Structural Inequities, Syndemics, and Resilience: The Critical Role of Social Support in Overcoming Barriers and Empowering Engagement in HIV Care for Young Black Sexual-Minority Men in the US South.

Autor: Storholm ED; School of Public Health, San Diego State University, San Diego, CA, USA. estorholm@sdsu.edu.; RAND Corporation, Santa Monica, CA, USA. estorholm@sdsu.edu., Siconolfi DE; RAND Corporation, Pittsburgh, PA, USA., Campbell CK; Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, La Jolla, CA, USA., Pollack LM; Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, San Francisco, CA, USA., Kegeles SM; Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, San Francisco, CA, USA., Rebchook GM; Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, San Francisco, CA, USA., Tebbetts S; Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, San Francisco, CA, USA., Vincent W; Department of Psychology, Temple University, Philadelphia, CA, USA.
Jazyk: angličtina
Zdroj: Journal of racial and ethnic health disparities [J Racial Ethn Health Disparities] 2023 Dec 14. Date of Electronic Publication: 2023 Dec 14.
DOI: 10.1007/s40615-023-01869-y
Abstrakt: Young Black sexual minority men (YBSMM) living in the US South are among those most disproportionately impacted by HIV in the USA. This health inequity is, in part, due to lower rates of sustained engagement in the HIV care continuum, resulting in a lower prevalence of viral suppression and higher overall community-level viral load. Social, structural, and economic inequities have previously been linked with poorer HIV care engagement among YBSMM. HIV-related social support, individual-level resilience, and healthcare empowerment have been shown to be independently associated with improved HIV care engagement. The current study sought to assess the relative contribution of individual, structural, and economic factors on engagement in HIV care and to elucidate the potentially mediating role of healthcare empowerment. Data from 224 YBSMM with HIV in the US South indicated that greater levels of socioeconomic distress, intimate partner violence, and depressive symptoms were associated with lower levels of engagement in HIV care, while greater levels of individual-level resilience and healthcare empowerment were associated with higher levels of HIV care engagement. Importantly, healthcare empowerment mediated the association between resilience and engagement in HIV care and the association between social support and engagement in HIV care. Findings emphasize the critical role that HIV-related social support plays in fostering resilience and overcoming syndemic factors to promote empowerment and engagement in HIV care for YBSMM in the USA.
(© 2023. W. Montague Cobb-NMA Health Institute.)
Databáze: MEDLINE
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