An exploratory study of community violence and HIV care engagement among Black gay and bisexual men

ABSTRACT

This study examined the relationship between exposure to community violence and HIV care engagement among 107 Black gay or bisexual men living with HIV in Chicago. Measures assessed the importance of demographic covariates (age, annual income, health insurance status, and years living with HIV), community violence exposures, mental health, social support, in explaining variations in missed doses of antiretroviral therapy (ART) medication and missed HIV care appointments. Results showed that participants who reported higher rates of exposure to community violence were two times more likely to have missed ART doses and HIV care appointments. Participants who reported depression scores were two times more likely to have greater non-ART adherence. Finally, older participants were more likely to report fewer missed ART doses. More research is needed to clarify the mechanisms between age or depression and ART adherence given community violence exposure. Health care providers should screen for depression when attempting to promote better ART adherence and keeping HIV care appointments for Black gay and bisexual men living with HIV. Younger Black gay and bisexual men living with HIV may be more vulnerable than older men for missed ART doses and may require additional screening and follow-up.

KEYWORDS:

• Community violence
• Black men living with HIV
• ART doses
• medication adherence
• depression

Acknowledgements

We thank the participants who enrolled in the study for their honesty and willingness to talk with us about their lives. We also thank the AIDS Foundation Chicago who supported important linkages with our community members and organizations. We also thank the editor and two anonymous reviewers for their helpful comments. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIMH.

Disclosure statement

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

Additional information

Funding

Research reported in this paper was supported by the National Institute of Mental Health of the National Institutes of Health [award number R21 MH122010] (MPI Voisin and Quinn).