Center for Health Equity Research, California State University Long Beach, 1250 Bellflower Blvd., FO5 Rm. 120, Long Beach, CA, 90840, USA.
AIDS Behav. 2024 May;28(5):1741-1751. doi: 10.1007/s10461-024-04267-5. Epub 2024 Feb 17.
Although several healthcare interventions have been developed to address HIV among young Black/African American men who have sex with men (YBMSM), the HIV epidemic in the United States continues to disproportionately burden this population. The current study examines previous healthcare discrimination and how it affects HIV intervention delivery. One hundred seventy-two YBMSM participated in the Peer Promotion of Wellness and Enhanced Linkage to Resources (PPOWER) project, which used a short, multi-faceted, community-level intervention based on Community Peers Reaching Out and Modeling Intervention Strategies (Community PROMISE). Data were collected at baseline, a 45-day follow up, and a 90-day follow up. Generalized Estimating Equations (GEE) were used to examine the effects of previous healthcare discrimination on outcomes related to HIV testing, alcohol and drug use, and sexual behaviors. Previous healthcare discrimination was found to moderate the relationship between time and intentions to test for HIV, perceptions of sexual risk, problem marijuana use, and problem other drug use, such that those who had experienced more healthcare discrimination showed greater improvements over time compared to those who had experienced less healthcare discrimination. The results of the current study suggest that a community-level peer intervention, in combination with a component to promote cultural competency and address prior experiences of discrimination in healthcare settings, may be highly effective for people who have experienced a barrier in their continuum of care as a result of racial discrimination.
尽管已经开发了几种医疗保健干预措施来解决与男男性行为者（MSM）相关的艾滋病毒问题，但美国的艾滋病毒疫情仍继续不成比例地给这一人群带来负担。本研究探讨了先前的医疗保健歧视及其对艾滋病毒干预措施实施的影响。172 名 YBMSM 参与了“同伴促进健康和增强资源联系”（PPOWER）项目，该项目采用了一种基于社区同伴伸出援手和模范干预策略（社区 PROMISE）的简短、多方面的社区层面干预措施。在基线、45 天随访和 90 天随访时收集数据。使用广义估计方程（GEE）来检验先前的医疗保健歧视对与 HIV 检测、酒精和药物使用以及性行为相关的结果的影响。研究发现，先前的医疗保健歧视会影响时间和进行 HIV 检测的意愿、对性风险的看法、大麻使用问题和其他药物使用问题之间的关系，即那些经历过更多医疗保健歧视的人相对于那些经历过较少医疗保健歧视的人在时间上显示出更大的改善。本研究的结果表明，一种基于社区的同伴干预措施，结合促进文化能力和解决医疗保健环境中先前歧视经验的组成部分，对于那些因种族歧视而在护理连续体中遇到障碍的人可能非常有效。
