Experiences Of Discrimination Research Articles

Female firefighters' experiences of discrimination and harassment: Implications for institutional gender policy

Women in uniformed professions, including firefighters, are at high risk of being victims of institutional discrimination and sexual harassment. The aim is to describe the occupational, social, and psycho-emotional experience of female firefighters in Chile in situations of discrimination and harassment in the organization and formulate guidelines for creating institutional gender policies. Data collection was carried out through three focus groups. Eleven female firefighters participated. The information obtained was analyzed through content analysis, forming four themes. Difficulties were identified in women doing their jobs as firefighters. Simultaneously, the presence of situations of gender discrimination and institutional sexual harassment were identified, which causes emotional exhaustion in female firefighters. Our results highlight the need for effective implementation and dissemination of institutional policies that protect female workers from abusive situations. Guidelines are proposed for the development of such institutional policies.

Experiences of Discrimination and its Impact on the Intensity of Pain: A Study in the Elderly Brazilian Population

Background: The experience of pain is multifactorial and may be exacerbated by everyday stressors like discrimination leading to a poor quality of life. Perceived discrimination has been associated with the presence and increased intensity of pain. The elderly population may be more likely to experience discrimination making them vulnerable to external stress factors that can make managing pain more difficult. We aimed to explore the influence of discrimination and stress on pain intensity in an elderly Brazilian population. Methods: In this cross-sectional study design, we analyzed the data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) in which participants answered the revised everyday discrimination questionnaire stating their pain intensity and perceived stress level. The effect of discrimination and stress on pain intensity was assessed using a multivariable-adjusted ordinal logistic regression. Sensitivity analysis with multiple imputations for missing data was also conducted to assess the robustness of the findings. Results: In the elderly Brazilian population, discrimination and perceived stress had a significant association with pain intensity. The odds of experiencing strong intense pain were 7% higher in an adult experiencing everyday discrimination (OR= 1.07, 95% CI: 1.03-1.11, p<0.001). Stress was also significantly associated with pain intensity (OR 1.05, 95% CI 1.05 - 1.06). This finding emphasizes the need to address the influence of such societal factors on the psychological and physical aspects of pain. Conclusion: Our study found that there is a significant association between experiences of discrimination and stress with pain intensity in a large population from Brazil in accordance with previous studies despite differences in population demographics and cultural contexts. These findings provide evidence of the generalizability of these associations and underscores the detrimental health consequences associated with perceived discrimination.

Multiple and intersectional discrimination and mental health of migrant populations in Portugal after the COVID-19 pandemic

PurposeA growing body of evidence suggests that experiences of discrimination may affect physical and mental health through multiple pathways. This paper aims to characterize the extent of everyday perceived discrimination among Brazilian and Cape Verdean immigrant adults in Portugal, to identify its forms and analyze its association with mental health.Design/methodology/approachThis study draws on data from the EQUALS4COVID19 (Equity in health in times of pandemic) project that implemented a cross-sectional survey combining online and face-to-face questionnaires for data collection between February and November 2022.FindingsWomen were less likely than men to report no discrimination experiences and more likely to report combined bases of discrimination. While Brazilian women were more likely than Cape Verdean counterparts to report gender and nationality-based discrimination, Cape Verdean women and men were more likely to report experiencing race-based discrimination. Gender (being identified as a woman) and length of stay in Portugal were the main predictors of depression, while resilience and perceived social support were protective factors. Participants with higher levels of resilience showed a significantly diminished association between perceived discrimination and depressive symptoms.Practical implicationsThis study highlights the need for further research on the interlocking influences of gender, race, nationality and other structures of power, on health and illness to increase our understanding of what would help meet the specific needs of migrants’ mental health and improve equitable health care.Originality/valueThe findings on the multiple and intersectional discrimination perceived by the Brazilian and Cape Verdean populations in Portugal illustrated the ways mental health can be affected by social structures, such as gender and ethnic hierarchies, and can be used to inform the relevance to design and implement programs on combating individual and institutional discrimination and improving the rights of all people.

