title: Perceived discrimination and mental health symptoms among Black men with HIV.
abstract: People living with HIV (PLWH) exhibit more severe mental health symptoms, including depression and posttraumatic stress disorder (PTSD) symptoms, than do members of the general public. We examined whether perceived discrimination, which has been associated with poor mental health in prior research, contributes to greater depression and PTSD symptoms among HIV-positive Black men who have sex with men (MSM), who are at high risk for discrimination from multiple stigmatized characteristics (HIV-serostatus, race/ethnicity, sexual orientation). A total of 181 Black MSM living with HIV completed audio computer-assisted self-interviews (ACASI) that included measures of mental health symptoms (depression, PTSD) and scales assessing perceived discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation. In bivariate tests, all three perceived discrimination scales were significantly associated with greater symptoms of depression and PTSD (i.e., reexperiencing, avoidance, and arousal subscales; all p values < .05). The multivariate model for depression yielded a three-way interaction among all three discrimination types (p < .01), indicating that perceived racial discrimination was negatively associated with depression symptoms when considered in isolation from other forms of discrimination, but positively associated when all three types of discrimination were present. In multivariate tests, only perceived HIV-related discrimination was associated with PTSD symptoms (p < .05). Findings suggest that some types of perceived discrimination contribute to poor mental health among PLWH. Researchers need to take into account intersecting stigmata when developing interventions to improve mental health among PLWH.
authors.affiliation: Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Boston, MA 02215, USA. laura.bogart@childrens.harvard.edu
authors.forename: Laura M
authors.initials: LM
authors.lastname: Bogart
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Wagner
authors.forename: Frank H
authors.initials: FH
authors.lastname: Galvan
authors.forename: Hope
authors.initials: H
authors.lastname: Landrine
authors.forename: David J
authors.initials: DJ
authors.lastname: Klein
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Sticklor
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D004192:Discrimination, Psychological; D015658:HIV Infections / Q000208:ethnology / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D015141:Los Angeles; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D010465:Perception; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D055815:Young Adult