The Impact of Racism, Homophobia, and Intimate Partner Violence on the Health and Well-Being of African American and Latino Young Men Who Have Sex with Men

Introduction

Today there is a generation of African American/Black and Hispanic/Latino young men who live in a constant state of fear and arousal. Many experience racism, discrimination, stigma, and violence in their communities, while African American young men experience repeated and frequent trauma by watching acts of violence and police brutality on television and social media. Latino young men, especially those living near the U.S./Mexico border, such as Los Angeles, are faced with yet another source of fear and anxiety -- enforcement of new U.S. immigration policies. Many of these young men live in poverty and in urban cities with high rates of crime, unemployment, illicit drug use, sexually transmitted infections (STIs), and community violence and/or disarray. Young men who have sex with men (YMSM) represent a segment of this population that is at particularly high risk for a wide range of negative physical health (e.g., STIs, HIV/AIDS) and mental health (e.g., depression, anxiety) outcomes. Racial/ethnic minority YMSM are at even higher risk for these negative outcomes due to increased exposure to racism, homophobia, and experiences of violence and victimization given their multiple-minority status. We examined how racism (institutional, sexualized), homophobia (harassment, identity-shaming) and experiences of intimate partner violence (emotional, physical, and sexual IPV) negatively impact the health and well-being of a cohort of racial/ethnic minority YMSM.

Method

Analyses were conducted with 450 YMSM from the Healthy Young Men Cohort Study. Eligibility criteria included: 16 to 24 years of age; male sex at birth; self-identified as gay, bisexual, or uncertain about their sexual orientation; reported a sexual encounter with a male within the previous 12 months; self-identified as Black/African American, Latino/Hispanic, or multi-ethnic; and resident of Los Angeles County. Multivariable (multiple and logistic) regression analyses tested models linking predictors, covariates, and outcomes.

Results

Young men who experienced high levels of racism, homophobia, and IPV were significantly more likely to report a) a greater number of depressive and anxiety-related symptoms (ΔR²_adj=0.11, ΔF(7,438)=7.8, p<0.001; and ΔR²_adj=0.15, ΔF(2,425)=11.03, p<0.001, respectively); b) having had an STI (Chi²(7)=21.02, p<0.01, Nagelkerke R²=0.15); and c) having had a chronic health condition, including a mental health diagnosis and HIV (Chi²(7)=18.06, p=0.01, Nagelkerke R²=0.17), after accounting for significant effects of race, age, food insecurity, housing instability, and healthcare access.

Conclusions

These findings highlight the unique challenges experienced by these youth, which can result in long-term poor health outcomes, across the lifespan without early and comprehensive interventions.