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Structural Discrimination against and Structural Support for Lesbian, Gay, and Bisexual People as a Predictor of Late HIV Diagnoses among Black Men who Have Sex with Men.
Williams, Leslie D; McKetta, Sarah C; Stall, Ronald; Beane, Stephanie; Ibragimov, Umedjon; Tempalski, Barbara; Hall, H Irene; Johnson, Anna Satcher; Wang, Guoshen; Friedman, Samuel R.
Afiliação
  • Williams LD; Division of Community Health Sciences, University of Illinois Chicago School of Public Health, 1603 W. Taylor Street, Rm. 677 (MC 923), Chicago, IL, 60612, USA. lesliedw@uic.edu.
  • McKetta SC; Columbia University, New York, NY, USA.
  • Stall R; Harvard Medical School, Boston, MA, USA.
  • Beane S; University of Pittsburgh, Pittsburgh, PA, USA.
  • Ibragimov U; Rollins School of Public Health, Emory University, Atlanta, GA, USA.
  • Tempalski B; Rollins School of Public Health, Emory University, Atlanta, GA, USA.
  • Hall HI; Institute for Infectious Disease Research, National Development and Research Institutes, New York, NY, USA.
  • Johnson AS; Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Wang G; Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Friedman SR; Centers for Disease Control and Prevention, Atlanta, GA, USA.
J Urban Health ; 101(2): 426-438, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38418647
ABSTRACT
Black men who have sex with men (MSM) have been consistently reported to have the highest estimated HIV incidence and prevalence among MSM. Despite broad theoretical understanding that discrimination is a major social and structural determinant that contributes to disparate HIV outcomes among Black MSM, relatively little extant research has empirically examined structural discrimination against sexual minorities as a predictor of HIV outcomes among this population. The present study therefore examines whether variation in policies that explicitly discriminate against lesbian, gay, and bisexual (LGB) people and variation in policies that explicitly protect LGB people differentially predict metropolitan statistical-area-level variation in late HIV diagnoses among Black MSM over time, from 2008 to 2014. HIV surveillance data on late HIV diagnoses among Black MSM in each of the 95 largest metropolitan statistical areas in the United States, from 2008 to 2014, were used along with data on time-varying state-level policies pertaining to the rights of LGB people. Results from multilevel models found a negative relationship between protective/supportive laws and late HIV diagnoses among Black MSM, and a positive relationship between discriminative laws and late HIV diagnoses among Black MSM. These findings illuminate the potential epidemiological importance of policies pertaining to LGB populations as structural determinants of HIV outcomes among Black MSM. They suggest a need for scrutiny and elimination of discriminatory policies, where such policies are currently in place, and for advocacy for policies that explicitly protect the rights of LGB people where they do not currently exist.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Negro ou Afro-Americano / Infecções por HIV / Homossexualidade Masculina / Minorias Sexuais e de Gênero Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Negro ou Afro-Americano / Infecções por HIV / Homossexualidade Masculina / Minorias Sexuais e de Gênero Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Ano de publicação: 2024 Tipo de documento: Article