Race-Based Medical Mistrust, HIV-Related Stigma, and ART Adherence in a Diverse Sample of Men Who Have Sex with Men with HIV

Meyers-Pantele, Stephanie A.; Sullivan, Patrick S.; Hirshfield, Sabina; Stephenson, Rob; Horvath, Keith J.

doi:10.1007/s10461-021-03500-9

Cited by 11 publications

(4 citation statements)

References 29 publications

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“…In our prior publication, entailing the baseline data of this prospective cohort study, social support was negatively associated with ART nonadherence for those with increased depressive symptoms, suggesting social support’s protective role by interrupting the effect of depressive symptoms on ART nonadherence ( 45 ). Social support may also play a protective role in the relationships between IPV, homophobic bullying, and ART nonadherence.…”

Section: Discussionmentioning

confidence: 91%

Effects of intimate partner violence and homophobic bullying on ART adherence among young Thai men who have sex with men: a causal mediation analysis

Cheung,

Reeves,

Waratworawan

et al. 2023

Preprint

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Background: Adherence to antiretroviral therapy is crucial in determining health outcomes and secondary HIV transmission for people living with HIV/AIDS. Young men who have sex with men (YMSM) living with HIV are often challenged by the prevailing experiences of psychosocial stressors, such as intimate partner violence and homophobic bullying, which may negatively affect their HIV care engagement. Methods: This study is the first to utilize a prospective cohort design (N= 185) involving YMSM living with HIV in Thailand. We examined the effects of intimate partner violence and homophobic bullying on ART adherence. We also tested the mediating effect of depression on the relationship between intimate partner violence and homophobic bullying on ART adherence. Results: We found that intimate partner violence (AOR: 2.58, 95% CI: 1.13, 5.42) and homophobic bullying (AOR: 2.40, 95% CI: 1.26, 4.48) were associated with subsequent ART nonadherence. Moreover, depression partially mediated 17.4% (95% CI: 0.75%, 56%) of the effect of homophobic bullying on ART nonadherence. Conclusions: The results suggest that tailored interventions to optimize ART adherence should address the impacts of intimate partner violence and homophobic bullying for HIV+ YMSM. The screening and subsequent treatment of depression alone may not be sufficient to address the effects of intimate partner violence, homophobic bullying, and possibly other MSM-specific psychosocial stressors on ART adherence.

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Section: Discussionmentioning

confidence: 91%

Effects of intimate partner violence and homophobic bullying on ART adherence among young Thai men who have sex with men: a causal mediation analysis

Cheung,

Reeves,

Waratworawan

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Some men expressed having no interest in switching to LAI-ART because they were satisfied with oral ART. Others worried about the newness of LAI technology or were simply opposed to changing to "witchery" and did not "want to inject nothing" into their bodies, which, to some extent, may reflect well-documented medical mistrust among Black Americans [17,26,40,41].…”

Section: Discussionmentioning

confidence: 99%

LAI-ART Awareness, Willingness, Barriers and Facilitators among Black Sexual Minority Men Living with HIV in the US South

Campbell,

Kielhold,

Reynolds

et al. 2024

IJERPH

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Black sexual minority men (BSMM) continue to bear a disproportionate burden of HIV in the United States, with the highest incidence and prevalence in the southern region of the country. In Texas, BSMM living with HIV (BSMM+) have the lowest rates of viral suppression of all SMM and have lower antiretroviral treatment (ART) adherence than white and Hispanic SMM. Long-acting injectable ART (LAI-ART) can potentially overcome several barriers to daily oral ART adherence (e.g., stigma, forgetfulness, pill fatigue). However, little is known about the knowledge, willingness, barriers, and facilitators regarding LAI-ART among BSMM+. From July 2022 to September 2023, we conducted in-depth, semi-structured interviews with 27 BSMM+ from the Houston and Dallas Metropolitan Areas, Texas. Data were analyzed using a thematic analysis approach. Most men knew about LAI-ART, but their understanding varied based on their existing sources of information. Some men were enthusiastic, some were cautious, and some reported no interest in LAI-ART. Barriers to LAI-ART included a lack of public insurance coverage of LAI-ART; fear of needles and side effects; the frequency of injection visits; the requirement of viral suppression before switching from oral ART to LAI-ART; and satisfaction with oral daily ART. Motivators of LAI-ART uptake included the eliminated burden of daily pills and reduced anxiety about possibly missing doses. BSMM+ may be among those who could most benefit from LAI-ART, though more research is needed to understand which factors influence their willingness and how the barriers to LAI-ART might be addressed, particularly among diverse communities of SMM of color.

