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北卡罗来纳州罗利-达勒姆地区有色人种性少数群体中的日常歧视与HIV传播易感性

Everyday Discrimination and Vulnerability to HIV Transmission Among Sexual and Gender Minorities of Color in Raleigh-Durham, North Carolina.

作者信息

Craven Dalton M, Dennis Ann M, Quimbo Justin, Piang Kham S K, Skaathun Britt

机构信息

Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA.

出版信息

AIDS Behav. 2025 Aug 14. doi: 10.1007/s10461-025-04839-z.


DOI:10.1007/s10461-025-04839-z
PMID:40810880
Abstract

Sexual and gender minority (SGM) individuals of color face disproportionate HIV burdens in the United States, partly due to the effects of discrimination. Discrimination may drive behaviors linked to HIV risk, including increased sexual activity and substance use, but these relationships remain underexplored in the Southern U.S. We conducted a cross-sectional analysis using data from a social network survey of adult persons of color assigned male sex at birth (AMAB) who have sex with other AMAB individuals in Raleigh-Durham, North Carolina. Everyday discrimination was measured using the five-item Everyday Discrimination Scale (EDS), summed by the number of situations reported. Participants were categorized by sexual activity level-high (≥ 3 partners in the past 6 months) or low (0-2 partners). Multivariable logistic regression was used to assess associations between EDS scores, substance use, and sexual activity. Among 100 participants (median age 32), 79% identified as Black/African American, 22% as Latinx, 55% were living with HIV, and 10% identified as gender diverse. Most (87%) reported experiencing at least one type of everyday discrimination in the past year. EDS scores were significantly higher among those with high sexual activity (median 4 vs. 3, p = 0.007). In adjusted models, both EDS (OR 1.76; 95% CI 1.25-2.61) and recreational drug use (OR 4.69; 95% CI 1.59-15.5) were associated with high sexual activity. Discrimination and substance use are significantly associated with elevated sexual activity among SGM of color. Multilevel interventions addressing these factors are needed to improve HIV prevention outcomes in this population.

摘要

在美国,有色人种的性取向和性别少数群体(SGM)面临着不成比例的艾滋病毒负担,部分原因是歧视的影响。歧视可能会促使与艾滋病毒风险相关的行为,包括性活动增加和药物使用,但在美国南部,这些关系仍未得到充分研究。我们使用来自北卡罗来纳州罗利 - 达勒姆市对出生时被指定为男性的有色人种成年人进行的社交网络调查数据进行了横断面分析,这些人与其他出生时被指定为男性的个体发生性行为。日常歧视使用五项日常歧视量表(EDS)进行测量,根据报告的情况数量进行汇总。参与者按性活动水平分为高(过去6个月内≥3个性伴侣)或低(0 - 2个性伴侣)。多变量逻辑回归用于评估EDS得分、药物使用和性活动之间的关联。在100名参与者(中位年龄32岁)中,79% 被认定为黑人/非裔美国人,22% 为拉丁裔,55% 感染了艾滋病毒,10% 被认定为性别多样化。大多数(87%)报告在过去一年中至少经历过一种日常歧视。性活动高的人EDS得分显著更高(中位数4对3,p = 0.007)。在调整后的模型中,EDS(比值比1.76;95%置信区间1.25 - 2.61)和娱乐性药物使用(比值比4.69;95%置信区间1.59 - 15.5)都与高性活动相关。歧视和药物使用与有色人种SGM中性活动增加显著相关。需要采取多层次干预措施来解决这些因素,以改善该人群的艾滋病毒预防结果。

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本文引用的文献

[1]
Discrimination based on gender identity and decision-making regarding HIV/STI-protected sex, a cross-sectional study among trans and non-binary people in Germany.

BMC Public Health. 2024-10-31

[2]
HIV incidence and its associated factors among young adults with multiple sexual partners in Maputo, Mozambique: a vaccine preparedness study.

BMC Public Health. 2024-10-2

[3]
Access to healthcare among transgender women living with and without HIV in the United States: associations with gender minority stress and resilience factors.

BMC Public Health. 2024-1-20

[4]
Violence, Discrimination, Psychological Distress, and HIV Vulnerability Among Men Who Have Sex With Men in Memphis, Tennessee.

Am J Mens Health. 2023

[5]
Discrimination, resilience, and HIV testing frequency among black women seeking services from STD clinics.

Soc Sci Med. 2023-1

[6]
Black Canadians' Exposure to Everyday Racism: Implications for Health System Access and Health Promotion among Urban Black Communities.

J Urban Health. 2022-10

[7]
Sexual Behaviors Associated with HIV Transmission Among Transgender and Gender Diverse Young Adults: The Intersectional Role of Racism and Transphobia.

AIDS Behav. 2022-11

[8]
Minority Stress, Identity Conflict, and HIV-Related Outcomes Among Men Who Have Sex with Men, Transgender Women, and Gender Nonbinary People of Color.

LGBT Health. 2022

[9]
Discrimination, psychological functioning, and substance use among U.S. young adults aged 18-28, 2017.

Exp Clin Psychopharmacol. 2022-12

[10]
Stigma, HIV Risk, and Access to HIV Prevention and Treatment Services Among Men Who have Sex with Men (MSM) in the United States: A Scoping Review.

AIDS Behav. 2021-11

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