title: Coping with discrimination among HIV-positive Black men who have sex with men.
abstract: In the USA, HIV-positive Black men who have sex with men show large disparities in disease outcomes compared to other racial/ethnic and risk groups. This study examined the strategies that HIV-positive Black men who have sex with men use to cope with different types of discrimination. A total of 27 HIV-positive Black men who have sex with men participated in semi-structured interviews, which were transcribed verbatim and coded using thematic analysis by multiple raters. Major coping themes included reactive avoidance (using behaviours, cognitions and emotions to escape from discrimination), a common reaction to racism; proactive avoidance (avoiding situations in which discrimination is anticipated), manifested as selective disclosure of HIV-serostatus; external attribution for discrimination (versus self-blame), used more for sexual orientation and HIV discrimination; and social support-seeking, which most often emerged in response to racism. Active coping strategies, such as self-advocacy (countering discrimination directly or indirectly), were infrequently reported. Findings suggest a need for structural anti-discrimination interventions, in tandem with culturally congruent individual- or group-level interventions that aim to enhance men's existing adaptive coping strategies.
authors.affiliation: a Health Unit , RAND Corporation , Santa Monica , USA.|b Division of General Pediatrics, Department of Medicine , Boston Children's Hospital , Boston , USA.|c Department of Pediatrics , Harvard Medical School , Boston , USA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Bogart
authors.affiliation: d Department of Psychiatry , Massachusetts General Hospital , Boston , USA.|e Department of Psychiatry , Harvard Medical School , Boston , USA.
authors.forename: Sannisha K
authors.initials: SK
authors.lastname: Dale
authors.affiliation: b Division of General Pediatrics, Department of Medicine , Boston Children's Hospital , Boston , USA.
authors.forename: Jana
authors.initials: J
authors.lastname: Christian
authors.affiliation: b Division of General Pediatrics, Department of Medicine , Boston Children's Hospital , Boston , USA.
authors.forename: Kinjal
authors.initials: K
authors.lastname: Patel
authors.affiliation: f Multicultural AIDS Coalition , Jamaica Plain , USA.
authors.forename: Gary K
authors.initials: GK
authors.lastname: Daffin
authors.affiliation: g The Fenway Institute , Fenway Health , Boston , USA.|h Department of Medicine, Division of Infectious Disease , Beth Israel Deaconess Medical Center , Boston , USA.|i Department of Medicine , Harvard Medical School , Boston , USA.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.affiliation: g The Fenway Institute , Fenway Health , Boston , USA.|j Department of Psychology , University of Massachusetts Boston , Boston , USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Pantalone
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D015658:HIV Infections / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D063505:Racism / Q000523:psychology*; D012309:Risk-Taking; D012938:Social Perception; D014481:United States; D055815:Young Adult
keywords: African American; Black; HIV; discrimination; intersectionality; men who have sex with men, USA