title: Social oppression, psychological vulnerability, and unprotected intercourse among young Black men who have sex with men.
abstract: OBJECTIVE
  Young Black men who have sex with men (YBMSM) are at extraordinarily high risk for HIV infection. Given their dual minority identity, they experience multiple forms of social oppression-racism, homophobia, and poverty. This study tested a model for how these forces contribute to their sexual risk behavior.
  
  
  METHODS
  YBMSM (n = 1,289) from 2 Texas cities completed a 1-time assessment of sexual behaviors and psychosocial variables. Structural equation modeling was used to characterize relationships among variables.
  
  
  RESULTS
  Experiences of racism, homophobia, and socioeconomic distress were all associated with unprotected anal intercourse (UAI) either directly or indirectly in a manner largely consistent with Díaz's (1997, 1998) model of the effects of social oppression. Racism, homophobia, and socioeconomic distress were each associated with specific psychological vulnerabilities, which were in turn associated with participation in difficult sexual situations (e.g., in a public setting), and then UAI. The effects of racism were largely mediated by depressive symptoms and participation in difficult sexual situations. Homophobia was mediated by depressive symptoms, social support, and internalized homophobia. The effects of socioeconomic distress were partially mediated by decreased social support and greater participation in difficult sexual situations. Socioeconomic distress also had a significant direct effect on UAI not explained by the proposed mediators.
  
  
  CONCLUSIONS
  Social oppression contributes to YBMSM's psychological vulnerabilities, participation in difficult sexual situations, and their UAI. Interventions to reduce sexual risk in YBMSM should address socioeconomic disadvantage, homophobia, and racism, as well as the psychological challenges that social oppression creates for them.
authors.affiliation: Department of Psychology, University of Utah.
authors.forename: David M
authors.initials: DM
authors.lastname: Huebner
authors.affiliation: Center for AIDS Prevention Studies, University of California, San Francisco.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Kegeles
authors.affiliation: Center for AIDS Prevention Studies, University of California, San Francisco.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Rebchook
authors.affiliation: Department of Psychology, Georgia State University.
authors.forename: John L
authors.initials: JL
authors.lastname: Peterson
authors.affiliation: Center for AIDS Prevention Studies, University of California, San Francisco.
authors.forename: Torsten B
authors.initials: TB
authors.lastname: Neilands
authors.affiliation: Centers for Disease Control and Prevention.
authors.forename: Wayne D
authors.initials: WD
authors.lastname: Johnson
authors.affiliation: Centers for Disease Control and Prevention.
authors.forename: Agatha N
authors.initials: AN
authors.lastname: Eke
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D003863:Depression / Q000208:ethnology / Q000523:psychology; D015658:HIV Infections / Q000208:ethnology; D063509:Homophobia / Q000208:ethnology* / Q000523:psychology; D018451:Homosexuality, Male / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008960:Models, Psychological; D011203:Poverty / Q000208:ethnology* / Q000523:psychology; D063505:Racism / Q000208:ethnology* / Q000523:psychology; D012309:Risk-Taking; D012725:Sexual Behavior / Q000208:ethnology / Q000523:psychology; D012944:Social Support; D013781:Texas; D047568:Unsafe Sex / Q000208:ethnology* / Q000523:psychology; D055815:Young Adult