Date of Conferral

2021

Degree

Ph.D.

School

Public Health

Advisor

Wen-Hung Kuo

Abstract

Human Immunodeficiency Virus (HIV) disproportionately affects African American men who have sex with men. According to the Centers for Disease Control and Prevention, in 2020 African American adult and adolescent African American men accounted for 42% (16,002) of all HIV diagnoses (37,968). Furthermore, while substance use is common among this population, in previous studies very few individuals with HIV have reported receiving substance abuse treatment or discussing substance use with HIV medical providers. The purpose of this study was to examine the differences in substance use/mental health problems by race, gender, and sexual orientation among HIV-infected individuals. This study also examined the association of perceived discrimination when receiving HIV medical care and the appointments missed for HIV-related medical care. The theoretical framework was grounded in the social ecological model. Using multiple regression on data from a survey titled “Positive Connections: Connecting HIV-Infected Patients to Care, 2004–2006,” the study sample included 96 low-income People Living with HIV/AIDS (PLWHA). Ad hoc analysis was then conducted after correcting the small sample size's power effect in the transgender population. Results showed a difference in substance use/mental health problems and missed appointments by sexual orientation among HIV-infected individuals. However, race and gender showed no association with substance use/mental health problems and missed appointments. Implications from this research show the influence of sexual orientation on substance use/mental health problems and missed appointments, tailored medical services are necessary to cater to the healthcare needs of HIV patients.

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