Healthcare discrimination, anticipated HIV stigma, and income as predictors of HIV testing among a community sample of YBMSM

ABSTRACT

Young Black men who have sex with men (YBMSM) are at particular risk for HIV, and knowing one’s HIV status is key to preventing new HIV infections. Data were derived from a community-based study involving 250 YBMSM to examine the relationships between race-based discrimination experienced in healthcare settings, anticipated HIV stigma, household income and lifetime HIV testing. Lifetime HIV testing was regressed on racial discrimination in healthcare settings, anticipated HIV stigma, and income, and a significant 3-way interaction was found. To help interpret the 3-way interaction, lifetime HIV testing was regressed on racial discrimination in healthcare settings and anticipated HIV stigma in two separate models; with low-income and higher-income YBMSM. Anticipated HIV stigma was found to predict HIV testing among low-income YBMSM. A significant interaction was detected such that low-income YBMSM with low levels of anticipated HIV stigma were more likely to get tested for HIV regardless of experiences with healthcare discrimination, while low-income YBMSM who reported greater anticipated HIV stigma and more experiences of healthcare discrimination were less likely to get tested for HIV. Understanding the complexity of potential barriers is crucial for developing interventions to increase HIV testing within this population.

KEYWORDS:

• Young Black men who have sex with men (YBMSM)
• Race-based discrimination in healthcare settings
• Anticipated HIV stigma
• Low income
• HIV testing

Acknowledgments

This work was supported by the Substance Abuse and Mental Health Services Administration (SAMHSA) under award number SP021340. The content is solely the responsibility of the authors and does not necessarily represent the official views of SAMHSA.

We would like to acknowledge and thank the men who participated in the PPOWER Project. We are also grateful for the significant contributions made by our community partners (Behavioral Health Services, Inc., St. Mary Medical Center CARE Program, and The LGBTQ Center of Long Beach) and all the staff of the PPOWER Project at the Center for Health Equity Research who made this study possible.

Compliance with Ethical Standards

Disclosure statement

No potential conflict of interest was reported by the author(s).

Research involving Human Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the California State University, Long Beach (16-376, 17-391, and 18-437) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Currently not available.

Code availability

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Additional information

Funding

This work was supported by Substance Abuse and Mental Health Services Administration: [Grant Number SP021340].