title: A study of perceived racial discrimination in Black men who have sex with men (MSM) and its association with healthcare utilization and HIV testing.
abstract: In HPTN 061, a study of Black men who have sex with men (MSM), we evaluated the association of healthcare-specific racial discrimination with healthcare utilization and HIV testing among 1167 HIV-negative participants. Median age was 38 years, 41 % were uninsured, and 38 % had an annual household income <$10,000. Overall, 19 % reported healthcare-specific racial discrimination directed toward family, friend, or self; 61 % saw a healthcare provider in the previous 6 months and 81 % HIV tested within the past year. Healthcare-specific racial discrimination was positively associated with seeing a provider [adjusted odds ratio (AOR) = 1.4 (1.0, 2.0)] and HIV testing [AOR = 1.6 (1.1, 2.4)] suggesting that barriers other than racial discrimination may be driving health disparities related to access to medical care and HIV testing among Black MSM. These results contrast with previous studies, possibly due to measurement or cohort differences, strategies to overcome discrimination, or because of greater exposure to healthcare.
authors.affiliation: Division of Infectious Diseases, Johns Hopkins University, 725 N. Wolfe Street, Suite 218A, Baltimore, MD, 21205, USA, rirvin1@jhmi.edu.
authors.forename: R
authors.initials: R
authors.lastname: Irvin
authors.forename: L
authors.initials: L
authors.lastname: Wilton
authors.forename: H
authors.initials: H
authors.lastname: Scott
authors.forename: G
authors.initials: G
authors.lastname: Beauchamp
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.forename: J
authors.initials: J
authors.lastname: Betancourt
authors.forename: M
authors.initials: M
authors.lastname: Lubensky
authors.forename: J
authors.initials: J
authors.lastname: Wallace
authors.forename: S
authors.initials: S
authors.lastname: Buchbinder
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D063505:Racism / Q000523:psychology / Q000706:statistics & numerical data*; D012725:Sexual Behavior; D012938:Social Perception; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires