethnic discrimination, problem behaviors, and mental health among minority urban youth. Ethn Health. 2013;18(4):337–49.
Bowleg L, Burkholder GJ, Massie JS, et al. Racial discrimination, social support, and sexual HIV risk among Black heterosexual men. AIDS Behav. 2013;17(1):407–18.
Reed E, Santana MC, Bowleg L, Welles SL, Horsburgh CR, Raj A. Experiences of racial discrimination and relation to sexual risk for HIV among a sample of urban black and African American men. J Urban Health. 2013;90(2):314–22.
Otiniano Verissimo AD, Dyer TP, Friedman SR, Gee GC. Discrimination and sexual risk among Caribbean Latinx young adults. Ethn Health. 2020;25(5):639–52.
Turpin R, Slopen N, Boekeloo B, Dallal C, Chen S, Dyer T. Testing a syndemic index of psychosocial and structural factors associated with HIV testing among Black men. J Health Care Poor Underserved. 2020;31(1):455–70.
Dyer TP, Shoptaw S, Guadamuz TE, et al. Application of syndemic theory to Black men who have sex with men in the Multicenter AIDS Cohort Study. J Urban Health. 2012;89(4):697–708.
Dyer TV, Turpin RE, Stall R, et al. Latent profile analysis of a syndemic of vulnerability factors on incident sexually transmitted infection in a cohort of Black men who have sex with men only and Black men who have sex with men and women in the HIV prevention trials network 061 study. Sex Transm Dis. 2020;47(9):571–9.
Freitag TM, Chen-Sankey JC, Duarte DA, Ramsey MW, Choi K. Variations in substance use and disorders among sexual minorities by race/ethnicity. Subst Use Misuse. 2021;56(7):921–8.
Carrico AW, Storholm ED, Flentje A, et al. Spirituality/religiosity, substance use, and HIV testing among young black men who have sex with men. Drug Alcohol Depend. 2017;174:106–12.
Mereish EH, Sheskier M, Hawthorne DJ, Goldbach JT. Sexual orientation disparities in mental health and substance use among Black American young people in the USA: effects of cyber and bias-based victimisation. Cult Health Sex. 2019;21(9):985–98.
Prestage G, Hammoud M, Jin F, Degenhardt L, Bourne A, Maher L. Mental health, drug use and sexual risk behavior among gay and bisexual men. Int J Drug Policy. 2018;55:169–79.
Spikes PS, Purcell DW, Williams KM, Chen Y, Ding H, Sullivan PS. Sexual risk behaviors among HIV-positive black men who have sex with women, with men, or with men and women: implications for intervention development. Am J Public Health. 2009;99(6):1072–8.
Gilbert PA, Daniel-Ulloa J, Conron KJ. Does comparing alcohol use along a single dimension obscure within-group differences? Investigating men’s hazardous drinking by sexual orientation and race/ethnicity. Drug Alcohol Depend. 2015;151:101–9.
Halkitis PN, Fischgrund BN, Parsons JT. Explanations for methamphetamine use among gay and bisexual men in New York City. Subst Use Misuse. 2005;40(9–10):1331–45.
Young SD, Shoptaw S. Stimulant use among African American and Latino MSM social networking users. J Addict Dis. 2013;32(1):39–45.
Slater ME, Godette D, Huang B, Ruan WJ, Kerridge BT. Sexual orientation-based discrimination, excessive alcohol use, and substance use disorders among sexual minority adults. LGBT Health. 2017;4(5):337–44.
Moradi S, Moradi Y, Rahmani K, Nouri B, Moradi G. The association between methamphetamine use and number of sexual partners in men who have sex with men: a systematic review and meta-analysis. Subst Abuse Treat Prev Policy. 2022;17(1):27.
Phillips S, Bloom B. In whose best interest? The impact of changing public policy on relatives caring for children with incarcerated parents. Child Welfare. 1998;77(5):531–41.
Alang S, McAlpine D, McCreedy E, Hardeman R. Police brutality and Black health: setting the agenda for public health scholars. Am J Public Health. 2017;107(5):662–5.
Feelemyer J, Duncan DT, Dyer TV, et al. Longitudinal associations between police harassment and experiences of violence among Black men who have sex with men in six US cities: the HPTN 061 study. J Urban Health. 2021;98(2):172–82.
Geller A, Fagan J, Tyler T, Link BG. Aggressive policing and the mental health of young urban men. Am J Public Health. 2014;104(12):2321–7.
University JH. Justice undone: examining the arrests ending in release without charges in Baltimore City 2007.
Khan MR, Kapadia F, Geller A, et al. Racial and ethnic disparities in “stop-and-frisk” experience among young sexual minority men in New York City. PLoS ONE. 2021;16(8): e0256201.
Milner AN, George BJ, Allison DB. Black and Hispanic men perceived to be large are at increased risk for police frisk, search, and force. PLoS ONE. 2016;11(1): e0147158.
Mallory C HA, Sears B. Discrimination and harassment by law enforcement officers in the LGBT community. 2015. https://williamsinstitute.law.ucla.edu/wp-content/uploads/LGBT-Discrimination-by-Law-Enforcement-Mar-2015.pdf. Accessed 22 Nov 2021.
Stenersen MR, Thomas K, McKee S. Police and transgender and gender diverse people in the United States: a brief note on interaction, harassment, and violence. J Interpers Violence 0(0):08862605211072161
English D, Rendina HJ, Parsons JT. The effects of intersecting stigma: a longitudinal examination of minority stress, mental health, and substance use among Black, Latino, and multiracial gay and bisexual men. Psychol Violence. 2018;8(6):669–79.
