*Department of Psychology, Georgia State University, Atlanta, GA; †Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA; ‡National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA; §Division of Health Promotion and Behavior, School of Public Health, Georgia State University, Atlanta, GA; ‖Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA; and ¶Department of Medicine, School of Medicine, Emory University, Atlanta, GA.
J Acquir Immune Defic Syndr. 2014 Aug 15;66(5):538-43. doi: 10.1097/QAI.0000000000000203.
To examine the associations of homophobia, racism, and resiliency with differences in prevalent HIV infection in black and white men who have sex with men (MSM).
The Involve[ment]t study is a cohort of black and white MSM aged 18-39 years in Atlanta, GA, designed to evaluate individual, dyadic, and community level factors that might explain racial disparities in HIV prevalence. Participants were recruited irrespective of HIV serostatus from community-based venues and from Internet advertisements and were tested for HIV. We assessed respondents' demographics, whether they had engaged in unprotected anal intercourse (UAI) within the past 6 months, and attitudes about perceived homophobia, perceived racism, and personal resiliency.
Compared with white MSM, black MSM were less likely to report UAI in the past 6 months [odds ratio (OR): 0.59, confidence interval (CI): 0.44 to 0.80], more likely to be HIV positive (OR: 5.05, CI: 3.52 to 7.25), and--among those HIV positive--more likely to report not being aware of their HIV infection (OR: 2.58, CI: 1.18 to 5.65). Greater perceived racism was associated with UAI in the black sample (partial odds ratio: 1.48, CI: 1.10 to 1.99). Overall, perceived homophobia, perceived racism, and resilience were not associated with prevalent HIV infection in our samples. Greater resilience was associated with less perceived homophobia in both black and white samples (Spearman r = -0.27, P < 0.001, for both).
Future studies of social discrimination at the institutional and network level, than at the individual level, may explain differences in HIV infection in black and white MSM.
探讨恐同、种族主义和适应能力与男男性行为者（MSM）中黑人和白人艾滋病毒感染流行率差异的关系。
Involve[ment]t 研究是一项在佐治亚州亚特兰大的黑人和白人 MSM 18-39 岁年龄组的队列研究，旨在评估可能解释艾滋病毒流行率种族差异的个体、对偶和社区层面的因素。参与者从基于社区的场所和互联网广告中招募，不论艾滋病毒血清状况如何，均接受艾滋病毒检测。我们评估了受访者的人口统计学特征、过去 6 个月内是否进行过无保护肛交（UAI）以及对感知到的恐同、感知到的种族主义和个人适应力的态度。
与白人 MSM 相比，黑人 MSM 在过去 6 个月内进行 UAI 的可能性较低（优势比[OR]：0.59，置信区间[CI]：0.44 至 0.80），艾滋病毒阳性的可能性更高（OR：5.05，CI：3.52 至 7.25），且在艾滋病毒阳性者中，更有可能不知道自己的艾滋病毒感染情况（OR：2.58，CI：1.18 至 5.65）。黑人样本中感知到的种族主义与 UAI 相关（部分 OR：1.48，CI：1.10 至 1.99）。总体而言，感知到的恐同、感知到的种族主义和适应力与我们样本中的艾滋病毒流行率无关。黑人样本和白人样本中，适应力越高，感知到的恐同程度越低（Spearman r = -0.27，P < 0.001，均如此）。
未来的研究可能需要关注制度和网络层面的社会歧视，而不是个体层面的社会歧视，以解释黑人和白人 MSM 之间的艾滋病毒感染差异。
