Modeling the Impact of Race, Socioeconomic Status, Discrimination and Cognitive Appraisal on Mental Health Concerns Among Heavy Drinking HIV+ Cisgender MSM.

Prior research has attributed mental health disparities between marginalized and non-marginalized populations to socioeconomic differences (i.e., education, income, employment), stigma (e.g., HIV-related discrimination), and cognitive appraisal (i.e., optimism, hostility, satisfaction with life), bu...

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Publicado en:AIDS & Behavior Vol. 26; no. 12; pp. 3925 - 3939
Autores principales: Zelaya, David G., Guy, Arryn A., Surace, Anthony, Mastroleo, Nadine R., Pantalone, David W., Monti, Peter M., Mayer, Kenneth H., Kahler, Christopher W.
Formato: research tables/charts Journal Article
Publicado: Springer Nature Dec2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2022
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        10.1007/s10461-022-03719-0
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        atl: Modeling the Impact of Race, Socioeconomic Status, Discrimination and Cognitive Appraisal on Mental Health Concerns Among Heavy Drinking HIV+ Cisgender MSM.
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          Zelaya, David G.
          Guy, Arryn A.
          Surace, Anthony
          Mastroleo, Nadine R.
          Pantalone, David W.
          Monti, Peter M.
          Mayer, Kenneth H.
          Kahler, Christopher W.
        affil: Alcohol Research Center on HIV, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, 02912, Providence, RI, USA
      sug:
        subj:
          Race Factors
          Social Determinants of Health
          Mental Health Psychosocial Factors
          Stigma
          Cognition
          Discrimination
          Alcoholism
          Persons with Substance Use Disorders Psychosocial Factors
          HIV-Positive Persons Psychosocial Factors
          Cisgender Persons Psychosocial Factors
          Men Who Have Sex With Men Psychosocial Factors
          Human
          Male
          Substance Use Disorders
          Structural Equation Modeling
          Motivational Interviewing
          Self Report
          Racism
          Health Status
          Sexism
          Socioeconomic Factors
          Patient Attitudes
          Male
      ab:
        Prior research has attributed mental health disparities between marginalized and non-marginalized populations to socioeconomic differences (i.e., education, income, employment), stigma (e.g., HIV-related discrimination), and cognitive appraisal (i.e., optimism, hostility, satisfaction with life), but the relations among these variables have not been examined concomitantly. The current study utilized structural equation modeling to examine how race and socioeconomic status impact mental health outcomes through increased exposure to stigma and more negative cognitive appraisals. Data came from a randomized controlled trial of motivational interviewing to address heavy drinking in cisgender men with HIV who have sex with men (n = 180). We found that self-reported discrimination experiences related to race/ethnicity, sexual orientation, and HIV status significantly mediated the relation between socioeconomic status and mental health concerns, whereas cognitive appraisal did not. These findings suggest that, among heavy drinking men with HIV who have sex with men, having low socioeconomic resources may increase exposure to discrimination which, in turn, may worsen mental health. Interventions that address social determinants, like socioeconomic disadvantage, and that enhance coping resources related to stigma, may have positive effects on mental health. ClinicalTrials.gov Identifier NCT01328743. Date of Registration 09/09/2019.
        Resumen: Investigaciones anteriores han atribuido las disparidades de salud mental entre poblaciones marginadas y no marginadas a diferencias socioeconómicas (es decir, educación, ingresos, empleo), estigma (por ejemplo, discriminación relacionada con el VIH) y evaluación cognitiva (es decir, optimismo, hostilidad, satisfacción con la vida), pero las relaciones entre estas variables no han sido examinadas concomitantemente. El estudio actual utilizó modelos de ecuaciones estructurales para examinar cómo la raza y el estatus socioeconómico afectan los resultados de salud mental a través de una mayor exposición al estigma y evaluaciones cognitivas más negativas. Los datos provienen de un ensayo controlado aleatorio de entrevistas motivacionales para abordar el consumo excesivo de alcohol en hombres cisgénero con VIH que tienen sexo con hombres (n = 180). Encontramos que las experiencias de discriminación autoinformadas relacionadas con la raza/etnicidad, la orientación sexual y el estado serológico respecto al VIH mediaron significativamente en la relación entre el estado socioeconómico y los problemas de salud mental, mientras que la evaluación cognitiva no lo hizo. Estos hallazgos sugieren que, entre los hombres con VIH que beben mucho y tienen sexo con hombres, tener bajos recursos socioeconómicos puede aumentar la exposición a la discriminación que, a su vez, puede empeorar la salud mental. Las intervenciones que abordan los determinantes sociales, como la desventaja socioeconómica, y que mejoran los recursos de afrontamiento relacionados con el estigma, pueden tener efectos positivos en la salud mental.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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