Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA.
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
LGBT Health. 2022 Aug-Sep;9(6):411-417. doi: 10.1089/lgbt.2021.0401. Epub 2022 May 20.
This study investigated conflict between sexual orientation and racial/ethnic identities as a mechanism linking minority stress to HIV-related outcomes among men who have sex with men (MSM), transgender women and gender nonbinary (TGN) people of color (POC). We tested longitudinal mediation models with sexual orientation microaggressions, internalized heterosexism (IH), and sexual orientation concealment at Time 1, and pre-exposure prophylaxis (PrEP) use and number of condomless anal sex (CAS) partners at Time 3, mediated by identity conflict at Time 2. Participants were 337 MSM and TGN POC. Data were collected in Chicago, Illinois, from September 2018 to February 2021. Indirect associations of IH and sexual orientation concealment, respectively, at Time 1 with CAS partners at Time 3 through identity conflict at Time 2 were significant. Mediation models with sexual orientation microaggressions as the predictor and PrEP use as the outcome were not significant. Minority stress may contribute to identity conflict and increase CAS by isolating MSM and TGN POC from sexual and gender minority communities, thus restricting access to safer sex resources, and by increasing psychological distress and decreasing self-care (e.g., condom use).
本研究调查了性取向和种族/民族认同之间的冲突，作为将少数群体压力与男男性行为者（MSM）、跨性别女性和非二元性别（TGN）有色人种（POC）的与 HIV 相关结果联系起来的机制。我们测试了纵向中介模型，其中包括性取向微侵犯、内化异性恋主义（IH）和性取向隐瞒在第 1 时间，以及暴露前预防（PrEP）使用和第 3 时间无保护肛交（CAS）伴侣数量，由第 2 时间的身份冲突介导。参与者为 337 名 MSM 和 TGN POC。数据于 2018 年 9 月至 2021 年 2 月在伊利诺伊州芝加哥收集。IH 和性取向隐瞒在第 1 时间的间接关联，分别与第 2 时间的身份冲突通过第 3 时间的 CAS 伴侣有关。以性取向微侵犯为预测因子和 PrEP 使用为结果的中介模型并不显著。少数群体压力可能导致身份冲突，并通过将 MSM 和 TGN POC 与性少数群体社区隔离，从而限制获得更安全的性行为资源，并通过增加心理困扰和减少自我保健（例如，使用避孕套）来增加 CAS。
