Understanding Intersectional Discrimination and Adversities among Black Queer Women Living with HIV

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Background: Black women represent the largest group of women with HIV, both nationally, and locally in Miami, a U.S. HIV epicenter; and 40% are not virally suppressed. Further, they live at the intersection of multiple marginalized identities and within social structures that take a daily toll. Microaggressions are every day and subtle insults via comments, jokes, and behaviors that are demeaning to a marginalized group (e.g. Black individuals, women, people living with HIV, LGBTQ+). Despite their frequency and potential importance, microaggressions have largely been ignored in the scientific literature on Black women living with HIV (BWLWH). Further, little research has been done to understand the experiences of Black cisgender queer women who are living with HIV. Logie et al. found that amongst an ethnically, and sexually diverse group of women living with HIV in Canada, systemic multilevel forms of discrimination such as HIV- related stigma, sexism, racism, and homophobia were interconnected with barriers to HIV-related care, well-being, and development of coping strategies. Among Black queer women living with HIV Logie et al. found that increased levels of quality of life are associated with having control over their HIV care and having a supportive team of healthcare professionals. However, studies are limited among Black queer women living with HIV and no prior studies examining the relationships among microaggressions, discrimination, reoccurring violence, mental health, and HIV outcomes specifically among Black queer women living with HIV in a U.S. epicenter (Miami, FL). Parent Grant: MMAGIC (Monitoring Microaggressions and Adversities to Generate Interventions for Change) focuses on microaggressions and other adversities as negative predictors of HIV viral suppression (main outcome) mediated by mental health symptoms and health behaviors (ART adherence and engagement in care) among Black women. It is longitudinally examining both potential direct effects and moderation by resilience factors at the individual (e.g., self-efficacy), interpersonal (e.g., social support), and neighborhood level (e.g., community health centers). Supplement Research Plan: This project will (a) examine the quantitative data for the queer women in MMAGIC (compared to non-queer women) on microaggressions (LGBTQ-, race-, gender- and HIV-related), macro discrimination (LGBTQ-, race-, gender- and HIV-related), trauma/violence, mental health, and HIV outcomes and observe how the variables relate and change over time and (b) conduct in-depth qualitative interviews with 20-30 of the women on their experiences of intersectional discrimination and microaggressions and how they are navigating these experiences (e.g., helpful coping and resources). Training Plan: This supplement would provide an unmatched training opportunity for Mya Wright, an African American queer PhD student in Clinical Health Psychology at the University of Miami. She will be (a) mentored by renown scholars (Drs. Dale, Bowleg, Logie, and Ironson) in HIV and intersectionality (b) obtain expertise in qualitative methods and advanced quantitative skills for assessing intersectional adversities among Black queer women living with HIV, (c) enhance and develop skills to utilize research findings to inform the development of culturally competent interventions for racial and sexually minoritized women, and (d) strengthen her skills in manuscript preparation, publication, and grant writing.