Narratives of Disconnection: A Life Course Perspective of Methamphetamine Use Among Sexual Minority Men Living with HIV.

IF 2 3区 心理学 Q3 PSYCHOLOGY, CLINICAL
Walter Gómez, Kurt C Organista, Tina K Sacks, Seth M Holmes, Adam W Carrico
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Abstract

Background: Sexual minority men (SMM) are exposed to societal and structural stressors that translate into poor health outcomes. One such outcome is substance use, which research has long documented as a prominent disparity among SMM. Methamphetamine is a particularly deleterious substance for SMM because its use is often framed as a coping response to social and structural stressors.

Method: Guided by stress and coping theory and a life course perspective, the purpose of this qualitative study is to assess the development of coping strategies in the context of prominent social and structural determinants among SMM living with HIV who use methamphetamine.

Results: Data were collected from 2016 to 2018 via in-depth interviews with 24 SMM living with HIV who use methamphetamine in San Francisco, CA. Mean age of participants was 47 and over half self-identified as ethnoracial minorities. Narrative analysis surfaced a sequential pattern of disconnection at foundational, relational, and recovery levels. This analysis revealed that multi-level stressors were present across the life course that amplified engagement in methamphetamine use.

Conclusion: Findings highlight the benefits of holistic, integrated, and trauma-informed approaches to address the function of methamphetamine use as a response to societal, cultural, and institutional processes of stigmatization and discrimination. Peer-based approaches may also be beneficial to reframe the ways in which SMM living with HIV who use methamphetamine form and sustain relationships.

断绝关系的叙述:从生命历程的角度看感染艾滋病毒的少数性取向男性使用甲基苯丙胺的情况。
背景:性少数群体男性(SMM)面临着社会和结构性压力,这些压力转化为不良的健康后果。其中一个结果就是药物使用,长期以来,研究记录表明这是性取向少数群体男性中的一个突出差异。甲基苯丙胺对少数族裔男性尤其有害,因为吸食甲基苯丙胺通常被视为对社会和结构性压力的一种应对措施:在压力与应对理论和生命历程视角的指导下,本定性研究旨在评估使用甲基苯丙胺的艾滋病病毒感染者和艾滋病患者在突出的社会和结构性决定因素背景下应对策略的发展情况:从 2016 年到 2018 年,通过对加利福尼亚州旧金山 24 名吸食甲基苯丙胺的艾滋病病毒感染者和艾滋病病毒携带者进行深入访谈收集了数据。参与者的平均年龄为 47 岁,半数以上自我认同为少数民族。叙事分析表明,在基础、关系和康复三个层面上存在着连续的脱节模式。该分析表明,多层次的压力因素存在于整个生命过程中,从而加剧了甲基苯丙胺的使用:研究结果凸显了整体、综合和创伤知情方法的益处,这些方法可以解决使用甲基苯丙胺作为对社会、文化和机构污名化和歧视过程的回应的功能问题。以同伴为基础的方法可能也有利于重新构建使用甲基苯丙胺的艾滋病病毒感染者和艾滋病患者形成和维持关系的方式。
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来源期刊
CiteScore
5.20
自引率
3.70%
发文量
97
期刊介绍: The International Journal of Behavioral Medicine (IJBM) is the official scientific journal of the International Society for Behavioral Medicine (ISBM). IJBM seeks to present the best theoretically-driven, evidence-based work in the field of behavioral medicine from around the globe. IJBM embraces multiple theoretical perspectives, research methodologies, groups of interest, and levels of analysis. The journal is interested in research across the broad spectrum of behavioral medicine, including health-behavior relationships, the prevention of illness and the promotion of health, the effects of illness on the self and others, the effectiveness of novel interventions, identification of biobehavioral mechanisms, and the influence of social factors on health. We welcome experimental, non-experimental, quantitative, qualitative, and mixed-methods studies as well as implementation and dissemination research, integrative reviews, and meta-analyses.
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