Multiple Minority Stress and Behavioral Health Among Young Black and Latino Sexual Minority Men

Abstract Background Compared to their heterosexual counterparts, sexual minority men (SMM) are at an increased risk of social anxiety disorder. Distal (i.e., everyday discrimination) and proximal (i.e., internalised homophobia, rejection sensitivity, concealment of sexual orientation) minority stress processes are associated with heightened social anxiety for SMM. Stressors emerging from within the sexual minority male community, termed intra-minority stress, and psychological processes that may foster resilience (i.e., a sense of coherence, connectedness to the LGBT community) are less explored in this area. This study examined potential pathways between everyday discrimination, intra-minority stress, proximal minority stressors, resilience and social anxiety. Methods Self-identified SMM (N = 255) residing in the Republic of Ireland completed an online survey containing measures of minority stress, intra-minority stress, resilience and social anxiety. Structural equation modelling was used to examine the model. Results The model yielded a good fit to the data, X2(16) = 26.61, CFI = .99, TLI = .97, RMSEA = .05, and SRMR = .03. Rejection sensitivity and a sense of coherence had a significant indirect effect in the relationships between both exogenous variables (i.e., discrimination and intra-minority stress) and social anxiety. There were no significant pathways to social anxiety involving concealment of sexual orientation, internalised homophobia or LGBT community connectedness. Conclusions For SMM, minority stress processes and intra-minority stress are important determinants of social anxiety. Our findings demonstrate that proximal minority stressors may operate differently in a social anxiety context for SMM in western European countries. A sense of coherence was an integral factor in the model and demonstrated the strongest association with social anxiety.

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Venturing beyond the “Behavioural MSM”: Sex, Chems, & Satisfaction in their Syndemic Contexts

10.35198/01-2019-002-0003 ◽

2020 ◽

Keyword(s):

Hiv Testing ◽

Sexual Minority ◽

Sexual Behaviour ◽

Minority Stress ◽

Online Survey ◽

Well Being ◽

Steady Partner ◽

Sexual Minority Men ◽

Sexually Transmitted ◽

Minority Men

BACKGROUND: The health and well-being of those sexual-minority men who are often behaviourally defined as men who have sex with men (MSM) is affected by a system of interlinked factors that interact on the structural, interpersonal, and individual levels. Recently, two of the most common MSM health issues have been (a) the risks of acquiring sexually transmitted infections (STIs), mostly HIV, and (b) the sexualized use of addictive substances, known as chemsex. AIMS: On the basis of the first comprehensive Czech dataset to integrate several mutually interlinked factors on the behavioural, as well as the psychological and structural domains, we attempt to shed light on the barriers to HIV testing and adherence to safer sex practices, including the most thorough description of the chemsex phenomenon that is available. We aim to go beyond the behavioural perspective and draw links to the well-being and satisfaction of this sexual minority and their sex lives. METHODS: A series of descriptive statistical analyses was conducted on a sample of 547 respondents obtained within a self-administered online survey. RESULTS: More than half of our respondents (55%) and three-quarters (72%) of the men younger than 25 years have never been tested for HIV. One-third of the respondents considered testing services to be insufficiently friendly to gay, bisexual, or other men, and they also reported stigmatization and discrimination by healthcare workers as a problem that exists. 84% of the MSM have experience with anal sex; 43% of them always use condoms. Of all the respondents, nearly 6% have had at least one chemsex experience during their life. Only 46% of the MSM reported being satisfied with their sex lives; 52% of those who were dissatisfied attributed this to “not having a steady partner” and 49% to “not having any sex”. CONCLUSION: The sexual behaviour of MSM and their experience with HIV testing, chemsex, perceived stigma, and satisfaction with their sex lives are among the phenomena that deserve to be more regularly covered by relevant epidemiological examinations. Although our current analysis was more exploratory than in-depth, it may contribute to a better understanding of the syndemic and multifactorial conditions that influence the sexual behaviour of MSM, including the minority stress that may be rooted in deficiencies in our understanding of these populations.

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Sexual and behavioral health disparities among African American sexual minority men and women

Ethnicity and Health ◽

10.1080/13557858.2018.1444149 ◽

2018 ◽

Vol 25 (5) ◽

pp. 653-664 ◽

Cited By ~ 4

Author(s):

Ashley E. Pérez ◽

Kristi E. Gamarel ◽

Jacob J. van den Berg ◽

Don Operario

Keyword(s):

African American ◽

Health Disparities ◽

Behavioral Health ◽

Sexual Minority ◽

Men And Women ◽

Sexual Minority Men ◽

Minority Men

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Scaling Up and Out HIV Prevention and Behavioral Health Services to Latino Sexual Minority Men in South Florida: Multi-Level Implementation Barriers, Facilitators, and Strategies

AIDS Patient Care and STDs ◽

10.1089/apc.2021.0018 ◽

2021 ◽

Vol 35 (5) ◽

pp. 167-179

Author(s):

Audrey Harkness ◽

Satyanand Satyanarayana ◽

Daniel Mayo ◽

Rosana Smith-Alvarez ◽

Brooke G. Rogers ◽

...

