Stress and Coping with Racism and Their Role in Sexual Risk for HIV among African American, Asian/Pacific Islander, and Latino Men Who Have Sex with Men

The deleterious effects of racism on a wide range of health outcomes, including HIV risk, are well documented among racial/ethnic minority groups in the United States. However, little is known about how men of color who have sex with men (MSM) cope with stress from racism and whether the coping strategies they employ buffer against the impact of racism on sexual risk for HIV transmission. 

We examined associations of stress and coping with racism with unprotected anal intercourse (UAI) in a sample of African American (N = 403), Asian/Pacific Islander (N = 393), and Latino (N = 400) MSM recruited in Los Angeles County, CA during 2008-2009. Almost two-thirds (65 %) of the sample reported being stressed as a consequence of racism experienced within the gay community. 

Overall, 51 % of the sample reported having UAI in the prior 6 months. After controlling for race/ethnicity, age, nativity, marital status, sexual orientation, education, HIV serostatus, and lifetime history of incarceration, the multivariate analysis found statistically significant main effects of stress from racism and avoidance coping on UAI; no statistically significant main effects of dismissal, education/confrontation, and social-support seeking were observed. None of the interactions of stress with the four coping measures were statistically significant. Although stress from racism within the gay community increased the likelihood of engaging in UAI among MSM of color, we found little evidence that coping responses to racism buffered stress from racism. Instead, avoidance coping appears to suggest an increase in UAI. 

Below:  Stress from Racism Experienced in the Gay Community, by Race/Ethnicity (%)

Below:  Coping Strategies Employed to Deal with Racism, by Race/Ethnicity: Mean Scale Scores¹

1. Range: 1 = “strongly disagree” to 4 = “strongly agree”

Full article at:   http://goo.gl/78mRbc

By:   Han CS1, Ayala G, Paul JP, Boylan R, Gregorich SE, Choi KH.

• 1Department of Sociology and Anthropology, Middlebury College (http://www.middlebury.edu/academics/soan), Middlebury, VT, 05753, USA, chongsukhan@gmail.com.
• Arch Sex Behav. 2015 Feb;44(2):411-20. doi: 10.1007/s10508-014-0331-1. Epub 2014 Jul 25. 

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Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening

Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. 

Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai'i-based project on anal cancer screening tools. Krueger's focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. 

Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being "on the radar" of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through "real talk" (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. 

Application of strategies for health practice are specific to the Hawai'i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales.

Purchase full article at:  http://goo.gl/Ku8PX0

By:  Ka'opua LS1, Cassel K2, Shiramizu B3, Stotzer RL4, Robles A4, Kapua C5, Orton M5, Milne C4, Sesepasara M5.

• 1University of Hawai'i-Ma-noa, Honolulu, HI, USA University of Hawai'i Cancer Center, Honolulu, HI, USA lskaopua@hawaii.edu.
• 2University of Hawai'i Cancer Center, Honolulu, HI, USA.
• 3University of Hawai'i-Ma-noa, Honolulu, HI, USA University of Hawai'i Cancer Center, Honolulu, HI, USA.
• 4University of Hawai'i-Ma-noa, Honolulu, HI, USA.
• 5Life Foundation of O'ahu, Honolulu, HI, USA. 

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