Characterizing Racial Differences of Mental Health Burdens, Psychosocial Determinants, and Impacts on HIV Prevention Outcomes Among Young Men Who have Sex With Men: a Community-based Study in Two US Cities
Characterizing Racial Differences of Mental Health Burdens, Psychosocial Determinants, and Impacts on HIV Prevention Outcomes Among Young Men Who have Sex With Men: a Community-based Study in Two US Cities
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DOI：
10.1007/s40615-021-01052-1
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发表时间：
2021-05-13
影响因子：
3.9
通讯作者：
Zhang, Chen
中科院分区：
文献类型：
--
作者：
Liu, Yu;Brown, Lauren;Zhang, Chen
很少有研究调查种族差异（例如，黑人与白人）在美国与男性发生性行为的年轻男性（MSM）中联系心理健康负担和各种艾滋病毒相关结果的社会心理途径。我们进行了一项基于社区的研究，以检查心理健康负担的种族差异（例如，抑郁，焦虑，压力），社会心理决定因素(例如，艾滋病毒耻辱，同性恋否定，恢复力，社会支持，孤独，住房/食品安全)以及对来自美国两个城市（田纳西州纳什维尔和纽约州布法罗）的年轻黑人男男性行为者（YBMSM, n = 209）和年轻白人男男性行为者（YWMSM, n = 109）的艾滋病毒相关结果的影响（例如，事件级别的性行为前饮酒/吸毒、无避孕套插入/接受肛交、最近的艾滋病毒检测和PrEP意识/意愿/使用）。总体而言，我们发现YBMSM比YWMSM更容易经历焦虑和抑郁（p < 0.05）。在YBMSM中，我们发现结构性不平等（住房不稳定、食物不安全、内化同质性）与焦虑/抑郁/压力呈正相关（p < 0.001）；我们还发现，焦虑/抑郁与性行为前酒精/药物使用增加有关，压力与近期艾滋病毒检测和暴露前预防意识/意愿/使用减少有关。在年轻男同性恋者中，我们发现心理缓冲（感知到的社会支持、恢复力）与焦虑/抑郁/压力的减少有关（p < 0.001）；焦虑与增加的无避孕套插入/接受肛交和最近的艾滋病毒检测有关。男同性恋者和男同性恋者在心理社会决定因素和与艾滋病毒有关的心理健康后果方面存在差异。我们的研究结果为制定适合文化和环境的干预措施提供了重要意义，以解决艾滋病毒感染风险最高的年轻男同性恋者的心理健康负担和艾滋病毒预防结果。
Few studies examine racial differences (e.g., Black vs. White) regarding the psychosocial pathways linking mental health burdens and various HIV-related outcomes among young men who have sex with men (MSM) in the U.S. We conducted a community-based study to examine the racial differences of mental health burdens (e.g., depression, anxiety, stress), the psychosocial determinants (e.g., HIV stigma, homonegativity, resilience, social support, loneliness, housing/food security) and impact on HIV-related outcomes (e.g., event-level alcohol/drug use before sex, condomless insertive/receptive anal sex, recent HIV testing, and PrEP awareness/willingness/use) among young Black MSM (YBMSM; n = 209) and young White MSM (YWMSM; n = 109) from two cities (Nashville, TN and Buffalo, NY) in the United States. Overall, we found YBMSM were more likely (p < 0.05) to experience anxiety and depression compared to YWMSM. Among YBMSM, we found structural inequities (housing instability, food insecurity, internalized homonegativity) were positively associated with anxiety/depression/stress (p < 0.001); we also found anxiety/depression was associated with increased alcohol/drug use before sex, and stress was associated with reduced recent HIV testing and pre-exposure prophylaxis awareness/willingness/use. Among YWMSM, we found psychological buffers (perceived social support, resilience) were associated with reduced anxiety/depression/stress (p < 0.001); anxiety was associated with increased condomless insertive/receptive anal sex and recent HIV testing among this subgroup. YBMSM and YWMSM differed in psychosocial determinants and HIV-related consequences regarding their mental health. Our findings provide important implications for developing culturally and contextually tailored interventions to address mental health burdens and HIV prevention outcomes among young MSM at highest risk for HIV acquisition.