Examining psychosocial links between discrimination and behavioral risks for HIV among Asian Pacific Islander and Latino Men who have Sex with Men

Background:  Asian Pacific Islander (API) and Latino Men who have Sex with Men (MSM) are emerging high-risk groups for HIV transmission, with high frequencies of unprotected sexual contact in these groups.  Studies have found racism and homophobia to predict risky sexual practices, yet the specific psychosocial mechanisms have not been well established.  This study aims to apply the framework of intersectionality to describe psychosocial responses to gender and to racial discriminations that are associated with risky sexual behavior among API and Latino MSM. 

Methods:  Systematic review of published literature in the U.S. was conducted on major journal databases, including Pub Med and Science Direct.  Key search terms included: MSM, gay, Asian, Latino, discrimination, racism, sexual risk, and HIV. 

Results: The review found that API and Latino MSM responded to discriminations in two distinct but non-mutually exclusive ways: 1) responses to racism included perceived exclusion, separation from racialized settings, self-modification, and adherence to stereotypes 2) responses to homophobia included suppression of gender identity, dismissal of discrimination, seeking support from social network, and direct confrontation.   Race-based responses, such as conforming to stereotypes, may place API and Latino MSM at greater risk for HIV transmission than gender-based responses, such as finding social support. 

Conclusion: API and Latino MSM exhibit psychosocial responses to racism or homophobia depending on the context of discrimination. These responses may promote or inhibit the risk of HIV transmission. Findings highlight the importance of providing culture-centered prevention strategies that address racism and homophobia experienced by MSM of Color.