Living While Black, Gay, and Poor: The Association of Race, Neighborhood Structural Disadvantage, and PrEP Utilization Among a Sample of Black Men Who Have Sex With Men in the Deep South

2021 ◽  
Vol 33 (5) ◽  
pp. 395-410
Author(s):  
Paul A. Burns ◽  
Casey D. Xavier Hall ◽  
Tonia Poteat ◽  
Leandro A. Mena ◽  
Frank Y. Wong
Keyword(s):  
Black Men ◽  
Structural Equation ◽  
Neighborhood Context ◽  
Multilevel Structural Equation Modeling ◽  
Equation Modeling ◽  
Black Msm ◽  
Deep South ◽  
Structural Level ◽  
Structural Disadvantage ◽  
Sex With Men

Utilizing the Andersen Healthcare Utilization Model, we examined the role of neighborhood context on pre-exposure prophylaxis (PrEP) utilization among a sample of Black men who have sex with men (MSM) residing in a medium-sized city in the Deep South. Data were derived from a sample of 142 Black MSM aged 18–64 years who were eligible for PrEP from a community-based study known as “ACCELERATE!” We used multilevel structural equation modeling to assess PrEP use. Social support, sexual risk, and health care access were predictive of PrEP use. Notably, residing in a neighborhood with concentrated poverty was associated with decreased PrEP use. Our findings reveal neighborhood structural disadvantage is associated with decreased PrEP use among Black MSM, after adjusting of individual-level sociodemographic characteristics. There is an urgent need to develop HIV prevention interventions and programs that explicitly address structural-level factors to eliminate racial/ethnic differences in HIV.

scholarly journals Stigma Diminishes the Protective Effect of Social Support on Psychological Distress Among Young Black Men Who Have Sex With Men

2018 ◽  
Vol 30 (5) ◽  
pp. 406-418 ◽  
Author(s):  
José A. Bauermeister ◽  
Kathryn E. Muessig ◽  
Dalmacio D. Flores ◽  
Sara LeGrand ◽  
Seulki Choi ◽  
...  
Keyword(s):  
Social Support ◽  
Psychological Distress ◽  
Black Men ◽  
Structural Equation ◽  
Equation Modeling ◽  
Baseline Survey ◽  
Depression Symptoms ◽  
Hiv Status ◽  
Sex With Men ◽  
Living With Hiv

Addressing stigma remains a pressing HIV priority globally. Young Black men who have sex with men (YBMSM, ages 18–30; N = 474) completed an in-person baseline survey and reported their experiences of externalized stigma (i.e., racial and sexuality discrimination), internalized stigma (i.e., homonegativity), social support, and psychological distress (i.e., anxiety and depression symptoms). We used structural equation modeling to test the association between stigma and psychological distress, and examined whether social support mediated the relationship between stigma and psychological distress. Recognizing that these associations may differ by HIV status, we compared our models by self-reported HIV status (n = 275 HIV negative/unknown; n = 199 living with HIV). Our findings suggest that YBMSM who experience stigma are more vulnerable to psychological distress and may have diminished buffering through social support. These effects are accentuated among YBMSM living with HIV, highlighting the need for additional research focused on the development of tailored stigma reduction interventions for YBMSM.

scholarly journals Examining the Relationships Between Religiosity, Spirituality, Internalized Homonegativity, and Condom Use Among African American Men Who Have Sex With Men in the Deep South

2016 ◽  
Vol 11 (2) ◽  
pp. 196-207 ◽  
Author(s):  
Stacy W. Smallwood ◽  
S. Melinda Spencer ◽  
Lucy Annang Ingram ◽  
Jim F. Thrasher ◽  
Melva V. Thompson-Robinson
Keyword(s):  
African American ◽  
Condom Use ◽  
Structural Equation ◽  
African American Men ◽  
Anal Intercourse ◽  
Equation Modeling ◽  
Internalized Homonegativity ◽  
Deep South ◽  
Sex With Men ◽  
Religiosity And Spirituality

The Sexual Health in Faith Traditions Study evaluated the relationships between religiosity, spirituality, internalized homonegativity, and sexual risk behaviors among a sample of African American men who have sex with men living in the Deep South. Participants were recruited primarily from Black Gay Pride celebrations to complete a self-administered, paper-and-pencil survey. Structural equation modeling was used to determine relationships between key constructs and condom use for insertive ( n = 285) and receptive ( n = 263) anal intercourse in the past 3 months. Almost half of respondents reported using condoms “every time” when engaging in insertive (48.3%) or receptive (45.1%) anal intercourse. Religiosity and spirituality were differentially associated with dimensions of internalized homonegativity. While no significant direct relationships were reported between either religiosity or spirituality and condom use, dimensions of internalized homonegativity mediated significant indirect relationships. Findings suggest that religiosity and spirituality influence African American men who have sex with men’s internalized homonegativity and, subsequently, engagement in safer sex behaviors.