Race, Gender, Class, and Perceived Everyday Discrimination

Everyday discrimination has been studied for the last three decades, but there is a lack of quantitative research on the effects of race, gender, and class, and especially their intersectional effects, on perceived everyday discrimination for the U.S. population as a whole, despite a few studies at the local or group levels. Using new data from the 2018 General Social Survey and multiple regression, this study investigates how race, gender, and class independently and intersectionally shape everyday discrimination experiences in the United States. The results indicate that, holding other variables constant, Blacks self-claimed a significantly higher level of everyday discrimination than Whites, but other races did not differ significantly from Whites in such an experience; class was inversely associated with the level of everyday discrimination, and gender did not have an independent effect. However, while Black men self-reported a higher level of everyday discrimination than White men, Black women self-reported a lower level of everyday discrimination than White women; higher-class Blacks tended to report a significantly higher level of everyday discrimination experiences than lower-class Blacks. The findings have significant implications for research and practice in the area of everyday discrimination.

Perceived discrimination, mental health help-seeking attitudes, and suicide ideation, planning, and attempts among black young adults

BackgroundDeveloping an understanding of the negative impact of discrimination is critical when examining the suicidality of Black young adults in the US. Suicide rates among Black young adults have increased at alarming rates. One of the reasons for this increase is the disparities related to access to mental health services, which has long-term health consequences. This study addresses a significant gap in the literature by examining associations between experiences of everyday discrimination, attitudes towards mental health help-seeking attitudes, on the outcomes suicide ideation, planning to die by suicide, and suicide attempts.MethodsThe data came from a national study of the experiences of Black young adults regarding mental, physical, and sexual health. Participants were recruited from across the Midwestern region of the United States through Qualtrics Panels, an online survey delivery service used to recruit study participants. The total sample for this study was N = 362, and the average age of the sample was 21 (SD: 1.96). We used a logistic regression analysis to examine the role of everyday discrimination, mental health support-seeking attitudes, and covariates on the outcomes: suicide ideation, planning to die by committing suicide, and suicide attempts.ResultsBlack young adults with positive mental health help-seeking attitudes were 34% less likely to attempt suicide (OR = 0.66; 95% CI: 0.46, 0.96) and 35% less likely to experience suicide ideation (OR = 0.65; 95% CI: 0.47, 0.89). However, those young adults who experienced discrimination daily were more likely to report having attempted suicide (OR = 1.70; 95% CI: 1.34, 2.15).ConclusionsOur findings offer valuable insights into the complex interplay between experiences of discrimination, attitudes toward seeking mental health support, and suicidal behaviors. However, our research also underscores how experiences of discrimination can significantly exacerbate feelings of isolation, hopelessness, and inadequacy, further contributing to suicidal behaviors in this population. By promoting positive mental health help-seeking behaviors, actively addressing discrimination, and applying an intersectional approach to suicide prevention efforts, we can take significant strides towards building a more supportive and inclusive society. This approach aims to empower individuals to seek help, reduce the risk of suicidal behaviors, and create a more welcoming environment for all members of our community.

“Especially Being Homeless, They Just Think You’re Infected with COVID or Something”: A Qualitative Exploration of the COVID-19 Pandemic’s Impact on People Experiencing Homelessness With a History of Injection Drug Use in Baltimore, Maryland

People experiencing homelessness with a substance use disorder are a highly structurally vulnerable population, facing a unique burden of compounding stigma, discrimination, and adverse health outcomes. Evidence remains mixed on best practices for housing interventions designed to meet the needs of this population. Ten people with a history of injection drug use experiencing homelessness during the COVID-19 pandemic were interviewed between July 2021 and February 2022 in Baltimore, Maryland. Thematic analysis was used to characterize the pandemic’s impact on their resource access, housing, and substance use. Participants highlighted substantial challenges resulting from structural changes during the pandemic, including limits on income-generating opportunities and resource access, and increases in experiences of stigma and discrimination. However, several individuals reported decreased substance use in response to changes to their housing status, with those placed in secure housing attributing their decreased use to this change. These accounts can help guide housing and social support interventions best suited to meet the unique needs of people experiencing homelessness with substance use disorders.

Parental incarceration and health risks in a population-based study of U.S. early adolescents: Results among racialized groups

