Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, MC 5065, Chicago, IL, 60637, USA.
Chicago Center for HIV Elimination, Chicago, IL, USA.
AIDS Behav. 2020 Jul;24(7):2119-2129. doi: 10.1007/s10461-020-02778-5.
The various forms of HIV-related stigma continue to serve as major barriers to HIV care and treatment among men who have sex with men (MSM). The study of resilience within the context of HIV-related stigma among MSM living with HIV represents a promising area of research to inform the development of future HIV interventions for this population. We examined resilience within the context of HIV related stigma among MSM living with HIV in Louisiana with a particular interest in how resilience may be more relevant for Black MSM. We utilized Pearson's correlations and layered chi-square non-parametric tests to examine associations and racial differences in resilience, four HIV-related stigma measures/consequences (i.e., anticipated, internalized, enacted, and consequences of enacted HIV stigma), and HIV care outcomes (i.e., length of time since last HIV care visit, time since last HIV lab result, most recent HIV viral load result) among 110 MSM living with HIV in Louisiana who participated in the Louisiana HIV Stigma Index Project. The majority of MSM participants were Black (75%), lived in New Orleans (52%), and reported limited education (52%) and income (76%). MSM who reported higher levels of enacted HIV stigma, consequences of enacted HIV stigma, and internalized HIV stigma reported poorer HIV care outcomes. Both internalized and anticipated HIV stigma significantly negatively impacted Black MSM perceptions of their overall health compared with White MSM. Compared with White MSM, Black MSM who reported greater consequences of enacted HIV stigma had poorer HIV care outcomes. Resilience was associated with positive HIV care outcomes for both Black and White MSM. However, having higher levels of resilience may have been more protective for Black MSM such that higher levels of resilience were associated with less time since last HIV care visit for Black MSM than for White MSM. The current study provides preliminary information on the potential positive relationship between resilience and HIV care outcomes among MSM, particularly Black MSM. However, these findings need to be confirmed among a more representative sample of Black and White MSM in Louisiana.
艾滋病毒相关污名的各种形式继续严重阻碍男男性行为者（MSM）获得艾滋病毒护理和治疗。在艾滋病毒相关污名背景下研究 MSM 人群的韧性，是为这一人群制定未来艾滋病毒干预措施提供信息的一个很有前途的研究领域。我们在路易斯安那州艾滋病毒感染者中研究了艾滋病毒相关污名背景下的韧性，特别关注韧性对于黑人 MSM 可能更为相关。我们利用 Pearson 相关系数和分层卡方非参数检验，研究了韧性与四个艾滋病毒相关污名指标/后果（即预期、内化、实施和实施艾滋病毒污名的后果）以及艾滋病毒护理结局（即上次艾滋病毒护理就诊时间、上次艾滋病毒实验室结果时间、最近艾滋病毒病毒载量结果）之间的关联和种族差异，该研究共纳入了 110 名参与路易斯安那州艾滋病毒污名指数项目的路易斯安那州艾滋病毒感染者 MSM。大多数 MSM 参与者是黑人（75%），居住在新奥尔良（52%），报告受教育程度有限（52%）和收入低（76%）。报告实施艾滋病毒污名程度较高、实施艾滋病毒污名后果和内化艾滋病毒污名程度较高的 MSM 报告艾滋病毒护理结局较差。内化和预期艾滋病毒污名均显著降低了黑人 MSM 对其整体健康状况的感知，与白人 MSM 相比。与白人 MSM 相比，报告实施艾滋病毒污名后果程度较高的黑人 MSM 艾滋病毒护理结局较差。韧性与黑人 MSM 和白人 MSM 的积极艾滋病毒护理结局相关。然而，对于黑人 MSM 而言，韧性水平较高可能具有更大的保护作用，因为与白人 MSM 相比，黑人 MSM 中较高的韧性水平与上次艾滋病毒护理就诊时间较短有关。本研究初步提供了韧性与 MSM，特别是黑人 MSM 艾滋病毒护理结局之间潜在积极关系的信息。然而，这些发现需要在路易斯安那州更具代表性的黑人和白人 MSM 样本中得到证实。
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