Intersectional Discrimination and PrEP use Among Young Black Sexual Minority Individuals: The Importance of Black LGBTQ Communities and Social Support

Intersectional stigma and discrimination have increasingly been recognized as impediments to the health and well-being of young Black sexual minority men (YBSMM) and transgender women (TW). However, little research has examined the relationship between intersectional discrimination and HIV pre-expos...

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Bibliographic Details
Published in:AIDS and behavior 2023-01, Vol.27 (1), p.290-302
Main Authors: Quinn, Katherine G., Dickson-Gomez, Julia, Craig, Amber, John, Steven A., Walsh, Jennifer L.
Format: Article
Language:English
Subjects:
African Americans
Black people
Discrimination
Female
Gays & lesbians
Health Psychology
HIV
HIV Infections - epidemiology
HIV Infections - prevention & control
Homosexuality, Male
Human immunodeficiency virus
Humans
Infectious Diseases
Intersectionality
LGBTQ community
LGBTQ people
Male
Medicine
Medicine & Public Health
Mens health
Original Paper
Pre-Exposure Prophylaxis - methods
Prophylaxis
Public Health
Resilience
Sexual and Gender Minorities
Sexually transmitted diseases
Social interactions
Social Stigma
Social Support
STD
Transgender persons
Transsexualism
Well being
Young adults
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Summary:Intersectional stigma and discrimination have increasingly been recognized as impediments to the health and well-being of young Black sexual minority men (YBSMM) and transgender women (TW). However, little research has examined the relationship between intersectional discrimination and HIV pre-exposure prophylaxis (PrEP) outcomes. This study with 283 YBSMM and TW examines the relationship between intersectional discrimination and current PrEP use and likelihood of future PrEP use. Path models were used to test associations between intersectional discrimination, resilience and social support, and PrEP use and intentions. Individuals with higher levels of anticipated discrimination were less likely to be current PrEP users (OR = 0.59, p  = .013), and higher levels of daily discrimination were associated with increased likelihood of using PrEP in the future (B = 0.48 (0.16), p  = .002). Greater discrimination was associated with higher levels of resilience, social support, and connection to the Black LGBTQ community. Social support mediated the effect of day-to-day discrimination on likelihood of future PrEP use. Additionally, there was a significant and negative indirect effect of PrEP social concerns on current PrEP use via Black LGBTQ community connectedness. The results of this study highlight the complexity of the relationships between discrimination, resilience, and health outcomes.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-022-03763-w