Effects of Discrimination on HIV-Related Symptoms in Heterosexual Men of Color

Abstract

HIV-related symptoms have a deleterious effect on quality of life. One determinant of HIV symptom burden among individuals of color may be discrimination. The aim of this study was to explore whether multiple lifetime discrimination events are associated with a greater number of HIV-related symptoms among heterosexual HIV-positive men of color and to examine the influence of anxiety and social support on this relationship. Data for this study were drawn from a cross-sectional survey of 307 heterosexual HIV-positive men recruited from health and social service agencies in New York City (NYC). This study indicated that the number of discrimination events experienced in one’s lifetime was positively associated with the number of HIV-related symptoms experienced in the past month. Moreover, the direct effect of discrimination on HIV symptoms remained significant after anxiety was included as a mediator in the model, and there was a significant indirect effect of discrimination on HIV symptoms through anxiety. Evidence supported a potential moderated mediation effect involving social support: As social support increased, the indirect effect of discrimination on HIV symptoms through anxiety decreased. The results of this study suggest an association between discrimination and HIV-related symptom burden. Furthermore, the relationship between number of major discrimination experiences and HIV symptom burden was partially mediated by anxiety. Future research should consider how lifetime discrimination might be associated with negative health outcomes among HIV-positive individuals of color.

Association of Medical Mistrust and Poor Communication with HIV-Related Health Outcomes and Psychosocial Wellbeing Among Heterosexual Men Living with HIV

“…Study procedure have been documented in detail elsewhere. 34 In brief, from 2011 to 2012, eligible participants were recruited using a two-stage sampling process. In the first stage, 121 agencies that provided services to PLWHA in New York City were randomly selected for future contact from a list of 656 such agencies.…”

Syndemic factors associated with adherence to antiretroviral therapy among HIV-positive adult heterosexual men

“…The study sample (N = 317) has been described in detail in prior publications [63,64]. Briefly, the mean age was 47.7 years (SD = 6.6; range 20 to 59); mean number of years since HIV diagnosis was 15 (SD = 7.1); 64.5% were African American/Black and 29.7% were Hispanic/ Latino; 35% had less than a high school education; 91.1% were unemployed, disabled or retired; 35.4% reported unstable housing; 60.6% had a primary female sexual partner (of whom, 53.7% were in an HIV-serodiscordant relationship with an HIV-negative partner); and 53.6% had used illicit drugs (marijuana, cocaine, crack, heroin, methamphetamines or hallucinogens) in the past 6 months.…”

Applying a Nursing Perspective to Address the Challenges Experienced by Cisgender Women in the HIV Status Neutral Care Continuum: A Review of the Literature

“…There is a growing body of literature that reports that structural level factors, such as racism and racial discrimination, and patient–provider communication in the clinical encounter pose significant health risks to individuals and communities of color, specifically Black and Latinx populations (Dale et al, 2018; Ford et al, 2009; Logie et al, 2011; Prather et al, 2018; Randolph, Golin, et al, 2020). For example, several studies have shown that racial discrimination is associated with high-risk sexual behaviors among Black communities (Braksmajer et al, 2018; Lewis et al, 2017; Rosenthal & Lobel, 2020). There is extensive literature that supports that poor patient–provider communication in the clinical encounter has a direct impact on the quality of care and health outcomes of Blacks (Agénor et al, 2015; Beach et al, 2011; Dolezsar et al, 2014; Earl et al, 2013; Eliacin et al, 2020; Hagiwara et al, 2016; Sutton et al, 2020).…”