Intersectional internalized stigma among Black gay and bisexual men: A longitudinal analysis spanning HIV/sexually transmitted infection diagnosis.

Internalized stigma undermines health among people diagnosed with HIV and other sexually transmitted infections (STI), yet limited research has examined how internalized stigma develops. Black gay and bisexual men (n = 151) reported their race and sexual orientation internalized stigma once before HIV/STI diagnosis and their HIV/STI internalized stigma monthly for 1 year after HIV/STI diagnosis. Multilevel analyses demonstrated that race and sexual orientation internalized stigma before diagnosis were associated with greater HIV/STI internalized stigma after diagnosis. More research is needed to understand how internalized stigma develops, including within the context of other identities and broader environmental characteristics to inform intervention efforts.

Masculine ideology and Black men who have sex with men's interest in HIV pre-exposure prophylaxis (PrEP).

We examined how traditional masculinity and stigma surrounding HIV pre-exposure prophylaxis (PrEP) affect PrEP interest among Black men who have sex with men (BMSM). One hundred twenty-three men attending a Black Gay Pride event completed measures assessing traditional masculinity, PrEP stigma, and PrEP interest along with two behavioral measures of interest in PrEP. Results demonstrated that avoidance of femininity directly related to interest in PrEP and indirectly through conformity to heterosexual self-presentation. Further, PrEP stigma differentially moderated both of these relationships. Interventions designed to improve engagement of PrEP for BMSM should be attentive to traditional masculinity as a barrier.

The Psychology of Martin Luther King Jr.'s "Creative Maladjustment" at Societal Injustice and Oppression.

Many theoretical frameworks in psychology are premised on the notion that people are hedonistic in nature-drawn to pleasure and avoidant of discomfort. In this essay, we argue that psychology's hedonism contrasts with Martin Luther King Jr's conception of creative maladjustment, wherein a feeling of "cosmic discontent" is focused on the ugly truth of societal injustice. After reviewing hedonistic assumptions in the psychology of coping, well-being, and views of societal inequality, we discuss MLK's conception of creative maladjustment and tie it to critical consciousness and the present-day idea of being "woke." We then use MLK's ideas as a lens on contemporary psychological research of views of societal injustice "from above" and "from below." We suggest that MLK's analysis continues to challenge psychology to develop an approach to cognition, emotion, and motivation at societal injustice that identifies the ethical value of a sustained discontent that illuminates truth and animates opposition.

The differences between medical trust and mistrust and their respective influences on medication beliefs and ART adherence among African-Americans living with HIV.

OBJECTIVE: The purpose of this study was to examine the relationships between medical mistrust and trust and to determine if these measures differentially predict antiretroviral therapy (ART) medication adherence for African-American adults living with HIV. DESIGN: A total of 458 HIV positive African-Americans completed a cross-sectional survey. MAIN OUTCOME MEASURES: Self-reported ART adherence was collected using the visual-analog scale. The Beliefs About Medicines Questionnaire was used to assess medication necessity and concern beliefs. RESULTS: All measures of medical mistrust and trust were significantly negatively correlated, ranging from r = -.339 to -.504. Race-based medical mistrust significantly predicted medication necessity and concern beliefs, whereas general medical mistrust only significantly predicted medication concerns. Both measures of trust significantly predicted medication necessity beliefs and medication concerns. Higher levels of race-based medical mistrust predicted lower medication adherence, whereas, neither trust in own physician nor trust in health care provider significantly predicted medication adherence. However, trust in own physician significantly predicted medication necessity beliefs, which predicted medication adherence. CONCLUSION: Trust and mistrust are not simply opposites of one another. These findings provide evidence for the complexity of understanding the relationship between health care trust, mistrust and patient-related health beliefs and behaviours.