Parental incarceration is an adverse childhood experience that inequitably burdens families of color and affects millions of U.S. children and adolescents. Although racialized disparities in exposure to parental incarceration are often acknowledged, researchers have yet to examine whether manifestations of racism may affect the link between parental incarceration and youth outcomes. This study provides a first look at how parental incarceration relates to health vulnerabilities in the Adolescent Brain Cognitive Development (ABCD) study, an ongoing, population-based study of U.S. children born between 2006 and 2008. We start by describing exposure to parental incarceration and then examine how parental incarceration, state-level racial prejudice, and discrimination relate to health risks among 9191 White (66%), Black (19%), or Hispanic (15%) youth. Consistent with what we know about pervasive racialized disparities in the U.S. criminal legal system, we find that 19.3% of Black children in our sample have experienced parental incarceration, followed by 7.8% of Hispanic children, and 4.8% of White children. Results of multilevel mixed models further indicate that parental incarceration was associated with increased health risks among White children whereas family economic hardship and discrimination experiences were more robustly associated with health vulnerabilities among Black and Hispanic children. Additional analyses explored whether parental incarceration was associated with other outcomes among Black and Hispanic children, revealing increased risk for behavior problems contingent upon parental incarceration and discrimination for Black children and Hispanic boys. Among Hispanic girls, parental incarceration was associated with increased risk of behavior problems in states with higher levels of racism. Results suggest that parental incarceration contributes to risk among early adolescents across racialized groups, but that the specific toll it takes depends on outcomes assessed and the context in which it occurs.

Translation and validation of the Portuguese version of the discrimination in medical settings scale: a cross-sectional study with Portuguese Roma

PurposePerceived discrimination in medical setting is associated to adverse healthcare outcomes. Yet, few tools exist for assessing such discrimination among patients in Portugal. This study aimed to validate the Discrimination in Medical Settings (DMS) scale for the Portuguese Roma population, explore their experiences of healthcare discrimination and analyze the association between perceived discrimination, health perception and healthcare trust.Design/methodology/approachIn this cross-sectional study, 84 Roma adults (60,7% women) completed the DMS, along with microaggression assessments, health perception and healthcare trust evaluations.FindingsThe seven-item DMS scale yielded a one-factor structure that explained 71.80% of variance, with strong reliability (a = 0.89). The average DMS-measured perceived discrimination was 2.46. Discrimination correlated inversely with health perception and was strongly negatively associated to trust in healthcare.Originality/valueThe DMS scale exhibited reliability, single-dimensionality and validity among the Roma. High perceived discrimination in medical settings among Portuguese Roma was notably associated with individual health perception and healthcare trust.

“They kill us mentally”: exploring microaggression towards LGBTQIA+ employees in Indian workplaces

PurposeThe current study aimed to (1) explore the prevalence and processes associated with microaggression, along with (2) the consequences of such instances on the queer employees’ life.Design/methodology/approachFor this purpose, semi-structured in-depth interviews were conducted on 29 LGBTQIA + persons (21–42 years). The qualitative data were analysed through the thematic analysis method (a hybrid of theoretical and inductive thematic analysis). Nadal and colleagues’ (2010) taxonomy on sexual orientation and transgender microaggression was used as a theoretical lens for detecting the acts of microaggression.FindingsThe result revealed eight themes: i.e. (1) overt discrimination (bullying and sexual harassment); (2) workplace discrimination; (3) environmental microaggressions; (4) interpersonal microaggressions; (5) mental health effects; (6) disclosure dilemma; (7) consequences on job-related functioning; and (8) policy changes. Microaggression was more common as compared to overt forms of aggression such as bullying. The study detected a serious lag in the implementation of queer-friendly policies in Indian organizations. Experiences of overt discrimination and microaggressions hinder the work performance and the psychological well-being of queer employees.Originality/valueLGBTQIA + microaggression is not explored in the Indian workplace context.

How immigration shapes health disadvantages and what healthcare organizations can do to deliver more equitable care.

That immigration is a determinant of health and that immigration systems themselves contribute to structural disadvantage remains under-addressed within healthcare in Canada. This article offers context for how immigration shapes health, and recommendations for how health systems can be better prepared to respond to the diverse needs of immigrants and migrants (together referred to as im/migrants), based on a community-based research project in British Columbia. Findings call attention to the varied and intersecting ways in which immigration status, access to health insurance, language, experiences of trauma and discrimination, lack of support for health system limits access to healthcare, and the roles community-based organizations play in supporting access. Recommendations are intended to help make sure that all health services are accessible to everyone, and move beyond a homogenizing category of "newcomers" into practical, meaningful strategies that attend to diverse and intersecting community needs.

The Socio-Economic Characteristics and Challenges of Homeless Youths in Maiduguri and Lagos: A Comparative Study

Homelessness is a pervasive and multifaceted global issue affecting societies across various economic landscapes. This study provides a critical and extensive examination of youth homelessness in Maiduguri and Lagos, Nigeria. By analysing socio-economic characteristics, pathways into homelessness, living conditions, health challenges and experiences of social discrimination, the study underscores the importance of tailored interventions considering regional variations and the diverse needs of homeless youth populations. The findings highlight both commonalities and disparities, reflecting the complex interplay of socio-economic factors and regional dynamics, and provide valuable insights for developing effective policies and interventions.

