title: The role of discrimination in alcohol-related problems in samples of heavy drinking HIV-negative and positive men who have sex with men (MSM).
abstract: Heavy drinking is a major public health concern among men who have sex with men (MSM), as it is in many other populations. However, the consequences of heavy drinking among MSM may be particularly severe, especially for sexual risk behavior, due to the relatively high prevalence of HIV. Minority stress models suggest that, among members of marginalized groups, discrimination may be associated with heavier alcohol use as these individuals increasingly drink to cope with such experiences. Past studies have provided some support for this association. However, they have not explored the role other drinking motives play, how these relationships might differ across MSM who are HIV-positive versus HIV-negative, or how this relationship extends to alcohol-related problems.
  
  
  
  In this study, we used path modeling to explore associations between perceived discrimination experiences, drinking motives, alcohol use, and alcohol-related problems in samples of heavy drinking MSM with and without HIV.
  
  
  
  In both HIV-negative and positive MSM, perceived discrimination was significantly positively associated with alcohol problems. Drinking to cope appears to play an important role in this relationship in both samples. Reporting more discrimination experiences was associated with drinking more frequently for sexual reasons among both groups. While the total effect of drinking to facilitate sex was positively associated with alcohol-related problems, sex motives did not mediate associations between discrimination and either drinking outcome.
  
  
  
  These results suggest that interventions addressing discrimination and specific drinking motivations may be useful in helping reduce alcohol use of heavy drinking MSM.
authors.affiliation: Center for Alcohol and Addictions Studies, Brown University School of Public Health, Providence, RI, United States. Electronic address: tyler_wray@brown.edu.
authors.forename: Tyler B
authors.initials: TB
authors.lastname: Wray
authors.affiliation: Department of Psychology, University of Massachusetts Boston, Boston, MA, United States; The Fenway Institute, Fenway Health, Boston, MA, United States.
authors.forename: David W
authors.initials: DW
authors.lastname: Pantalone
authors.affiliation: Center for Alcohol and Addictions Studies, Brown University School of Public Health, Providence, RI, United States.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Kahler
authors.affiliation: Center for Alcohol and Addictions Studies, Brown University School of Public Health, Providence, RI, United States.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Monti
authors.affiliation: The Fenway Institute, Fenway Health, Boston, MA, United States; Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, United States.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D019973:Alcohol-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011287:Prejudice; D012725:Sexual Behavior / Q000187:drug effects; D013223:Statistics as Topic; D055815:Young Adult
keywords: Alcohol; Alcohol problems; Discrimination; Drinking motives; Gay/bisexual men; MSM