title: Race-based differentials in the impact of mental health and stigma on HIV risk among young men who have sex with men.
abstract: OBJECTIVE
  In the U.S., young men who have sex with men (YMSM) are disproportionately affected by HIV, with YMSM of color being the most impacted by the epidemic.
  
  
  METHODS
  To advance prevention research, we examined race-based differences in gay-related stress in conjunction with the moderating role of mental health on substance use and sexual risk among 206 high-risk YMSM, recruited September, 2007-2010.
  
  
  RESULTS
  Negative binomial regressions and 3-way interaction graphs indicated that psychological distress and acute gay-related stigma placed all participants at most risk for HIV acquisition. Low psychological distress appeared to "buffer" all YMSM against HIV risk, whereas the reverse was evidenced for those reporting low gay-related stigma and psychological distress. YMSM of color reported more risk behavior, and less decreases in risk with attenuated psychological distress, compared with White YMSM. We hypothesize these trends to be associated with experiencing multiple stigmatized identities, indicating points of intervention for YMSM of color to achieve positive identity integration. There were sharper increases in HIV risk behavior for White YMSM with increasing gay-related stigma than for YMSM of color, which could be attributed to the latter's prolonged exposure to discrimination necessitating building coping skills to manage the influx of adversity.
  
  
  CONCLUSIONS
  Emphases on: (a) identity-based interventions for YMSM of color; and (b) skills-based interventions for White YMSM should supplement existing successful HIV risk-reduction programs. Lastly, mental health needs to be a target of intervention, as it constitutes a protective factor against HIV risk for all YMSM.
authors.affiliation: Department of Psychology.
authors.forename: Corina
authors.initials: C
authors.lastname: Lelutiu-Weinberger
authors.affiliation: Department of Psychiatry and Human Behavior.
authors.forename: Kristi E
authors.initials: KE
authors.lastname: Gamarel
authors.affiliation: Department of Psychology.
authors.forename: Sarit A
authors.initials: SA
authors.lastname: Golub
authors.affiliation: Department of Psychology.
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Parsons
mesh_terms: D000293:Adolescent; D000328:Adult; D015658:HIV Infections / Q000208:ethnology* / Q000517:prevention & control / Q000523:psychology; D018451:Homosexuality, Male / Q000208:ethnology* / Q000523:psychology; D006801:Humans; D008297:Male; D008603:Mental Health / Q000208:ethnology*; D044469:Racial Groups / Q000208:ethnology* / Q000523:psychology; D012725:Sexual Behavior / Q000208:ethnology / Q000523:psychology; D057545:Social Stigma; D055815:Young Adult