Multiple Discrimination, Substance-Related Coping, and Depression Among Sexual Minority Men with HIV

Sexual minority men (SMM) with HIV who use substances experience multiple forms of stigma (e.g., experienced discrimination) related to aspects of themselves and their behaviors and are disproportionately affected by depression. More research is needed to examine the interrelations between multiple discrimination, including substance-related discrimination, and depression, and the intervening role of substance-related coping among SMM with HIV who use drugs. Self-report data (N = 195) collected between 2017-2018 included experienced discrimination (categories included HIV, sexual orientation, race/ethnicity, substance use), substance-related coping, and depressive symptoms. ANCOVA results revealed significant differences in depressive symptoms based on the number of discrimination categories endorsed, F(6,188) = 11.71, p < .001, with groups that endorsed discrimination across more stigmatized categories reporting higher depressive symptoms. Supplemental ANCOVA results also indicated differences in depressive symptoms based on endorsement of substance use discrimination, F(4,190) = 19.16, p < .001. Analysis of indirect associations revealed substance-related coping partially accounted for the relation between multiple discrimination and depressive symptoms, b = 1.19, 95%CI [0.58, 1.91]. Results suggest that there is a cumulative association between multiple discrimination and depressive symptoms, and substance-related discrimination and substance-related coping may be particularly important influencers on this association. Multi-level intervention efforts that target multiple discrimination could help ameliorate the high rates of depression in this community

Coping (psychology · Homosexuality · Human immunodeficiency virus (HIV · Male Homosexuality · Men who have sex with men · Minority stress · Psychiatry · Sexual minority · Sexual orientation · Substance use · Syphilis · Clinical Psychology · HIV/AIDS Research and Interventions · LGBTQ Health, Identity, and Policy · Medicine · Psychology · Reproductive Health and Technologies · Social Psychology · Virology

• Social Determinants of Mental Health

  Open Access•Margarita Alegria, Amanda Nemoyer et al.•Current Psychiatry Reports•2018

  Incluir item

• Stigma and social support in substance abuse

  Open Access•Michèle D Birtel, Lisa Wood et al.•Psychiatry Research•2017

  Incluir item

• Discrimination, Mental Health, and Substance Use Disorders Among Sexual Minority Populations

  Open Access•Ji Hyun Lee, Kristi E Gamarel et al.•LGBT Health•2016

  Incluir item

• Screening for Depression in the General Population with the Center for Epidemiologic Studies Depression (CES-D)

  Open Access•Gemma Vilagut, Carlos G Forero et al.•PLoS ONE•2016

  Incluir item

• Self-Reported Experiences of Discrimination and Health

  Tené T Lewis, Courtney D Cogburn et al.•Annual Review of Clinical…•2015

  Incluir item

• Examining the associations between HIV-related stigma and health outcomes in people living with HIV/Aids

  Open Access•Salvador Rueda, Sanjana Mitra et al.•BMJ Open•2016

  Incluir item

• Minority stress and mental health among LGBT populations

  Francesca Mongelli, Daniela Perrone et al.•Minerva Psichiatrica•2019

  Incluir item

• Substance Use Related Stigma

  Magdalena Kulesza•Journal of Addictive Behaviors…•2013

  Incluir item

• A systematic review of multi-level stigma interventions

  Open Access•Deepa Rao, Ahmed Elshafei et al.•BMC Medicine•2019

  Incluir item

• Sexual Stigma and Sexual Prejudice in the United States

  Gregory M Herek•Kinetic logic•2009

  Incluir item

• Depression and HIV/Aids Treatment Nonadherence

  Jeffrey S Gonzalez, Abigail W Batchelder et al.•JAIDS Journal of Acquired Immune…•2011

  Incluir item

• You want to measure coping but your protocol’ too long

  Charles S Carver•International Journal of…•1997

  Incluir item

• The CES-D Scale

  Open Access•Lenore Sawyer Radloff•Applied Psychological Measurement•1977

  Incluir item

• Importance of substance use and violence in psychosocial syndemics among women with and at-risk for HIV

  Abigail W Batchelder, David W Lounsbury et al.•AIDS Care•2016

  Incluir item

• Substance-related coping, HIV-related factors, and mental health among an HIV-positive sexual minority community sample

  Robert J Cramer, Scholar L Colbourn et al.•AIDS Care•2015

  Incluir item

• What do we know about interventions to reduce intersectional stigma and discrimination in the context of HIV? A systematic review

  Anne Stangl, Kaitlyn Atkins et al.•Stigma and Health•2022

  Incluir item

• Coping with sexual orientation microaggressions

  Jacob L Scharer, Matthew Taylor•Journal of Gay & Lesbian Mental…•2017

  Incluir item

• Substance Use and Experienced Stigmatization Among Ethnic Minority Men Who Have Sex with Men in the United States