scholarly journals Childhood Exposure to Religions With High Prevalence of Members Who Discourage Homosexuality Is Associated With Adult HIV Risk Behaviors and HIV Infection in Black Men Who Have Sex With Men

2016 ◽  
Vol 11 (5) ◽  
pp. 1309-1321 ◽  
Author(s):  
LaRon E. Nelson ◽  
Leo Wilton ◽  
Nanhua Zhang ◽  
Rotrease Regan ◽  
Chia T. Thach ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Black Men ◽  
Risk Behaviors ◽  
Structural Equation ◽  
Internalized Homophobia ◽  
Path Model ◽  
Equation Modeling ◽  
Transmitted Infection ◽  
High Prevalence ◽  
Sex With Men

Exposure to childhood religious affiliations where the majority of members discourage homosexuality may have negative psychological impacts for Black men who have sex with men. This study tested the hypothesis that exposures to these environments during childhood were associated with adulthood human immunodeficiency virus (HIV)/sexually transmitted infection (STI) behavioral risk and HIV infection, because these exposures influenced HIV/STI risk by undermining race/sexual identity congruence and increasing internalized homophobia and interpersonal anxiety. Structural equation modeling as well as logistic and Poisson regressions were performed using baseline data from HIV Prevention Trials Network 061 ( N = 1,553). Childhood religion affiliations that were more discouraging of homosexuality were associated with increased likelihood of HIV infection; however, the association was no longer significant after adjusting for age, income, and education. Having a childhood religion affiliation with high prevalence of beliefs discouraging homosexuality was associated with increased numbers of sexual partners (adjusted odds ratio = 4.31; 95% confidence interval [3.76, 4.94], p < .01). The hypothesized path model was largely supported and accounted for 37% of the variance in HIV infection; however, interpersonal anxiety was not associated with HIV/STI risk behaviors. Structural interventions are needed that focus on developing affirming theologies in religious institutions with Black men who have sex with men congregants.

The Protective Impact of Immigrant Concentration on Juvenile Recidivism: A Multilevel Examination of Potential Mechanisms

2017 ◽  
Vol 64 (10) ◽  
pp. 1271-1305 ◽  
Author(s):  
Kevin T. Wolff ◽  
Jonathan Intravia ◽  
Michael T. Baglivio ◽  
Alex R. Piquero
Keyword(s):  
Criminal Behavior ◽  
Structural Equation ◽  
Neighborhood Context ◽  
Policy Implications ◽  
Multilevel Structural Equation Modeling ◽  
Equation Modeling ◽  
Individual Level ◽  
Individual Outcomes ◽  
Immigrant Concentration ◽  
Persistent Offending

Both macro- and micro-level research suggests that immigration is unrelated or negatively associated with crime and violence. However, far less research has examined the indirect effects of immigrant concentration on individual-level criminal behavior, and specifically with respect to persistent offending. Moreover, researchers have only begun to explore the mechanisms that link neighborhood context, such as immigrant concentration, to individual outcomes. Thus, identification of the potential mechanisms that may mediate the effect of immigrant concentration on offending remains little understood. Using a unique sample of more than 26,000 youthful offenders from the state of Florida, multilevel structural equation modeling (MSEM) analyses reveal that family structure, familial incarceration, and social ties partially mediate the effect of immigrant concentration on youth reoffending. Findings and implications from the present study are discussed, along with policy implications and future directions for research in this area.

Meta-Accuracy and Perceived Reciprocity From the Perception-Meta-Perception Social Relations Model

2019 ◽  
Vol 50 (1) ◽  
pp. 24-37
Author(s):  
Ben Porter ◽  
Camilla S. Øverup ◽  
Julie A. Brunson ◽  
Paras D. Mehta
Keyword(s):  
Structural Equation Modeling ◽  
Social Relations ◽  
Latent Variables ◽  
Structural Equation ◽  
Multilevel Structural Equation Modeling ◽  
Equation Modeling ◽  
Complete Understanding ◽  
Social Relations Model ◽  
Flexible Framework ◽  
Multilevel Structural Equation

Abstract. Meta-accuracy and perceptions of reciprocity can be measured by covariances between latent variables in two social relations models examining perception and meta-perception. We propose a single unified model called the Perception-Meta-Perception Social Relations Model (PM-SRM). This model simultaneously estimates all possible parameters to provide a more complete understanding of the relationships between perception and meta-perception. We describe the components of the PM-SRM and present two pedagogical examples with code, openly available on https://osf.io/4ag5m . Using a new package in R (xxM), we estimated the model using multilevel structural equation modeling which provides an approachable and flexible framework for evaluating the PM-SRM. Further, we discuss possible expansions to the PM-SRM which can explore novel and exciting hypotheses.

