Daniel Teixeira da Silva, Pablo K Valente, Willey Lin, Lisa Hightow-Weidman, Kenneth Mayer, Katie Biello, José Bauermeister
{"title":"不同种族身份的性少数群体年轻男性的社会心理和结构性压力与就医情况。","authors":"Daniel Teixeira da Silva, Pablo K Valente, Willey Lin, Lisa Hightow-Weidman, Kenneth Mayer, Katie Biello, José Bauermeister","doi":"10.1080/08964289.2023.2277931","DOIUrl":null,"url":null,"abstract":"<p><p>Psychosocial and structural stressors and low engagement in medical care likely contribute to the disproportionate burden of chronic disease among sexual minority men (SMM) across the life course. However, how these stressors impact engagement in medical care among young SMM (YSMM) across racial identities remains understudied. The association of psychosocial and structural stressors with forgoing care among YSMM across racial identities was examined using race-stratified adjusted logistic regression of cross-sectional data. Among 737 HIV-negative SMM aged 16-24 years, nearly all (93%) experienced discrimination in their daily lives. Non-Hispanic/Latinx Black participants reported significantly higher levels of discrimination, exposure to community violence, and food insecurity. Medical mistrust and mental health were not significantly different across racial groups. In the full sample model, education, food insecurity, and discrimination were associated with forgoing care. Among the non-Hispanic/Latinx White sample, medical mistrust and discrimination were associated with forgoing care. Among the non-Hispanic/Latinx Black sample, discrimination was associated with forgoing care. Among the Hispanic/Latinx sample, food insecurity was associated with forgoing care. Psychosocial and structural stressors were common in this YSMM cohort, and significantly different across racial/ethnic identities. Race-stratified analysis revealed differences in the association of stressors with forgoing care among YSMM across racial identities, not appreciated in the analysis limited to the total study population. Our findings may support efforts to address health inequity and improve engagement in medical care among SMM.</p>","PeriodicalId":55395,"journal":{"name":"Behavioral Medicine","volume":" ","pages":"321-329"},"PeriodicalIF":2.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Psychosocial and structural stressors and engagement in medical care among young sexual minority men across racial identities.\",\"authors\":\"Daniel Teixeira da Silva, Pablo K Valente, Willey Lin, Lisa Hightow-Weidman, Kenneth Mayer, Katie Biello, José Bauermeister\",\"doi\":\"10.1080/08964289.2023.2277931\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Psychosocial and structural stressors and low engagement in medical care likely contribute to the disproportionate burden of chronic disease among sexual minority men (SMM) across the life course. However, how these stressors impact engagement in medical care among young SMM (YSMM) across racial identities remains understudied. The association of psychosocial and structural stressors with forgoing care among YSMM across racial identities was examined using race-stratified adjusted logistic regression of cross-sectional data. Among 737 HIV-negative SMM aged 16-24 years, nearly all (93%) experienced discrimination in their daily lives. Non-Hispanic/Latinx Black participants reported significantly higher levels of discrimination, exposure to community violence, and food insecurity. Medical mistrust and mental health were not significantly different across racial groups. In the full sample model, education, food insecurity, and discrimination were associated with forgoing care. Among the non-Hispanic/Latinx White sample, medical mistrust and discrimination were associated with forgoing care. Among the non-Hispanic/Latinx Black sample, discrimination was associated with forgoing care. Among the Hispanic/Latinx sample, food insecurity was associated with forgoing care. Psychosocial and structural stressors were common in this YSMM cohort, and significantly different across racial/ethnic identities. Race-stratified analysis revealed differences in the association of stressors with forgoing care among YSMM across racial identities, not appreciated in the analysis limited to the total study population. Our findings may support efforts to address health inequity and improve engagement in medical care among SMM.</p>\",\"PeriodicalId\":55395,\"journal\":{\"name\":\"Behavioral Medicine\",\"volume\":\" \",\"pages\":\"321-329\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Behavioral Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/08964289.2023.2277931\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/12/21 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"BEHAVIORAL SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Behavioral Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08964289.2023.2277931","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/21 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"BEHAVIORAL SCIENCES","Score":null,"Total":0}
Psychosocial and structural stressors and engagement in medical care among young sexual minority men across racial identities.
Psychosocial and structural stressors and low engagement in medical care likely contribute to the disproportionate burden of chronic disease among sexual minority men (SMM) across the life course. However, how these stressors impact engagement in medical care among young SMM (YSMM) across racial identities remains understudied. The association of psychosocial and structural stressors with forgoing care among YSMM across racial identities was examined using race-stratified adjusted logistic regression of cross-sectional data. Among 737 HIV-negative SMM aged 16-24 years, nearly all (93%) experienced discrimination in their daily lives. Non-Hispanic/Latinx Black participants reported significantly higher levels of discrimination, exposure to community violence, and food insecurity. Medical mistrust and mental health were not significantly different across racial groups. In the full sample model, education, food insecurity, and discrimination were associated with forgoing care. Among the non-Hispanic/Latinx White sample, medical mistrust and discrimination were associated with forgoing care. Among the non-Hispanic/Latinx Black sample, discrimination was associated with forgoing care. Among the Hispanic/Latinx sample, food insecurity was associated with forgoing care. Psychosocial and structural stressors were common in this YSMM cohort, and significantly different across racial/ethnic identities. Race-stratified analysis revealed differences in the association of stressors with forgoing care among YSMM across racial identities, not appreciated in the analysis limited to the total study population. Our findings may support efforts to address health inequity and improve engagement in medical care among SMM.
期刊介绍:
Behavioral Medicine is a multidisciplinary peer-reviewed journal, which fosters and promotes the exchange of knowledge and the advancement of theory in the field of behavioral medicine, including but not limited to understandings of disease prevention, health promotion, health disparities, identification of health risk factors, and interventions designed to reduce health risks, ameliorate health disparities, enhancing all aspects of health. The journal seeks to advance knowledge and theory in these domains in all segments of the population and across the lifespan, in local, national, and global contexts, and with an emphasis on the synergies that exist between biological, psychological, psychosocial, and structural factors as they related to these areas of study and across health states.
Behavioral Medicine publishes original empirical studies (experimental and observational research studies, quantitative and qualitative studies, evaluation studies) as well as clinical/case studies. The journal also publishes review articles, which provide systematic evaluations of the literature and propose alternative and innovative theoretical paradigms, as well as brief reports and responses to articles previously published in Behavioral Medicine.