  Jay P Paul, Ross Boylan et al.•Journal of Ethnicity in Substance…•2014

  Incluir item

• Substance Use Stigma, Avoidance Coping, and Missed HIV Appointments Among MSM Who Use Substances

  Open Access•Abigail W Batchelder, James D Foley et al.•AIDS and Behavior•2020

  Incluir item

• Age and Year of HIV Diagnosis are Associated with Perceptions of Discrimination and Internalized Stigma Among Sexual Minority Men Who Use Substances

  Open Access•Abigail W Batchelder, Claire Burgess et al.•AIDS and Behavior•2021

  Incluir item

• Perceived Discrimination and Physical Health Among HIV-Positive Black and Latino Men Who Have Sex with Men

  Open Access•Laura M Bogart, Hope Landrine et al.•AIDS and Behavior•2013

  Incluir item

• Reduction in substance use stigma following a peer-recovery specialist behavioral activation intervention

  Open Access•Mary B Kleinman, Morgan S Anvari et al.•International Journal of Drug…•2024

  Incluir item

• A critical review of current evidence on multiple types of discrimination and mental health

  Sylvanna M Vargas, Stanley J Huey et al.•American Journal of Orthopsychiatry•2020

  Incluir item

• The role of substance use motives in the associations between minority stressors and substance use problems among young men who have sex with men

  Open Access•Brian A Feinstein, Michael E Newcomb•Psychology of Sexual Orientation…•2016

  Incluir item

• Discrimination and sexual minority mental health

  Sakkaphat Ngamake, Susan E Walch et al.•Psychology of Sexual Orientation…•2016

  Incluir item

• Can additive measures add to an intersectional understanding? Experiences of gay and ethnic discrimination among HIV-positive Latino gay men

  Carol A Reisen, Kelly D Brooks et al.•Cultural Diversity & Ethnic…•2013

  Incluir item

• A Social Ecological Model of Syndemic Risk affecting Women with and At‐Risk for HIV in Impoverished Urban Communities

  Open Access•Abigail W Batchelder, Jeffrey S Gonzalez et al.•American Journal of Community…•2015

  Incluir item

• Association of Co-Occurring Psychosocial Health Problems and Increased Vulnerability to HIV/Aids Among Urban Men Who Have Sex With Men

  Ron Stall, Thomas C Mills et al.•American Journal of Public Health•2003

  Incluir item

• Intersectional Stigma and Prevention Among Gay, Bisexual, and Same Gender–Loving Men in New York City, 2020

  Priscila Lutete, D W Matthews et al.•American Journal of Public Health•2022

  Incluir item

• HIV-Related Intersectional Stigma and Discrimination Measurement

  Tahilin Sanchez Karver, Kaitlyn Atkins et al.•American Journal of Public Health•2022

  Incluir item

• The Relationship Between Discrimination and Substance Use Disorders Among Lesbian, Gay, and Bisexual Adults in the United States

  Sean Esteban Mccabe, Wendy Bostwick et al.•American Journal of Public Health•2010

  Incluir item

• The health equity promotion model

  Karen I Fredriksen-Goldsen, Karen Fredriksen Goldsen et al.•American Journal of Orthopsychiatry•2014

  Incluir item

• Discrimination and mental health among lesbian, gay, and bisexual adults in the United States

  Wendy Bostwick, Wendy B Bostwick et al.•American Journal of Orthopsychiatry•2014

  Incluir item

• Multiple minorities as multiply marginalized

  Kali D Cyrus, Kali Cyrus•Journal of Gay & Lesbian Mental…•2017

  Incluir item

• Perceived discrimination and mental health symptoms among Black men with HIV

  Laura M Bogart, Glenn J Wagner et al.•Cultural Diversity & Ethnic…•2011

  Incluir item

• Measuring multiple minority stress

  Kimberly F Balsam, Yamile Molina et al.•Cultural Diversity & Ethnic…•2011

  Incluir item

• Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations

  Ilan H Meyer•Psychological Bulletin•2003

  Incluir item

• Intersecting internalized stigmas and HIV self-care among men who have sex with men and who use substances

  Open Access•Abigail W Batchelder, James D Foley et al.•Social Science & Medicine•2021

  Incluir item

• How does sexual minority stigma "get under the skin"? A psychological mediation framework

  Mark L Hatzenbuehler•Psychological Bulletin•2009

  Incluir item

• Intersectionality of internalized HIV stigma and internalized substance use stigma

  Open Access•Valerie A Earnshaw, L R Smith et al.•Journal of Health Psychology•2015

  Incluir item

• The Stigma Complex

  Bernice A Pescosolido, Jack Martins et al.•Annual Review of Sociology•2015

  Incluir item