title: Association of discrimination-related trauma with sexual risk among HIV-positive African American men who have sex with men.
abstract: OBJECTIVE
  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.
authors.affiliation: Division of Adolescent Medicine and General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA, USA. errol.fields@jhmi.edu
authors.forename: Errol L
authors.initials: EL
authors.lastname: Fields
authors.forename: Laura M
authors.initials: LM
authors.lastname: Bogart
authors.forename: Frank H
authors.initials: FH
authors.lastname: Galvan
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Wagner
authors.forename: David J
authors.initials: DJ
authors.lastname: Klein
authors.forename: Mark A
authors.initials: MA
authors.lastname: Schuster
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000208:ethnology; D006679:HIV Seropositivity / Q000208:ethnology* / Q000523:psychology; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011287:Prejudice / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D011329:Prisoners / Q000706:statistics & numerical data; D040921:Stress Disorders, Traumatic / Q000208:ethnology* / Q000209:etiology / Q000523:psychology; D019966:Substance-Related Disorders / Q000208:ethnology; D047568:Unsafe Sex / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D014754:Violence / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult