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HIV: Researchers Say Hurtful Discrimination Leads to Risky Behaviors in US South

HIV is spread by risky sexual behaviors. But since most people know that, why do they do it? An ongoing study of black men who have sex with men in the Southern US blames racial slights for changing these men's self-esteem and fostering this self-destructive behavior.

Mississippi researchers who studied black men who have sex with men (MSM) found that experiencing racial discrimination--even in the form of slights and rudeness--put these subjects at higher risk of getting HIV.

Specifically, they report, those MSM who said they had experienced the most types of discrimination were more likely that those who said they had not experienced much or any discrimination to engage in risky sex acts, substance use before and during sex, and to have many sexual partners including participating in "orgies.".

All those behaviors put them at higher likelihood of HIV exposure. The South is the epicenter of the AIDS/HIV epidemic in the US and most of those who have the virus are black men.

According to US Centers for Disease Control and Prevention (CDC) estimates, one in two black MSM will be diagnosed with HIV in their lifetimes, compared to 1 in 11 white MSM.

The researchers propose that “appropriate interventions addressing discrimination on multiple levels may be essential in reducing the burden of HIV among Black MSM.”

They defined discrimination as not things that have legal remedies, like being turned down for jobs or barred from living in certain neighborhoods. Their definition includes slights and slurs like being treated with less courtesy, getting poor service in restaurants, being treated as though they weren't smart, or seeing others act as though they assumed they were dangerous or dishonest..

In a poster presentation recently at the United States Conference of AIDS, held in Hollywood, FL, DeMarc Hickson, PhD, MPH and colleagues at My Brother’s Keeper ( a community based AIDS outreach organization) and Jackson State University note that in the deep South, black MSM are at the center of the US AIDS/HIV epidemic.

Discrimination or unfair treatment plays many roles in this setting, they said.

There are internalized attitudes and beliefs, religious communities that do not accept gays, and similar negativity and segregation in neighborhood environments.

That can add up to “a stress-isolation pathway” that contributes to these men behaving in ways that leads to getting HIV.

The study enrolled 465 black MSM who lived in Jackson, MS, or Atlanta, GA’s metropolitan area.

All self-identified as African American and reported having had sex with a man in the past six months.

The authors were reporting on preliminary results of the federally funded MARI study, the design of which is detailed in an article in PLOS One. They expect to publish the full results in coming months.

Further Coverage:Southern Living: Why the South Is the Epicenter of AIDS in the US

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