Keyword(s):

Hiv Prevention ◽

Health Services ◽

Behavioral Health ◽

Sexual Minority ◽

Scaling Up ◽

South Florida ◽

Implementation Barriers ◽

Sexual Minority Men ◽

Multi Level ◽

Minority Men

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Transdiagnostic Approaches to Improve Sexual Minority Individuals’ Co-occurring Mental, Behavioral, and Sexual Health

Handbook of Evidence-Based Mental Health Practice with Sexual and Gender Minorities ◽

10.1093/med-psych/9780190669300.003.0020 ◽

2019 ◽

pp. 457-476

Author(s):

Craig Rodriguez-Seijas ◽

Charles L. Burton ◽

John E. Pachankis

Keyword(s):

Sexual Minority ◽

Minority Stress ◽

Psychosocial Health ◽

Illustrative Case ◽

Sexual Minority Women ◽

Stress Theory ◽

Sexual Minority Men ◽

Sexually Transmitted ◽

Minority Men ◽

And Gender

Sexual and gender minority individuals are at elevated risk of many adverse psychosocial health outcomes, including mood, anxiety, and substance use disorders, as well as suicidality and sexually transmitted infections. Despite greater utilization of mental health services, there remain few evidence-based approaches specifically tailored for sexual minority individuals and even fewer that are designed to explicitly address the multiple co-occurring conditions that afflict this group. This chapter describes one such approach, rooted in minority stress theory, that has been shown to empirically address the multitude of problematic outcomes and behaviors among sexual minority men and is currently being developed for sexual minority women. The chapter begins by describing the theoretical underpinnings of this therapeutic approach, subsequently providing a description of the major principles underlying this intervention. This chapter ends with an illustrative case example taken from the current clinical trials of this treatment program.

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The Integrated Attachment and Sexual Minority Stress Model: Understanding the Role of Adult Attachment in the Health and Well-Being of Sexual Minority Men

Behavioral Medicine ◽

10.1080/08964289.2016.1165173 ◽

2016 ◽

Vol 42 (3) ◽

pp. 164-173 ◽

Cited By ~ 15

Author(s):

Stephanie H. Cook ◽

Benjamin J. Calebs

Keyword(s):

Sexual Minority ◽

Minority Stress ◽

Well Being ◽

Stress Model ◽

Sexual Minority Men ◽

Model Understanding ◽

Minority Men ◽

Minority Stress Model ◽

Health And Well Being

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Examining inequities in rates of undiagnosed HIV and rectal STIs in a large nationwide cohort study of sexual minority men

Sexually Transmitted Infections ◽

10.1136/sextrans-2021-055047 ◽

2021 ◽

pp. sextrans-2021-055047

Author(s):

H Jonathon Rendina ◽

Ali Talan ◽

K Marie Sizemore ◽

Nicola F Tavella ◽

Brian Salfas ◽

...

Keyword(s):

Cohort Study ◽

Hiv Infection ◽

Ethnic Groups ◽

Sexual Minority ◽

Race And Ethnicity ◽

Sexual Minority Men ◽

Undiagnosed Hiv ◽

Incarceration History ◽

Minority Men ◽

Black And Latino

ObjectiveSexual minority men (SMM) of colour are disproportionately impacted by HIV and bacterial STIs (bSTIs). To better understand within-group heterogeneity and differential risk factors by race and ethnicity, we sought to examine rates of undiagnosed HIV and rectal bSTI at the intersection of racial and ethnic identity with other sociodemographic factors.MethodsWe examined data from 8105 SMM conducting home-based self-testing at enrolment in a nationwide cohort study collected from November 2017 to August 2018. We conducted analyses stratified by racial and ethnic groups to examine within-group (ie, subgroup) unadjusted rates of HIV and rectal bSTI infection across a range of characteristics.ResultsRates of undiagnosed HIV were highest among Black (4.3%, n=39) and Latino (2.4%, n=38) SMM, with lower rates among those identified as multiracial (1.6%, n=15), white (1.3%, n=56) and other races (1.3%, n=6). Across the stratified analyses of HIV infection, 15 significant associations emerged showing that age, region, insurance type, sexual positioning and incarceration history had differential impacts across racial and ethnic groups. In particular, private and public insurance were protective against HIV for white but not Black and Latino SMM, and incarceration was associated with substantially higher rates of HIV infection for Black and Latino SMM relative to white SMM. We found significant co-occurrence of HIV and bSTI rates for participants who identified as Latino (OR=7.5, 95% CI 2.12 to 26.54), white (OR=3.19, 95% CI 1.14 to 8.98) and multiracial (OR=5.5, 95% CI 1.08 to 27.90), but not those who identified as Black (OR=0.82, 95% CI 0.10 to 6.56) or other races (OR=3.56 95% CI 0.31 to 40.80).ConclusionsStratified analyses showed differential rates of HIV infection at the intersection of racial and ethnic groups with other characteristics, particularly insurance status and incarceration history, pointing to structural inequities rather than individual behaviours underlying disproportionately high rates of HIV for Black and Latino SMM.

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