This study examined and sought to verify the possible association between social discrimination, resiliency, and HIV prevalence in black and white men who have sex with men (MSM). Specifically, the authors sought to determine whether experiences of perceived homophobia among both blacks and whites, and perceived racism among blacks, would be positively associated with HIV infection. The authors also sought to determine whether resiliency, the ability to adapt in the presence of adversity, would mediate any association between perceived homophobia and HIV infection among both black men and white men, as well as any association between perceived racism and HIV infection among blacks.
Eligible participants were 18- to 39-year-old black and white males who reported sex with another man in the previous three months. From June 2010 through December 2012, a cohort of 454 black and 349 white MSM were tested for HIV. All men who had HIV and who were not already in care were linked to care for further evaluation and treatment, as needed. Participants completed an approximately 1.5-hour computer-assisted self-interview questionnaire to answer questions about demographic, individual, and community level factors of HIV risk. Men who reported that they had been previously diagnosed with HIV were considered to be aware of their HIV status.
The study found that perceived racism was not associated with HIV infection in black MSM. Structural racism might be indirectly linked with HIV infection in black MSM. The effects of poverty, including unstable housing and residence in low-income neighborhoods, were positively associated with greater HIV infection and HIV diagnosis. Additionally, evidence suggests structural racism, more than individual racism, may better explain the link between social discrimination and HIV infection. There were no significant associations between perceived homophobia and HIV infection for either racial group. Also, the study found no significant association between resiliency and HIV infection for either racial group.