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Enacted Sexual Minority Stigma, Social Support, and Cognitive Function Among Midlife and Older Men Who Have Sex with Men from the Multicenter AIDS Cohort Study

Henderson, Emmett Robert (2021) Enacted Sexual Minority Stigma, Social Support, and Cognitive Function Among Midlife and Older Men Who Have Sex with Men from the Multicenter AIDS Cohort Study. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Men who have sex with men (MSM) in midlife and older adulthood experience many health disparities to their heterosexual peers that can be attributed, in part, to their stigmatized sexual minority identity or behavior. However, how psychosocial factors affect cognitive function among MSM has yet to be explored. This dissertation analyzed data from the Healthy Aging Study, a sub-study of the Multicenter AIDS Cohort Study (MACS) to explore the effects of social support and enacted sexual minority stigma on three tests of cognitive function. In the first analysis, social support was associated with a lower Trail Making Test (TMT) Part A score at baseline (b = -2.01, 95% CI = -3.24, -0.77) and across 2 years (b = -1.76, 95% CI = -2.42, -1.10), indicating better psychomotor ability. Social support was also associated with a higher Symbol Digit Modalities Tasks (SDMT) score at baseline (b = 2.28, 95% CI = 0.22, 4.34) and across 2 years (b = 1.05, 95% CI = 0.20, 1.90), indicating better information processing. In the second analysis, at baseline enacted sexual minority stigma was associated with higher TMT Part B/A ratios, indicating worse set-shifting performance (b = 0.14, 95% CI = 0.06, 0.22) and fewer correct answers on the SDMT (b = -1.63, 95% CI = -2.81, -0.44). Longitudinally, enacted sexual minority stigma was associated with higher TMT B/A ratios (b = 0.04, 95% CI = 0.01, 0.07). In the third analysis, experiencing or witnessing enacted sexual minority stigma during adolescence were not associated with cognitive function. However, we observed significant moderating effects of social support at baseline between witnessing enacted sexual minority stigma in adolescence and the TMT B/A ratio, and enacted sexual minority stigma experienced in adulthood and the SDMT score. Longitudinally, social support moderated the association between adulthood enacted sexual minority stigma and the TMT A and SDMT scores. The public health significance of these analyses shows that psychosocial factors such as sexual minority stigma may contribute to additional risk for poor cognitive function among MSM, and that social support may be an important resource to mitigate negative effects of social stressors.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Henderson, Emmett Roberterh101@pitt.eduerh101
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairEgan, James E.jee48@pitt.edujee48
Committee MemberCoulter, Robert W. S.robert.ws.coulter@pitt.edurobert.ws.coulter
Committee MemberFriedman, M. Reuelmrf9@pitt.edumrf9
Committee MemberWeinstein, Andrea M.weinsteinam2@upmc.eduweinsteinam2
Date: 27 August 2021
Date Type: Publication
Defense Date: 3 August 2021
Approval Date: 27 August 2021
Submission Date: 9 July 2021
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 122
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Behavioral and Community Health Sciences
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Stigma; Social Support; Men Who Have Sex With Men; Cognitive Function
Date Deposited: 27 Aug 2021 16:51
Last Modified: 27 Aug 2021 16:51
URI: http://d-scholarship.pitt.edu/id/eprint/41569

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