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Perceived discrimination experiences and social well-being among midlife and older adult men who have sex with men from the Multicenter AIDS Cohort Study

Meanley, Steven (2017) Perceived discrimination experiences and social well-being among midlife and older adult men who have sex with men from the Multicenter AIDS Cohort Study. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Many men who have sex with men (MSM) in midlife (40-64 years) and older adulthood (65+ years) have survived a lifetime fighting and advocating for equality given exposures to social discrimination attributed to stigmatized social identities (e.g., sexual orientation, racial/ethnic minority, and HIV-positive status). Few public health research efforts have given attention to how MSM’s exposure and salience of social discrimination across the life course have shaped social well-being in midlife and older age. Three studies were conducted using a cross-sectional healthy aging sub-study of the Multicenter AIDS Cohort Study (MACS). Study 1 explored whether older adulthood, racial/ethnic minorities, and HIV+ serostatus were associated with higher prevalence of any lifetime, any sexuality-related, and multifactorial (number of discrimination types) discrimination. Non-Hispanic Blacks were associated with greater any lifetime discrimination (aOR=1.42, p<0.001) and associated with less sexuality-related discrimination (aOR=0.56, p=0.001) compared to Non-Hispanic Whites. There was a statistically significant interaction associated to multifactorial discrimination between Non-Hispanic Black identity and HIV serostatus (aOR=0.46, p=0.019). Interestingly, no statistically significant differences in discrimination were observed by age cohort. Study 2 examined current internalized homophobia by discrimination exposure and salience. We observed no statistically significant differences in internalized homophobia by any discrimination or salience variables. Study 3 assessed differences in six indicators of social well-being (attachment, social integration, guidance, reassurance of worth, reliable alliance, and opportunity for nurturance) by discrimination exposure and salience. Though the mean scores for social well-being indicators were high overall, both any lifetime discrimination and multifactorial discrimination were negatively associated with indicator scores except opportunity for nurturance. Sexuality-related discrimination was negatively associated with social integration only. Across all discrimination salience variables, participants who reported discrimination and no/low salience exhibited lower scores on social well-being indicators than participants who reported no discrimination. Study 3 extended the public health literature on aging MSM, elucidating the role of salience on discrimination’s relationship to social well-being and that despite social adversity, these men have been able to maintain or achieve high social well-being. Future research should continue exploring midlife and older adult MSM’s resiliencies to identify factors that interrupt the deleterious impact of discrimination on health.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Meanley, Stevenspm76@pitt.eduSPM76
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairStall, Ronrstall@pitt.eduRSTALL
Committee MemberEgan, Jamesjee48@pitt.eduJEE48
Committee MemberHawk, Marymary.hawk@pitt.eduMary.Hawk
Committee MemberMatthews, Derrickderrick.matthews@pitt.eduDerrick.Matthews
Committee MemberSilvestre, Anthonytonys@pitt.edutonys
Committee MemberPlankey,
Date: 26 September 2017
Date Type: Publication
Defense Date: 20 July 2017
Approval Date: 26 September 2017
Submission Date: 18 July 2017
Access Restriction: 1 year -- Restrict access to University of Pittsburgh for a period of 1 year.
Number of Pages: 168
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Discrimination, Aging, Social Well-Being, MSM
Date Deposited: 26 Sep 2017 17:08
Last Modified: 01 Sep 2018 05:15


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