Mortgage discrimination at the intersection of race and sexual orientation and its association with HIV incidence among sexual minority men in the U.S.

IF 3.3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Epidemiology Pub Date : 2025-07-04 DOI:10.1016/j.annepidem.2025.06.020

Kyle J. Moon , Brian W. Weir , Koichi Sakakibara , Leslie M. Carson , Marcus O. Reed , Srija Dutta , Daniel I. Alohan , McKinsey Bullock , Antonio Newman , Samuel C.O. Opara , Kamini Doraivelu , Sophia A. Hussen , Sabriya L. Linton

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Abstract

Purpose

Structural racism and homonegativity influence access to housing and shape the HIV risk environment. We assess disparities in mortgage loan denial and evaluate the association of intersectional mortgage discrimination with HIV incidence among sexual minority men (SMM) across U.S. counties.

Methods

Using loan applications from 2018–2022, we conducted a decomposition analysis to measure national disparities in mortgage denial by race and sexual orientation. We then constructed a county-level measure of mortgage discrimination against Black same-sex male couples using mixed-effects logistic regression, and we evaluated its association with HIV incidence among SMM in 2022 using Poisson regression adjusted for county-level covariates.

Results

Mortgage loan denial was 14.9 percentage points higher among Black same-sex couples (22.0 %) than White heterosexual couples (7.1 %). HIV incidence rate among SMM was 26 % [95 % CI: 22, 30] higher in counties in the highest versus lowest tertile of intersectional mortgage discrimination.

Conclusions

Contemporary forces of structural racism and homonegativity continue to influence housing access, evidenced by higher loan denial for Black same-sex male couples versus White heterosexual couples. Such discrimination may contribute to the population-level burden of HIV. Anti-discrimination policies that increase access to housing for Black sexual minority men may aid in addressing HIV inequities.

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美国性少数群体男性中种族和性取向交叉点的抵押贷款歧视及其与艾滋病发病率的关系

目的：结构性种族主义和同性恋负面影响获得住房和塑造艾滋病毒风险环境。我们评估了抵押贷款拒绝的差异，并评估了美国各县性少数男性（SMM）中交叉抵押贷款歧视与艾滋病毒发病率的关系。方法：利用2018-2022年的贷款申请，我们进行了分解分析，以衡量种族和性取向在拒绝抵押贷款方面的国家差异。然后，我们使用混合效应逻辑回归构建了针对黑人同性男性伴侣的抵押贷款歧视的县级测量，并使用调整了县级协变量的泊松回归评估了其与2022年SMM中HIV发病率的关系。结果：黑人同性伴侣拒绝抵押贷款的比例（22.0%）比白人异性恋伴侣（7.1%）高14.9个百分点。在交叉抵押歧视比例最高的县和最低的县，SMM的艾滋病毒感染率要高出26% [95% CI: 22,30]。结论：当代结构性种族主义和同性恋负面力量继续影响住房获取，黑人同性男性伴侣比白人异性恋伴侣更容易被拒绝贷款就是证据。这种歧视可能导致艾滋病毒的人口负担。增加黑人性少数群体获得住房的机会的反歧视政策可能有助于解决艾滋病毒不平等问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.40

自引率

1.80%

发文量

207

审稿时长

59 days

期刊介绍： The journal emphasizes the application of epidemiologic methods to issues that affect the distribution and determinants of human illness in diverse contexts. Its primary focus is on chronic and acute conditions of diverse etiologies and of major importance to clinical medicine, public health, and health care delivery.