Impulsivity, Affect, and Stress in Daily Life: Examining a Cascade Model of Urgency

2019 ◽  
Author(s):  
Brinkley M. Sharpe ◽  
Leonard Simms ◽  
Aidan G.C. Wright
Keyword(s):  
Negative Affect ◽  
Structural Equation ◽  
Psychiatric Patients ◽  
Cascade Model ◽  
Multilevel Structural Equation Modeling ◽  
Equation Modeling ◽  
Daily Stress ◽  
Daily Diary Study ◽  
Daily Affect ◽  
Multilevel Structural Equation

Using multilevel structural equation modeling, we examined within- and between-person predictors of daily impulsivity, with a particular focus on testing a cascade model of affect and daily stress in a 100-day daily diary study of 101 psychiatric patients with personality disorder diagnoses. On average (i.e., fixed effect), within-person increases in daily stress were associated with increased daily impulsivity, both independently and as accounted for by positive associations with increased negative and positive affect. Higher Personality Inventory for DSM-5 (PID-5) Impulsivity scores were associated with amplified within-person links between impulsivity and daily stress and negative affect, but not the links between daily stress and either positive or negative affect. The results of this cascade model are consistent with the hypothesized link between daily affect and stress and daily impulsivity while providing further evidence for the validity of the PID-5 Impulsivity scale and its ability to predict daily impulsivity above and beyond fluctuations in affect and stress.

scholarly journals Connection to the Gay Community and Self-Appraisals Among Older Men Who Have Sex With Men

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 824-824
Author(s):  
Mark Brennan-Ing ◽  
Michael Plankey ◽  
Sabina Haberlen ◽  
Steven Meanley ◽  
Andre Brown ◽  
...  
Keyword(s):  
Body Dissatisfaction ◽  
Psychological Health ◽  
Structural Equation ◽  
Healthy Aging ◽  
Developmental Regulation ◽  
Equation Modeling ◽  
Gay Community ◽  
Aging Study ◽  
Regulation Strategies ◽  
Sex With Men

Abstract Men who have sex with men (MSM) report greater body dissatisfaction compared with heterosexual men, which increases with age. This may result from internalized gay community values regarding ideal physiques and youth. Using structural equation modeling, we examined these relationships among 1,118 MSM men age 40 and older from the Healthy Aging Study (M age=59.9 years/50.1% HIV+/69.8% non-Hispanic White). We hypothesized gay community attachment would be related to self-appraisals (body dissatisfaction/internalized ageism), and that this relationship would be mediated by developmental regulation strategies (physical activity/exercise intentions). The model fit the data well (RMSEA = .048, 90% CI 0.017-0.079). Contrary to our hypothesis, connection to the gay community was related to positive self-appraisals (-.40, p&lt;.001), with significant indirect effects via regulation strategies (-.12, p&lt;.002). Thus, gay community connections are related to positive self-appraisals in older GB men and enhance strategies supporting physical and psychological health. Implications for practice will be discussed.

scholarly journals Intersectional analysis of life stress, incarceration and sexual health risk practices among cisgender Black gay, bisexual and other men who have sex with men in the Deep South of the US: the MARI Study

Sexual Health ◽  
2020 ◽  
Vol 17 (1) ◽  
pp. 38
Author(s):  
Dustin T. Duncan ◽  
Denton Callander ◽  
Lisa Bowleg ◽  
Su Hyun Park ◽  
Lauren Brinkley-Rubinstein ◽  
...  
Keyword(s):  
Drug Use ◽  
Sexual Health ◽  
Health Risk ◽  
Sexual Risk ◽  
Life Stress ◽  
Black Msm ◽  
Deep South ◽  
Risk Practices ◽  
Sex With Men ◽  
Group Sex

Objectives The purpose of the present study was to examine associations between life stress and incarceration history in relation to sexual health risk practices among a sample of cisgender Black gay, bisexual and other men who have sex with men (MSM) in the Deep South. Methods: Using data from a sample of 355 cisgender Black MSM in Mississippi and Georgia, multivariable logistic regression analyses were conducted to examine associations between life stress and sexual risk practices. In addition, we assessed whether stress may interact with experiences of incarceration to influence sexual health risk practices. Results: After controlling for sociodemographic characteristics, stress was associated with some sexual risk practices (e.g. alcohol and drug use during sex and group sex). Further, when an interaction with incarceration was assessed, among participants who had been incarcerated, high compared with low levels of stress were associated with alcohol use during sex (adjusted odds ratio (aOR) 4.59, 95% confidence interval (CI) 2.11–9.99, P &lt; 0.001), drug use during sex (aOR 3.92, 95% CI 1.79–8.60, P &lt; 0.001), condomless sex with casual partners (aOR 2.83, 95% CI 1.31–6.12, P &lt; 0.001), having six or more casual partners (aOR 2.77, 95% CI 1.09–7.06, P = 0.02) and participating in group sex (aOR 5.67, 95% CI 2.07–15.51, P &lt; 0.001). Stress and incarceration produced a dose–response effect for each association; similar associations with stress were not observed among men who had not been incarcerated. Conclusions: Among people with experiences of incarceration, there are several possible ways our findings could be applied practically, including through safer sex and stress management interventions designed specifically for Black MSM following their release.

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