Lifetime Prevalence and Sociodemographic Correlates of Multifactorial Discrimination Among Middle-Aged and Older Adult Men Who Have Sex with Men

ABSTRACT

This study describes multifactorial discrimination (discrimination attributed to multiple social identities) among middle-aged and older adult MSM. MSM aged 40+ years (N = 1,193) enrolled in the Multicenter AIDS Cohort Study completed behavioral surveys ascertaining experiences of discrimination and their social identity attributions. Non-proportional odds regressions assessed multifactorial discrimination by age, race/ethnicity, HIV status, and covariates. Twenty-seven percent of participants reported multifactorial discrimination. Adjusted models indicated that middle-aged men were more likely to report multifactorial discrimination compared to older adult men. Racial/ethnic minorities were more likely to report multifactorial discrimination compared to non-Hispanic white participants. These same patterns emerged among the sub-sample of participants living with HIV. To our knowledge, this is the first assessment of multifactorial discrimination in middle-aged and older MSM. Our findings support the deleterious association between multiple-marginalization and multifactorial discrimination. Multilevel interventions targeting interconnected experiences of stigma may improve the health of MSM in transition to older age.

KEYWORDS:

• MSM
• aging
• stigma
• discrimination
• HIV
• multiple marginalization
• health disparities

Acknowledgments

The study was supported by grants from the National Institute on Minority Health and Health Disparities (5R01MD010680-03). This article was developed from the first author’s dissertation in partial fulfillment of his PhD in behavioral and community health sciences. The authors acknowledge the support of the members of the Center for LGBT Health Research at the University of Pittsburgh Graduate School of Public Health for their support and insight. Most importantly, the authors thank the men who have continued to give their time to participating in the Multicenter AIDS Cohort Study.

Disclosure statement

No potential conflict of interest was reported by the authors.