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(Unpublished)
Abstract
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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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| 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 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/32852 |
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