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Cited by 77LGBTQ Health, Identity, and PolicyRacial and Ethnic Identity ResearchHIV/AIDS Research and Interventions

Intersecting Structural Oppression and Black Sexual Minority Men's Health

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English, Devin, Carter, Joseph A., Boone, Cheriko A., Forbes, Nicola, Bowleg, Lisa, Malebranche, David J., Talan, Ali J., Rendina, H. Jonathon·2021·American Journal of Preventive Medicine
DOI 10.1016/j.amepre.2020.12.022PMC PMC8274250
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Abstract

Introduction Although evidence indicates that Black gay, bisexual, and other sexual minority men experience vast psychological and behavioral health inequities, most research has focused on individual rather than structural drivers of these inequities. This study examines the associations between structural racism and anti-lesbian, gay, bisexual, transgender, and queer policies and the psychological and behavioral health of Black and White sexual minority men. Methods Participants were an Internet-based U.S. national sample of 1,379 Black and 5,537 White sexual minority men during 2017-2018. Analysis occurred in 2019-2020. Structural equation modeling tested the associations from indicators of structural racism, anti‒lesbian, gay, bisexual, transgender, and queer policies, and their interaction to anxiety symptoms, depressive symptoms, perceived burdensomeness, heavy drinking, and HIV testing frequency. Separate models for Black and White sexual minority men adjusted for contextual and individual covariates. Results For Black participants, structural racism was positively associated with anxiety symptoms (β=0.20, SE=0.10, p=0.04), perceived burdensomeness (β=0.42, SE=0.09, p<0.001), and heavy drinking (β=0.23, SE=0.10, p=0.01). Anti‒lesbian, gay, bisexual, transgender, and queer policies were positively associated with anxiety symptoms (β=0.08, SE=0.04, p=0.03), perceived burdensomeness (β=0.20, SE=0.04, p<0.001), and heavy drinking (β=0.10, SE=0.04, p=0.01) and were negatively associated with HIV testing frequency (β= -0.14, SE=0.07, p=0.04). Results showed significant interaction effects, such that the positive associations between structural racism and both perceived burdensomeness (β=0.38, SE=0.08, p≤0.001) and heavy drinking (β=0.22, SE=0.07, p=0.003) were stronger for individuals living in states with high levels of anti‒lesbian, gay, bisexual, transgender, and queer policies. Neither of the oppression variables nor their interaction was significantly associated with outcomes for White sexual minority men. Conclusions Results highlight the intersectional nature of structural oppression and suggest that racist and anti-lesbian, gay, bisexual, transgender, and queer policies must be repealed to rectify health inequities facing Black sexual minority men.

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Authors
English, D., Carter, J. A., Boone, C. A., Forbes, N., Bowleg, L., Malebranche, D. J., Talan, A. J., & Rendina, H. J.
Affiliations
  • Rutgers, The State University of New Jersey (US)
  • The Graduate Center, CUNY (US)
  • George Washington University (US)
  • Fordham University (US)
  • Hunter College (US)
Corresponding author
Rendina, H. Jonathon
ORCID
Venue
American Journal of Preventive Medicine
Publisher
Elsevier BV
Published
2021-06
Volume
60
Issue
6
Pages
781-791
ISSN
0749-3797 (ISSN-L)
DOI
10.1016/j.amepre.2020.12.022
PMC
PMC8274250
OpenAlex
W3149999542
Cited by
77
References
6
Citations by year
2026: 11 · 2025: 20 · 2024: 16 · 2023: 15 · 2022: 14 · 2021: 1
FWCI
11.27
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Child Health and Human Development
  • National Institutes of Health
  • National Institute of Mental Health (K01-MH118091, UG3-AI133674)
  • National Institute of Allergy and Infectious Diseases
Topics
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords
structural racism, Black sexual minority men, gay, bisexual and other men, anxiety symptoms, depressive symptoms, perceived burdensomeness, heavy drinking, HIV testing, intersectionality, racial disparities, state policy, health disparities, black-white disparities, substance use, access to mental health care, systemic oppression
MeSH terms
Sexual and Gender Minorities, Bisexuality, Black or African American, Humans, Male, Sexual Behavior, Men's Health

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