Associations of past-year stigma and psychosocial syndemic conditions: Considerations for intersectional stigma measures among Black sexual minority men.

Abstract

This secondary analysis of a mixed-serostatus sample of Black sexual minority men (BSMM) used conditional inference tree methods to explore associations of past-year experienced stigma and psychosocial syndemic conditions. Experienced stigmas were attributed to race, sexuality, socioeconomic status, HIV status, or some "other" reason. Psychosocial syndemic conditions studied included physical assault, intimate partner violence, polysubstance use, and depression symptomology. Data are from Promoting Our Worth, Equality, and Resilience (POWER), a serial, crosssectional study conducted between 2014 and 2017 (N = 4,430). Experiences of multiple stigmas were reported by n = 938 (22.1%) of BSMM. Conditional inference tree results revealed that HIVrelated stigma and its intersection with "other" stigma showed the greatest variance in psychosocial condition prevalence. Our findings suggest that when developing intercategorical intersectional analyses with BSMM, there are important stigmas for BSMM beyond those attributed to race, sexuality, and socioeconomic status (SES), particularly intersecting with HIV-related stigma. Conditional inference tree analysis shows promise in quantitative explorations of intersectional stigma with BSMM but will benefit from the inclusion of additional forms of stigma, which should be considered by the field moving forward.

Introduction to the special issue on intersectionality in Stigma and Health research.

“…In the following article, Chandler et al (2023) analyze their data using the machine learning approach of multivariable conditional inference tree (CTree) analysis to construct homogeneous subgroups based not on social identity but rather on outcome variables. Exploring within-group heterogeneity (or intracategorical complexity) in their sample of Black sexual minority men, Chandler and colleagues examine how stigma attributed to HIV status in combination with other stigmas explained variance in psychosocial syndemic outcomes, including depressive symptoms, polydrug use, and intimate partner violence.…”