Intersectional experiences, stigma-related stress, and psychological health among Black LGBQ individuals.

Abstract

Objectives:We used microlongitudinal methods to examine the prevalence and day-to-day correlates of intersectional experiences (IEs) in a U.S. sample of 131 Black sexual minorities. Method: Participants were 97 gay/lesbian people (74.0%) and 34 bisexuals (26.0%); nearly a third of the sample also identified as queer (32.1%). Most participants identified solely as Black; however, 23 participants (17.6%) indicated at least 1 secondary racial/ethnic identification. Every evening for 1 week, participants reported both negative and positive IEs from the last 24 hr and completed measures of identity conflict, rumination, and affect. Multilevel path analysis was used to test daily relations between IEs and mood-as well as the mediating roles of identity conflict and rumination-at the within-and betweenperson levels, controlling for nonintersectional experiences (e.g., related only to race, related only to sexual orientation, unrelated to identity). Results: Negative IEs (n ϭ 97, 11.4% of total days) were related with identity conflict and negative affect at both levels of analysis and with negative rumination at the within-person level only. Positive IEs (n ϭ 263, 31.0% of total days) predicted positive rumination and positive affect (but not identity conflict) both within and between persons. Many hypothesized indirect paths were supported-for example, identity conflict and rumination mediated the relation between negative IEs and negative affect at the within-person level. Conclusion: Building upon accumulating research linking stigma and health, this study demonstrates that multiple axes of oppression can jointly shape daily events and predict fluctuations in psychological health. What is the public health significance of this article?Whereas most studies of stigma-related stress focus on one type of stigma (e.g., racism) in isolation from others (e.g., homophobia), this study demonstrates that daily events related to both one's race and sexual orientation (i.e., intersectional experiences) are associated with day-to-day changes in Black sexual minorities' psychological well-being. Findings may inform clinical and community interventions aiming to increase the health and resilience of this understudied population.

Autonomy-Supportive Healthcare Climate and HIV-Related Stigma Predict Linkage to HIV Care in Men Who Have Sex With Men in Ghana, West Africa

“… 21 The influence of multiple intersecting stigmas has been demonstrated to have effects on health and healthcare behaviors across domains and populations. 12 , 22 , 23 Intersectional stigma is conceptualized as affecting HIV care continuum outcomes through the influences it exerts on interpersonal interactions between health providers and stigmatized patients, the fear and distress this stimulates in patients and consequently physiological stress responses that may manifest in avoidance behaviors—such as avoiding re-exposure to healthcare environments that are potential sources of stigma. 24 This conceptualization is also supported by evidence from a randomized controlled trial demonstrating that healthcare providers exhibit higher number of stigmatizing behaviors to patients that they perceived to have multiple socially marginalized identities such as being a PLWHIV and homosexual-identified, or a PLWHIV and substance user compared to a PLWHIV who is heterosexual-identified.…”

Intersectional Stigma, Identity, and Culture: A Grounded Theory of Female Escort Perspectives from Brazil and Pakistan

“…Brazilian culture is open about sexuality (Parker, 2009) hence why they were more comfortable about their work. But they still chose not to tell brothers and some friends about it in the belief they would be judgemental, so this points to a more complex gendered and intersectional dimension to stigma (Jackson et al, 2020;Schmitz et al, 2019).…”

“…Drawing on recent work on intersectional experiences, stigma-related stress, and psychological health (Jackson et al, 2020;Iram, et al , 2019;Schmitz et al, 2019) and relationship dynamics between female sex workers and their family groups (Onyango, 2018) we aim to understand the resilience and vulnerabilities of independent escorts dealing with stigma (Koken, 2012).…”

Early Use of the Palliative Approach to Improve Patient Outcomes in HIV Disease: Insights and Findings From the Care and Support Access (CASA) Study 2013-2019

“…In the US, young men who have sex with men (yMSM) living with HIV are described as “difficult-to-engage and -retain” in care and multiple axes of oppression can jointly shape daily events and predict fluctuations in psychological health. 7 - 10 Worldwide, these young men continue to be excluded from usual HIV services because of stigma, discrimination, and criminalization. 11 Health-care delivery must be tailored to the unique needs of this key, young population 12,13 including accommodating, or attending to, the impact of social determinants upon their health.…”

“…This comparative effectiveness study was conducted to determine whether application of the early palliative approach (ePA) by multidisciplinary clinic staff, 10 in combination with usual, or standard, HIV care and treatment, improved patient-level outcomes for HIV positive yMSM, compared to usual, or standard care only, in a second HIV clinic. Because of the federal funding that underpins outpatient HIV care delivery in the US, care delivery at outpatient HIV clinics is considered to be equivalent to assure equal access to quality care.…”