交叉结构性压迫与黑人男同性恋者的健康。
Intersecting Structural Oppression and Black Sexual Minority Men's Health.
机构信息
Rutgers School of Public Health, Newark, New Jersey.
Department of Psychology, Hunter College of City University of New York, New York, New York; Health Psychology and Clinical Science Doctoral Program, The Graduate Center, City University of New York, New York, New York.
出版信息
Am J Prev Med. 2021 Jun;60(6):781-791. doi: 10.1016/j.amepre.2020.12.022. Epub 2021 Apr 8.
INTRODUCTION
Although evidence indicates that Black gay, bisexual, and other sexual minority men experience vast psychological and behavioral health inequities, most research has focused on individual rather than structural drivers of these inequities. This study examines the associations between structural racism and anti-lesbian, gay, bisexual, transgender, and queer policies and the psychological and behavioral health of Black and White sexual minority men.
METHODS
Participants were an Internet-based U.S. national sample of 1,379 Black and 5,537 White sexual minority men during 2017-2018. Analysis occurred in 2019-2020. Structural equation modeling tested the associations from indicators of structural racism, anti‒lesbian, gay, bisexual, transgender, and queer policies, and their interaction to anxiety symptoms, depressive symptoms, perceived burdensomeness, heavy drinking, and HIV testing frequency. Separate models for Black and White sexual minority men adjusted for contextual and individual covariates.
RESULTS
For Black participants, structural racism was positively associated with anxiety symptoms (β=0.20, SE=0.10, p=0.04), perceived burdensomeness (β=0.42, SE=0.09, p<0.001), and heavy drinking (β=0.23, SE=0.10, p=0.01). Anti‒lesbian, gay, bisexual, transgender, and queer policies were positively associated with anxiety symptoms (β=0.08, SE=0.04, p=0.03), perceived burdensomeness (β=0.20, SE=0.04, p<0.001), and heavy drinking (β=0.10, SE=0.04, p=0.01) and were negatively associated with HIV testing frequency (β= -0.14, SE=0.07, p=0.04). Results showed significant interaction effects, such that the positive associations between structural racism and both perceived burdensomeness (β=0.38, SE=0.08, p≤0.001) and heavy drinking (β=0.22, SE=0.07, p=0.003) were stronger for individuals living in states with high levels of anti‒lesbian, gay, bisexual, transgender, and queer policies. Neither of the oppression variables nor their interaction was significantly associated with outcomes for White sexual minority men.
CONCLUSIONS
Results highlight the intersectional nature of structural oppression and suggest that racist and anti-lesbian, gay, bisexual, transgender, and queer policies must be repealed to rectify health inequities facing Black sexual minority men.
简介
尽管有证据表明，黑人男同性恋、双性恋和其他性少数群体经历着巨大的心理和行为健康不平等，但大多数研究都集中在这些不平等的个体驱动因素上，而不是结构驱动因素上。本研究考察了结构性种族主义与反同性恋、双性恋、跨性别和酷儿政策之间的关联，以及这些关联与黑人男性和白人男同性恋、双性恋和其他性少数群体的心理和行为健康之间的关联。
方法
参与者是 2017 年至 2018 年期间通过互联网进行的一项美国全国性的黑人参与者和 5537 名白人参与者的样本。分析于 2019 年至 2020 年进行。结构方程模型测试了结构性种族主义、反同性恋、双性恋、跨性别和酷儿政策的指标，以及它们与焦虑症状、抑郁症状、感知负担、重度饮酒和 HIV 检测频率之间的相互作用。针对黑人参与者和白人参与者的单独模型调整了背景和个体协变量。
结果
对于黑人参与者，结构性种族主义与焦虑症状呈正相关（β=0.20，SE=0.10，p=0.04），与感知负担（β=0.42，SE=0.09，p<0.001）和重度饮酒（β=0.23，SE=0.10，p=0.01）呈正相关。反同性恋、双性恋、跨性别和酷儿政策与焦虑症状呈正相关（β=0.08，SE=0.04，p=0.03），与感知负担（β=0.20，SE=0.04，p<0.001）和重度饮酒（β=0.10，SE=0.04，p=0.01）呈正相关，与 HIV 检测频率呈负相关（β=-0.14，SE=0.07，p=0.04）。研究结果显示出显著的交互作用，例如，在反同性恋、双性恋、跨性别和酷儿政策水平较高的州，结构性种族主义与感知负担（β=0.38，SE=0.08，p≤0.001）和重度饮酒（β=0.22，SE=0.07，p=0.003）之间的正相关更强。对于白人男同性恋、双性恋和其他性少数群体，这两种压迫变量及其相互作用均与结果无显著关联。
结论
研究结果突出了结构性压迫的交叉性质，并表明必须废除种族主义和反同性恋、双性恋、跨性别和酷儿政策，以纠正黑人男同性恋、双性恋和其他性少数群体面临的健康不平等问题。
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