Symposia
Addictive Behaviors
Kaitlyn R. Gorman, M.A.
University of Massachusetts Boston
Watertown, Massachusetts
Kaitlyn R. Gorman, M.A.
University of Massachusetts Boston
Watertown, Massachusetts
Jacklyn D. Foley, Ph.D.
Postdoctoral Fellow
Massachusetts General Hospital
Boston, MA
Abigail W. Batchelder, M.P.H., Ph.D.
Assistant Professor
MGH/Harvard Medical School
Boston, Massachusetts
Men who have sex with men (MSM) are disproportionately affected by experiences of stigma and discrimination, which are compounded when MSM hold additional marginalized identities, (i.e., being a person who injects drugs; PWID). Previous literature demonstrates an association between discrimination and unprotected sex in MSM living with HIV. However, few studies have explored this association in MSM who also report injection drug use (IDU). In a sample of 202 MSM living with HIV who endorsed recent substance use, we compared reported experiences of stigma and discrimination attributed to substance use and using substances before unprotected sex among those who reported IDU versus those who did not. The sample was 22% Black, 69% White, 29% Hispanic, and over 50% reported ≤$20,000 annual income. Nineteen percent (n=39) reported IDU in the past three months. Using independent sample t-tests, PWID (versus denied) reported significantly higher levels of stigma (0=less stigma-4=more stigma), including both enacted stigma M=2.70 (SD=1.26) versus M=1.98 (SD=.92), respectively; t(197) =-4.06, p< .001, and internalized stigma M=3.43 (SD=1.14) versus M=2.41 (SD=1.18), respectively; t(197)=-4.86, p< .001). Similarly, PWID (versus denied) reported significantly more forms of discrimination attributable to substance use (range 0-13) M=5.26 (SD=4.67) versus M=1.82 (SD=3.32) respectively; t(198)=-5.321, p< .001. Finally, PWID (versus denied) were also more likely to endorse using substances before unprotected sex M=11.12 (SD=11.74) versus M=4.18 (SD=6.84) respectively; t(181)=-4.58, p< .001. In a correlation matrix, enacted stigma, internalized stigma, and forms of discrimination attributed to substance use were all significantly correlated with using substances before unprotected sex (r’s=.151-359, p’s< .05). However, when internalized stigma, discrimination, and IDU were entered into a linear regression model predicting substance use before unprotected sex, only injection drug use remained significant (β=.250, p=.002). The association between IDU and sexual risk-taking behavior should be explored further, as these behaviors put individuals at greater risk of violence, STI’s, and other deleterious outcomes. Our exploratory findings suggest that MSM living with HIV who inject drugs may benefit from intervention strategies that not only provide harm-reduction services to mitigate the deleterious consequences of substance use, stigma, and discrimination, but also to reduce sexual transmission risk.