Social Support Affects PrEP Use in Black Sexual Minority Individuals Experiencing Discrimination

Findings from a study on intersectional discrimination and the use of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) in young Black sexual minority individuals show a complex relationship between discrimination, resilience, and health outcomes. Results were published in AIDS and Behavior.

“While our findings showed some unanticipated relationships, they provide insight into how discrimination and stigma may influence PrEP use and disparities,” wrote study lead and corresponding author Katherine G. Quinn, PhD, of the Medical College of Wisconsin Center for AIDS Intervention Research, and coauthors.

The study included 283 young Black sexual minority men and transgender women living in Milwaukee, Wisconsin, and Cleveland, Ohio.

According to the findings, participants who reported more anticipated discrimination had lower odds of current PrEP use. The study identified an odds ratio of 0.59.

“Unexpectedly,” researchers reported, “our results also showed that while major discrimination was not associated with PrEP outcomes, daily experiences of intersectional discrimination in the past year were positively associated with likelihood of future PrEP use. This was surprising and stands in contrast to our qualitative research, which indicated that intersectional racism and homophobia can impede PrEP use among young Black sexual minority men. However, this finding does align with other recent studies.”

In other findings, the study showed an association between greater discrimination and higher levels of resilience, social support, and connection to the Black lesbian, gay, bisexual, transgender, queer (LGBTQ) community. The effect of day-to-day discrimination on the likelihood PrEP use in the future was mediated by social support.

“Individuals who experience greater discrimination may seek out social support and LGBTQ community connections in response to these experiences, which may, in turn, positively impact PrEP outcomes,” researchers wrote. “These social connections can also increase positive perceptions of PrEP and likelihood of current and future use, while mitigating the negative effects of discrimination.”

Reference:
Quinn KG, Dickson-Gomez J, Craig A, John SA, Walsh JL. Intersectional discrimination and PrEP use among young Black sexual minority individuals: the importance of Black LGBTQ communities and social support. AIDS Behav. Published online ahead of print July 5, 2022. doi:10.1007/s10461-022-03763-w