School Nurse Leadership and the Implementation of School-Based Support for LGBTQ+ Students.

In 2021, the National Association of School Nurses published an updated position statement affirming the unique position of school nurses to support the health and well-being of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) students who are faced with a variety of health disparities rooted in experiences of stigma, discrimination, and bias. The 5-year cluster randomized controlled trial "Reducing LGBTQ+ Adolescent Suicide" leveraged school nurses as leaders to facilitate the uptake of six evidence-informed, LGBTQ-supportive practices in New Mexico high schools. We analyzed 5 years of interview data from 24 school nurses in 13 intervention schools to examine what factors impacted their ability to serve as an effective leader for this initiative. Several factors including job characteristics, leadership and organizational skills, relationships and reputation, and personal commitments emerged from analysis. Contextual factors, such as working in urban or rural school, and the size of the school also influenced nurses' leadership.

Experiences of divorced people in Pentecostal churches in Botswana

Background: Cases of divorce are on the increase across societies and within the Pentecostal churches. Pentecostal church doctrine disapproves of divorce, and the people experience discrimination consequently. Despite the overall impact divorce has on the spiritual well-being of the victims, Pentecostal churches do not provide sufficient support to them.Objectives: The objectives of the study were to explore the lived experiences of divorced people in Pentecostal churches and the impact divorce had on their spiritual well-being.Method: A qualitative phenomenological design was utilised. The study recruited six divorced people, three pastors and 24 men and women from three Pentecostal churches. Purposive and snowball sampling were used to select the sample. A thematic content analysis was used to analyse data.Results: The study revealed four major effects that divorced people face such as psychological and emotional effects, social effects, spiritual effects and economic effects.Conclusion: The study’s findings unearthed the impact that divorce has on the divorcee’s spiritual well-being. Although the Bible disapproves of divorce, some research indicates that divorce may have positive outcomes in some instances, and therefore, it should not always be viewed negatively.Contribution: The findings of the study would possibly assist Pentecostal church leadership in coming up with effective interventions that can support divorced members in the church.

Identifying pathways from childhood adversity to suicidal thoughts and behaviors among sexual minority adults: An exploratory mediation analysis

BackgroundThe current study uses a nationally representative longitudinal dataset of sexual minority adults in the US to investigate the pathways from adverse childhood experiences (ACEs) to adulthood suicidal thoughts and behaviors. MethodsACEs were measured at year one, potential mediators at year two, and suicidal thoughts and behaviors (suicidal ideation, intent, plan, and attempt) at year three. We conducted an exploratory mediation analysis to identify potential mediating factors linking ACEs to suicidal thoughts and behaviors. Ten candidate mediators were examined: social well-being, felt stigma, experiences of everyday discrimination, social support, psychological distress, alcohol and drug use, importance of sexual identity, community connection, and internalized homophobia. ResultsParticipants were 1518 adults who identified as lesbian or gay (n = 833; 55 %), bisexual (n = 493; 33 %), or with other sexual minority identities (n = 181; 12 %) and were on average 36.48 years (SD = 14.7) of age. Psychological distress served as a common mediator between ACEs and suicidal ideation, intent, plan, and attempt. Additionally, experiences of everyday discrimination emerged as a specific mediator leading to suicidal intent, whereas social support uniquely mediated the relation between ACEs and suicide plan. LimitationsPotential recall bias due to retrospective reporting of ACEs may be a limitation. Future studies should broaden the measurement scope of ACEs and implement intersectional methods. ConclusionThe current findings underscore the urgent need for targeted interventions that address the specific mental health needs of sexual minority individuals, particularly focusing on mitigating psychological distress, combating systemic discrimination, and enhancing social support.

On the margins of refuge: Queer Syrian refugees and the politics of belonging and mobility in post-2019 Lebanon

This paper explores the dual marginalization of LGBTIQ+ Syrian refugees in Lebanon, highlighting the interplay between national policies on deportation and the crackdown on the LGBTIQ+ community post-2019. Lebanon, home to 1.5 million Syrian refugees—the highest per capita globally—is a case study in how social, political, economic, and legal frameworks do not merely overlook refugee challenges but actively intensify their isolation. Particularly for LGBTIQ+ Syrian refugees, everyday experiences of violence, discrimination, stigmatization, and isolation are exacerbated by these frameworks. In 2022, this situation worsened when Lebanon's Minister of Interior, yielding to pressure from religious groups, directed security forces to disrupt gatherings within the LGBTIQ+ community. Employing qualitative research methods, this study delves into the compounded effects of these policies on the intersectional vulnerabilities of queer Syrian refugees. It examines their perceptions of vulnerability and security, underlining the profound impacts of overlapping decisions on deportation and the suppression of LGBTIQ+ rights.

