title: Social discrimination and resiliency are not associated with differences in prevalent HIV infection in black and white men who have sex with men.
abstract: OBJECTIVE
  To examine the associations of homophobia, racism, and resiliency with differences in prevalent HIV infection in black and white men who have sex with men (MSM).
  
  
  METHODS
  The Involve[ment]t study is a cohort of black and white MSM aged 18-39 years in Atlanta, GA, designed to evaluate individual, dyadic, and community level factors that might explain racial disparities in HIV prevalence. Participants were recruited irrespective of HIV serostatus from community-based venues and from Internet advertisements and were tested for HIV. We assessed respondents' demographics, whether they had engaged in unprotected anal intercourse (UAI) within the past 6 months, and attitudes about perceived homophobia, perceived racism, and personal resiliency.
  
  
  RESULTS
  Compared with white MSM, black MSM were less likely to report UAI in the past 6 months [odds ratio (OR): 0.59, confidence interval (CI): 0.44 to 0.80], more likely to be HIV positive (OR: 5.05, CI: 3.52 to 7.25), and--among those HIV positive--more likely to report not being aware of their HIV infection (OR: 2.58, CI: 1.18 to 5.65). Greater perceived racism was associated with UAI in the black sample (partial odds ratio: 1.48, CI: 1.10 to 1.99). Overall, perceived homophobia, perceived racism, and resilience were not associated with prevalent HIV infection in our samples. Greater resilience was associated with less perceived homophobia in both black and white samples (Spearman r = -0.27, P < 0.001, for both).
  
  
  CONCLUSIONS
  Future studies of social discrimination at the institutional and network level, than at the individual level, may explain differences in HIV infection in black and white MSM.
authors.affiliation: *Department of Psychology, Georgia State University, Atlanta, GA; †Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA; ‡National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA; §Division of Health Promotion and Behavior, School of Public Health, Georgia State University, Atlanta, GA; ‖Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA; and ¶Department of Medicine, School of Medicine, Emory University, Atlanta, GA.
authors.forename: John L
authors.initials: JL
authors.lastname: Peterson
authors.forename: Roger
authors.initials: R
authors.lastname: Bakeman
authors.forename: Patrick
authors.initials: P
authors.lastname: Sullivan
authors.forename: Gregorio A
authors.initials: GA
authors.lastname: Millett
authors.forename: Eli
authors.initials: E
authors.lastname: Rosenberg
authors.forename: Laura
authors.initials: L
authors.lastname: Salazar
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: DiClemente
authors.forename: Hannah
authors.initials: H
authors.lastname: Cooper
authors.forename: Colleen F
authors.initials: CF
authors.lastname: Kelley
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Mulligan
authors.forename: Paula
authors.initials: P
authors.lastname: Frew
authors.forename: Carlos
authors.initials: C
authors.lastname: del Rio
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D055500:Resilience, Psychological; D063508:Social Discrimination; D044465:White People; D055815:Young Adult