School of Medicine, Vanderbilt University, Nashville, TN, USA.
HIV/STI/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA.
Am J Mens Health. 2023 Mar-Apr;17(2):15579883231163727. doi: 10.1177/15579883231163727.
Gay, bisexual, and other men who have sex with men (MSM) are disproportionally impacted by HIV. Discrimination, violence, and psychological distress (PD) may influence engagement with HIV prevention services and amplify HIV vulnerability among this priority population. These dynamics are understudied in the Southern United States. Understanding how these relationships interact is critical to designing effective HIV programs. We examined associations between MSM-related discrimination, MSM-related violence, and severe PD with HIV status among 2017 National HIV Behavioral Surveillance study participants in Memphis, Tennessee. Eligible participants were aged ≥18 years, born and identified as male, and reported having sex with another man in their lifetime. Participants completed a Centers for Disease Control and Prevention-designed anonymous survey and self-reported discrimination and violence across their lifetime, and PD symptoms within the past month, scored on the Kessler-6 Scale. Optional HIV rapid tests were performed on-site. Logistic regressions examined the associations between the exposure variables and HIV antibody-positive results. Among 356 respondents, 66.9% were aged <35 years and 79.5% identified as non-Hispanic Black; 13.2% reported experiencing violence, 47.8% reported discrimination, and 10.7% experienced PD. Of the 297 participants who tested, 33.33% were living with HIV. Discrimination, violence, and PD were significantly associated with each other ( < .0001). HIV antibody-positive test results were associated with violence ( < .01). Memphis-based MSM face a complex array of social experiences, which may increase vulnerability to HIV. On-site testing at community-based organizations and clinical settings among MSM may be an opportunity to screen for violence and incorporate strategies when designing HIV programs.
男同性恋者、双性恋者和其他与男性发生性关系的男性(MSM)不成比例地受到艾滋病毒的影响。歧视、暴力和心理困扰(PD)可能会影响他们对艾滋病毒预防服务的参与,并放大这一优先人群的艾滋病毒易感性。这些动态在美国南部研究得还不够充分。了解这些关系如何相互作用对于设计有效的艾滋病毒项目至关重要。我们研究了 2017 年田纳西州孟菲斯市全国艾滋病毒行为监测研究参与者中与 MSM 相关的歧视、与 MSM 相关的暴力以及严重 PD 与艾滋病毒状况之间的关联。符合条件的参与者年龄≥18 岁,出生并被认定为男性,并报告在一生中与另一名男性发生过性关系。参与者完成了疾病控制和预防中心设计的匿名调查,并在一生中自我报告了歧视和暴力行为,以及过去一个月内的 PD 症状,使用 Kessler-6 量表进行评分。现场进行了可选的艾滋病毒快速检测。逻辑回归分析了暴露变量与艾滋病毒抗体阳性结果之间的关系。在 356 名受访者中,66.9%的人年龄<35 岁,79.5%的人是非西班牙裔黑人;13.2%的人报告遭受过暴力,47.8%的人报告遭受过歧视,10.7%的人经历过 PD。在 297 名接受检测的参与者中,33.33%的人携带艾滋病毒。歧视、暴力和 PD 彼此显著相关(<0.0001)。艾滋病毒抗体阳性检测结果与暴力有关(<0.01)。孟菲斯市的 MSM 面临着一系列复杂的社会经历,这可能会增加他们感染艾滋病毒的脆弱性。在 MSM 所在的社区组织和临床机构进行现场检测可能是筛查暴力行为并在设计艾滋病毒项目时纳入相关策略的机会。