Nacht Carrie L, Lentz Cody, Vincent Wilson, Siconolfi Daniel, Pollack Lance M, Kegeles Susan M, Campbell Chadwick K, Ogunbajo Adedotun, Storholm Erik D
School of Public Health, San Diego State University, San Diego, CA, USA.
Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA.
AIDS Behav. 2025 Jun 5. doi: 10.1007/s10461-025-04774-z.
Black sexual minority men living with HIV (BSMM+) in the Southern United States encounter multiple forms of discrimination, which are associated with decreased HIV care engagement. We analyzed data from 166 BSMM + in the South to assess direct associations between experiences of racism, heterosexism, and HIV-related discrimination with HIV care engagement. We further investigated indirect associations through three mediators: internalized racism, internalized heterosexism, and internalized HIV stigma. Experienced heterosexism was indirectly associated with HIV care engagement through internalized HIV stigma (b = -0.039, p = 0.098). HIV discrimination was associated with internalized heterosexism (b = 0.577, p = 0.007) and internalized racism (b = 0.253, p = 0.009). There were significant direct associations between internalized HIV stigma and HIV care engagement (b = -0.040, p = 0.001) and experienced heterosexism and internalized HIV stigma (b = 0.974, p = 0.050). These findings aim to understand the factors affecting HIV care engagement among this population to improve HIV care engagement.
美国南部感染艾滋病毒的黑人性少数群体男性（BSMM+）面临多种形式的歧视，这与艾滋病毒护理参与度降低有关。我们分析了来自南部166名BSMM+的数据，以评估种族主义、异性恋主义和与艾滋病毒相关的歧视经历与艾滋病毒护理参与度之间的直接关联。我们还通过三个中介因素进一步调查了间接关联：内化的种族主义、内化的异性恋主义和内化的艾滋病毒污名。经历的异性恋主义通过内化的艾滋病毒污名与艾滋病毒护理参与度间接相关（b = -0.039，p = 0.098）。艾滋病毒歧视与内化的异性恋主义（b = 0.577，p = 0.007）和内化的种族主义（b = 0.253，p = 0.009）相关。内化的艾滋病毒污名与艾滋病毒护理参与度（b = -0.040，p = 0.001）以及经历的异性恋主义与内化的艾滋病毒污名（b = 0.974，p = 0.050）之间存在显著的直接关联。这些发现旨在了解影响该人群艾滋病毒护理参与度的因素，以提高艾滋病毒护理参与度。