Tuned In! An affirmative mindfulness intervention for sexual and gender diverse young people

Sexual and gender diverse youth and young adults (SGDY) experience significant mental health disparities compared to non-SGDY, which is exacerbated by ongoing anti-LGBTQIA + political attacks across the U.S. SGDY lack access to culturally responsive mental health supports and are overlooked in clinical practice/research. Mindfulness is a transformative practice that fosters well-being and provides tools to address the psychological impact of discriminatory experiences. This study investigated feasibility, acceptability, and outcomes of a mindfulness-based intervention (MBI), Tuned In!, co-developed with SGDY to improve mental health and navigate and challenge the current anti-LGBTQIA + sociopolitical context. Participants (n = 56), 16 to 29 yrs., were recruited and participated online. Surveys were administered pre, post-intervention, and at 6-month follow-up. Hierarchical Linear Modeling and Reflexive Thematic Analysis were used to analyze data. Rates of engagement and retention were high. High levels of satisfaction and acceptability, a significant decrease in depression, anxiety, and psychological distress, and a significant increase in sexual self-efficacy, mindfulness, and self-compassion were found, with gains maintained at 6-month follow-up. Qualitative analysis uncovered the following themes: Development of Crucial Coping Skills and Strategies, A Sense of Community Among SGDY, Learning from Peers Through Dialogue. Study results suggest that Tuned In! is a promising intervention to improve SGDY mental health.

Friendship Network and School Socialization Correlates of Adolescent Ethnic-Racial Identity Development.

Ethnic-racial identity (ERI) development is consequential for youth adjustment and includes exploration, resolution, and affect about the meaning of one's ethnic-racial group membership. Little is known about how identity-relevant experiences, such as ethnic-racial socialization and discrimination in peer relationships and school contexts, catalyze adolescent ERI development. The present study examines how identity-relevant experiences in friend and school contexts (i.e., proportion of same-ethnoracial friends, cultural socialization among friends, friends' ERI dimensions, friends' experiences of ethnoracial discrimination, and school promotion of cultural competence and critical consciousness) are associated with ERI development. A multivariate path model with a sample from four southwestern U.S. schools (N = 717; 50.5% girls; Mage = 13.76; 32% Latinx, 31.5% Multiethnic, 25.7% White, 11% other) was used to test these associations. Findings showed that friend and school predictors of ERI did not differ between early and middle adolescents, but significant differences and similarities emerged in some of these associations between ethnoracially minoritized and White youth. Specifically, friend cultural socialization was positively associated with ERI exploration for ethnoracially minoritized youth only, whereas school critical consciousness socialization was positively linked with ERI exploration only for White youth. Friend cultural socialization and friend network's levels of ERI resolution were positively associated with ERI resolution across both ethnoracial groups. These friend and school socialization associations were documented above and beyond significant contributions of personal ethnoracial discrimination to ERI exploration and negative affect for both ethnoracially minoritized and White youth. These findings expand our understanding of how friend and school socialization mechanisms are associated with adolescent ERI development, which is vital to advancing developmental theory and fostering developmental competences for youth to navigate their multicultural yet socially stratified and inequitable world.

Development and validation of the Ethnic-Racial Discrimination Stress Inventory (ERDSI) for Mexican-origin U.S. adults and Turkish-origin German adults.

We developed the 26-item Ethnic-Racial Discrimination Stress Inventory (ERDSI) to assess ethnic-racial discrimination stress in Mexican-origin adults in the United States and Turkish-origin adults in Germany, two groups with similar sociocultural characteristics and immigration experiences. We developed 73 items measuring firsthand, intragroup, and vicarious discrimination, and internalization and expectations of discrimination experiences. If participants reported experiencing a given situation, they were asked to rate its stressfulness. U.S.-based Mexican-origin adults (N = 222) and German-based Turkish-origin adults (N = 105) completed an online survey of these items, measures of related constructs, and sociodemographic measures. Study 1: We eliminated items based on interitem correlations and exploratory factor analyses in the U.S.-based Mexican sample. The exploratory factor analyses yielded four reliable and valid factors (F1: Vicarious Discrimination Stress, seven items; F2: Internalization of Discrimination Stress, seven items; F3: Intragroup Discrimination Stress, seven items; and F4: Firsthand Discrimination Stress, five items). The ERDSI factors predicted well-being measures, even after adjusting for control variables. Study 2: The three ERDSI factors (F1, F2, F4, not F3) that applied to the German-based Turkish sample demonstrated reliability and validity. Confirmatory factor analyses demonstrated metric invariance for F2 and partial scalar invariance for F1, F3, and F4. The ERDSI can be used to assess ethnic-racial discrimination stress in future studies with U.S.-based Mexican-origin adults and German-based Turkish-origin adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Burnout, Exhaustion, Experiences of Discrimination, and Stress Among Underrepresented and First-Generation College Students in Graduate Health Profession Education.