DeVylder J, Fedina L, Link B. Impact of police violence on mental health: a theoretical framework. Am J Public Health. 2020;110(11):1704–10.
Bowleg L, Maria Del Río-González A, Mbaba M, Boone CA, Holt SL. Negative police encounters and police avoidance as pathways to depressive symptoms among US Black men, 2015–2016. Am J Public Health. 2020;110(S1):S160–6.
DeVylder JE, Jun H-J, Fedina L, et al. Association of exposure to police violence with prevalence of mental health symptoms among urban residents in the united states. JAMA Netw Open. 2018;1(7): e184945.
Slavinski I, Spencer-Suarez K. The price of poverty: policy implications of the unequal effects of monetary sanctions on the poor. J Contemp Crim Justice. 2021;37(1):45–65.
Blankenship KM, Del Rio Gonzalez AM, Keene DE, Groves AK, Rosenberg AP. Mass incarceration, race inequality, and health: expanding concepts and assessing impacts on well-being. Soc Sci Med. 2018;215:45–52.
Brayne S. Surveillance and system avoidance. Am Sociol Rev. 2014;79(3):367–91.
Pascoe EA, Richman LS. Perceived discrimination and health: a meta-analytic review. Psychol Bull. 2009;135(4):531–54.
Sewell AA, Jefferson KA. Collateral damage: the health effects of invasive police encounters in New York city. J Urban Health. 2016;93 Suppl 1(1):42–67.
Add Health TNLSoAtAH. Social, behavioral, and biological linkages across the life course. 2022. https://addhealth.cpc.unc.edu/. Accessed 22 Nov 2021.
Princeton University. Future of families and child wellbeing study 2022. https://ffcws.princeton.edu/about. Accessed 22 Nov 2021.
Brewer RA, Magnus M, Kuo I, Wang L, Liu T-Y, Mayer KH. Exploring the relationship between incarceration and HIV among Black men who have sex with men in the United States. J Acquir Immune Defic Syndr. 2014;65(2):218–25.
Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction. 1993;88(6):791–804.
Tieu H-V, Liu T-Y, Hussen S, et al. Sexual networks and HIV risk among Black men who have sex with men in 6 U.S. cities. PLoS ONE. 2015;10(8):e0134085.
Latkin CA, Van Tieu H, Fields S, et al. Social network factors as correlates and predictors of high depressive symptoms among black men who have sex with men in HPTN 061. AIDS Behav. 2017;21(4):1163–70.
Team RC. R: A language and environment for statistical computing. R Foundation for Statistical Computing. 2018.
Downey RG, King C. Missing data in Likert ratings: a comparison of replacement methods. J Gen Psychol. 1998;125(2):175–91.
van Buuren S, Groothuis-Oudshoorn K. mice: multivariate imputation by chained equations in R. J Stat Softw. 2011;45(3).
Brewer RA, Magnus M, Kuo I, Wang L, Liu TY, Mayer KH. The high prevalence of incarceration history among Black men who have sex with men in the United States: associations and implications. Am J Public Health. 2014;104(3):448–54.
Khan MR, Brewer R, Abrams J, et al. Incarceration and sexual risk behavior and incident sexually transmitted infection/HIV in HIV prevention trials network 061: differences by study city and among Black sexual minority men who have sex with men, Black sexual minority men who have sex with men and women, and black transgender women. Sex Transm Dis. 2022;49(4):284–96.
Scheidell J, Kapadia F, Turpin R, et al. Incarceration, social support networks, and health among Black sexual minority men and transgender women: evidence from the HPTN 061 study. Int J Environ Res Public Health. 2022;19:12064.
Scheidell JD, Dyer TV, Hucks-Ortiz C, et al. Characterisation of social support following incarceration among black sexual minority men and transgender women in the HPTN 061 cohort study. BMJ Open. 2021;11(9): e053334.
Sewell AA, Jefferson KA, Lee H. Living under surveillance: gender, psychological distress, and stop-question-and-frisk policing in New York City. Soc Sci Med. 2016;159:1–13.
Aneshensel CS. Toward explaining mental health disparities. J Health Soc Behav. 2009;50(4):377–94.
Amaro H, Sanchez M, Bautista T, Cox R. Social vulnerabilities for substance use: stressors, socially toxic environments, and discrimination and racism. Neuropharmacology. 2021;188: 108518.
Duncan DT, Callander D, Bowleg L, et al. Intersectional analysis of life stress, incarceration and sexual health risk practices among cisgender Black gay, bisexual and other men who have sex with men in the Deep South of the US: the MARI Study. Sex Health. 2020;17(1):38–44.
Jackson AN, Butler-Barnes ST, Stafford JD, Robinson H, Allen PC. “can I live”: Black American adolescent boys’ reports of police abuse and the role of religiosity on mental health. Int J Environ Res Public Health. 2020;17(12):4330.
Decriminalizes possession of controlled substances, establishes the drug decriminalization task force; repealer Assembly Codes; 2023.
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).
Author information
Authors and Affiliations
Contributions
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.
Corresponding author
Ethics declarations
Ethics Approval
This is an observational study. The Institutional Review Board at NYU Grossman School of Medicine has confirmed that no ethical approval is required.
Consent to Participate
Informed consent was obtained from all individual participants included in the study.
Consent for Publication
The authors affirm that human research participants provided informed consent for publication of the results of this study.
Competing Interests
The authors declare no competing interests.
Disclaimer
The funding agencies had no role in designing the research, data analyses, and preparation of the report.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
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
Received:
Revised:
Accepted:
Published:
DOI: https://doi.org/10.1007/s40615-024-01909-1