Inter-Group and Intraminority-Group Discrimination Experiences and the Coping Responses of Latino Sexual Minority Men Living With HIV.

Sarah MacCarthy, Laura M Bogart, Frank H Galvan, David W Pantalone
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Abstract

Discrimination negatively impacts the health of HIV-positive Latino sexual minority men (LSMM+). A growing literature on LSMM+ chronicles associations based on multiple devalued identities and mental health symptoms, HIV medication nonadherence, and sexual behaviors with the potential to transmit HIV. To gain additional insights on identity-based discrimination-as well as the associated coping responses-we conducted 30 qualitative interviews with LSMM+.Participantswereprobedregardingrecentdiscriminationevents(context,details,perpetrator, type) based on their intersecting identities (Latinx ethnicity, residency status, sexual minority orientation, HIV-positive serostatus) and their coping responses. We transcribed and translated the interviews and conducted a content analysis. Participants reported inter-group (i.e., between majority and minority group members) and intraminority-group (i.e., within minority group members) experiences as common. Participants described their intraminority-group experiences with discrimination based on being a Latinx sexual minority person in their families and home communities. Participants reported a range of coping responses to discrimination experiences. However, participants reported only functional (and no dysfunctional) coping strategies, and they endorsed using similar strategies in response to inter-group and intraminority-group discrimination. Coping strategies included strategic avoidance, social support, self-advocacy, and external attribution. Additional coping strategies (spirituality and positive reframing) emerged more strongly in response to inter-group experiences with discrimination. Our results underscore the need to address both inter-group and intraminority-group discrimination experiences. Future interventions can focus on strengthening the effective coping skills that LSMM+ currently employ as potential levers to address LSMM+ health disparities.

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拉丁裔性少数群体男性艾滋病感染者的群体间和群体内歧视经历及应对措施。
歧视对艾滋病毒呈阳性的拉丁裔性少数群体男性(LSMM+)的健康产生了负面影响。越来越多关于拉美裔性少数群体男性的文献记录了基于多重被贬低的身份和心理健康症状的关联、HIV 药物治疗的不依从性以及可能传播 HIV 的性行为。为了进一步深入了解基于身份的歧视以及相关的应对措施,我们对 LSMM+ 进行了 30 次定性访谈。我们根据参与者的交叉身份(拉丁裔、居住身份、性少数取向、HIV 阳性血清状态)对他们所受的歧视事件(背景、细节、肇事者、类型)及其应对措施进行了调查。我们对访谈内容进行了誊写和翻译,并进行了内容分析。参与者报告了群体间(即多数群体成员与少数群体成员之间)和群体内(即少数群体成员内部)的共同经历。参与者描述了他们作为拉丁裔性少数群体成员在家庭和家乡社区受到歧视的群体内经历。与会者报告了一系列应对歧视经历的方法。然而,参与者只报告了功能性(而没有功能失调)应对策略,他们认可在应对群体间和群体内歧视时使用类似的策略。应对策略包括策略性回避、社会支持、自我辩护和外部归因。其他应对策略(灵性和积极重塑)在应对群体间歧视经历时出现得更为强烈。我们的研究结果表明,需要同时应对群体间和群体内的歧视经历。未来的干预措施可以侧重于加强 LSMM+ 目前使用的有效应对技能,以此作为解决 LSMM+ 健康差异的潜在杠杆。
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