Mental health disorders are increasing among health profession students. Compounding this, students from underrepresented backgrounds may face additional stressors and challenges. The aims of this study were to: (1) assess the extent to which burnout, exhaustion, experiences of discrimination, and stress exist among students in dentistry, nursing, occupational therapy, pharmacy, and physical therapist professional education programs; (2) determine if there are significant differences by key demographic characteristics (those who are first-generation college students [FGCSs], a member of an underrepresented minority [URM] group, or both); and (3) highlight strategies and solutions to alleviate these challenges identified by students. Cross-sectional survey using a mix of question types of a sample of graduate students from dentistry, nursing, occupational therapy, pharmacy, and physical therapy programs from February to June 2020. Utilizing the Maslach Burnout Inventory Student Survey and campus climate and stress survey, mean subscale scores were calculated for the following outcomes of interest: MBI-SS burnout, dimensions of stress, and observed racism. Logistic regressions examined student factors that may help explain these outcomes. Content analysis examined participants' responses to open-ended questions. There were 611 individuals who completed all survey questions. FGCSs were significantly more likely than non-FGCSs to report exhaustion (adjusted odds ratio [aOR]: 1.50; 95% CI = 1.04-2.16), family stress (aOR: 3.11; 95% CI = 2.13-4.55), and financial stress (aOR: 1.74; 95% CI = 1.21-2.50). URM students reported not feeling supported in their program and mentioned needing additional support, particularly for well-being, from staff and faculty. Findings from this study are consistent with literature that FGCSs experience additional stressors that may lead to burnout and exhaustion. URM students reported not feeling supported in their programs. This study's findings point to the need for leadership and faculty of health professional schools to implement or strengthen current policies, practices, and strategies that support URM students and FGCSs. Research demonstrates that a diverse student body and faculty enhances the educational experience for health professional students, and that diversity strengthens the learning environment and improves learning outcomes, preparing students to care for an increasingly diverse population. However, this study finds that students from underrepresented backgrounds may still experience more burnout, exhaustion, discrimination, and stress than their peers. Programs and policies to support URM students and FGCSs throughout their academic careers can help improve graduation and retention rates, leading to improved workforce diversity.

Interest in and Willingness to Use PrEP: A Cross-Sectional Study of Individuals with Problematic Substance Use Residing in a High HIV Prevalence Jurisdiction

Although it is an effective HIV prevention method, pre-exposure prophylaxis (PrEP) is underutilized in the Southern US. Many people who use drugs (PWUD) have increased susceptibility to HIV which could be lessened by using PrEP. Potential barriers to PrEP use include lack of awareness of PrEP, low knowledge about HIV prevention, low self-efficacy for HIV prevention, inaccurate risk perceptions, and anticipated stigma. The current study examined predisposing, enabling, and reinforcing factors that may predict interest in PrEP. The purpose of the current study was to explore factors associated with interest in and willingness to use daily oral and long acting injectable PrEP among sexually active adult PWUD. The data were collected from adult participants (n = 270) residing in Harris County, TX, who self-reported problematic substance use and who reported oral, anal, or vaginal sex in the six months prior to completing the survey. The survey was distributed and completed online via Qualtrics Panels in March of 2022 and included measures of PrEP and HIV knowledge, PrEP stigma, sexual health self-efficacy, experiences of discrimination, health literacy, and medical mistrust. The majority of participants reported circumstances or behaviors that increased their susceptibility to HIV. Findings indicated that PrEP user stereotypes and PrEP anticipated disapproval by others were associated with interest in using daily oral PrEP and willingness to use long acting injectable PrEP. These results provide insight into reasons for low PrEP uptake among PWUD who live in a high HIV prevalence jurisdiction. Implications for HIV prevention intervention are discussed.