Association of Discrimination-Related Trauma With Sexual Risk Among HIV-Positive African American Men Who Have Sex With Men
Association of Discrimination-Related Trauma With Sexual Risk Among HIV-Positive African American Men Who Have Sex With Men
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DOI：
10.2105/ajph.2012.300951
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发表时间：
2013-05-01
影响因子：
12.7
通讯作者：
Schuster, Mark A.
中科院分区：
文献类型：
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作者：
Fields, Errol L.;Bogart, Laura M.;Schuster, Mark A.
目标。我们调查了一种形式的创伤压力，歧视相关的创伤（例如，由于种族原因的身体攻击）是否与无保护的肛交有关，特别是与非歧视相关的创伤相比，在与男性发生性关系的非洲裔美国男性中。131名接受抗逆转录病毒治疗的HIV阳性非裔美国男性与男性发生性行为，他们完成了计算机辅助的音频自我访谈，内容包括无保护肛交、人际创伤以及创伤是否由于种族/民族歧视、HIV血清状态或性取向造成。60%的人报告至少有一次人际创伤；他们将至少一次创伤归因于同性恋（47%）、非裔美国人（17%）或艾滋病毒阳性（9%）。在多变量回归中，经历歧视相关的创伤与无保护肛交显著相关（校正优势比[AOR] = 2.4； 95%可信区间[CI] = 1.0, 5.7; P = 0.04），而经历非歧视相关的创伤与无保护肛交无关（AOR = 1.3; 95% CI = 0.6, 3.1; P = 0.53）。与男性发生性行为的hiv阳性非裔美国男性经历了高度的与歧视相关的创伤，这是一种与更大风险相关的压力源。艾滋病毒预防干预措施应考虑到在创伤背景下歧视的潜在破坏性影响。
Objectives. We investigated whether 1 form of traumatic stress, discrimination-related trauma (e. g., physical assault because of race), was associated with unprotected anal intercourse, especially when compared with non-discrimination-related trauma, among African American men who have sex with men.Methods. A convenience sample of 131 HIV-positive African American men who have sex with men receiving antiretroviral treatment completed audio computer-assisted self-interviews that covered unprotected anal intercourse, interpersonal trauma, and whether trauma was because of discrimination on the basis of race/ethnicity, HIV serostatus, or sexual orientation.Results. Sixty percent reported at least 1 interpersonal trauma; they attributed at least 1 trauma to being gay (47%), African American (17%), or HIV positive (9%). In a multivariate regression, experiencing discrimination-related trauma was significantly associated with unprotected anal intercourse (adjusted odds ratio [AOR] = 2.4; 95% confidence interval [CI] = 1.0, 5.7; P = .04), whereas experiencing non-discrimination-related trauma was not (AOR = 1.3; 95% CI = 0.6, 3.1; P = .53).Conclusions. HIV-positive African American men who have sex with men experience high levels of discrimination-related trauma, a stressor associated with greater risk taking. HIV prevention interventions should consider the potential damaging effects of discrimination in the context of trauma.