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“…[18][19][20] Race-based medical distrust among racial and ethnic minorities contributes lack of engagement with medical settings and providers, which compromises the opportunities for education, vaccination, and other prevention. 21,22 The mpox epidemic highlighted the need for continued prevention and meaningful engagement with gay and bisexual men of color in Alameda County, as in other settings.…”

Section: Discussionmentioning

confidence: 99%

“…Sexual and gender minority people experience compounded barriers to prevention and treatment, including access to information, language barriers, racism, homophobia, stigma, discrimination, and poverty 18-20. Race-based medical distrust among racial and ethnic minorities contributes to lack of engagement with medical settings and providers, which compromises the opportunities for education, vaccination, and other prevention 21,22. The mpox epidemic highlighted the need for continued prevention and meaningful engagement with gay and bisexual men of color in Alameda County, as in other settings.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Mpox Cases, and Tecovirimat and JYNNEOS Utilization, Alameda County, California, June-October 2022

Ouyang,

Marusinec,

Bayard

et al. 2024

Journal of Public Health Management &Amp; Practice

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Context: The 2022 United States mpox outbreak disproportionately affected racial and ethnic minority gay, bisexual, and other men who have sex with men. Program: We utilized surveillance data and vaccination registries to determine whether populations most impacted by mpox in Alameda County received JYNNEOS vaccines and tecovirimat (TPOXX) during June 1-October 31, 2022. Implementation: Alameda County Public Health Department responded to the mpox epidemic through partnerships with local health care providers who serve communities disproportionately affected by mpox. Evaluation: During June 1-October 31, 2022, a total of 242 mpox cases were identified in Alameda County. Mpox incidence rates per 100 000 were highest among Black/African American (35.7; 95% confidence interval [CI], 26.8-46.5) and Hispanic/Latinx (25.1; CI, 20.1-30.9) residents, compared to Asian (3.8; CI, 2.3-5.9) and White (10.5; CI, 7.7-13.9) residents. Most confirmed cases were identified as gay, lesbian, or same-gender-loving (134, 67.3%) and bisexual (31, 15.6%); 226 (93.8%) cases were male. Sixty-nine (28.5%) mpox patients received TPOXX. There were no statistically significant differences in demographic and clinical characteristics of mpox cases when compared by TPOXX receipt status. JYNNEOS vaccine was received by 8277 Alameda County residents. The largest proportion of vaccinees were White residents (40.2%). Administration rates per 100 000 men who have sex with men were lowest among Asian and Hispanic/Latinx individuals, at 8779 (CI, 8283-9296) and 14 953 (CI, 14 156-15 784), respectively. Black/African American and Hispanic/Latinx males had the lowest vaccination-to-case ratios at 16.7 and 14.8, respectively. Discussion: Mpox disproportionately affected Black/African American and Hispanic/Latinx men who have sex with men in Alameda County. Strong partnerships with local health care providers ensured that persons with mpox received TPOXX treatment when indicated. However, higher JYNNEOS vaccine uptake in Black and Latinx communities needs improvement through ongoing and meaningful engagement with Black/African American and Hispanic/Latinx gay, bisexual, and transgender communities.

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Race-Based Medical Mistrust, HIV-Related Stigma, and ART Adherence in a Diverse Sample of Men Who Have Sex with Men with HIV

Cited by 11 publications

References 29 publications

Effects of intimate partner violence and homophobic bullying on ART adherence among young Thai men who have sex with men: a causal mediation analysis

Effects of intimate partner violence and homophobic bullying on ART adherence among young Thai men who have sex with men: a causal mediation analysis

LAI-ART Awareness, Willingness, Barriers and Facilitators among Black Sexual Minority Men Living with HIV in the US South

Epidemiology of Mpox Cases, and Tecovirimat and JYNNEOS Utilization, Alameda County, California, June-October 2022

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