Structural Effects on HIV Risk Among Youth: A Multi-level Analysis.

TitleStructural Effects on HIV Risk Among Youth: A Multi-level Analysis.
Publication TypePublication
Year of Publication2018
AuthorsMiller RLin, Strzyzykowski T, Lee K-S, Chiaramonte D, Acevedo-Polakovich I, Spring H, Santiago-Rivera O, Boyer CB, Ellen JM
JournalAIDS Behav
Volume22
Issue11
Pagination3451-3467
Date Published2018 Nov
ISSN1573-3254
KeywordsAdolescent, Female, HIV Infections, Humans, Male, Multilevel Analysis, Sexual and Gender Minorities, Sexual Behavior, Sexual Partners, Social Stigma, Social Support, Stress, Psychological, United States
Abstract

<p>We proposed a multilevel model of structural influences on HIV-risky sexual partnerships in a diverse sample of 1793 youth residing in 23 states and the District of Columbia. We examined the influence of concentrated disadvantage, HIV stigma, and sexual and gender minority stigma on engagement in HIV risky sexual partnerships and whether youth's participation in opportunity structures, anticipation of HIV stigma, and perceptions of their community as youth-supportive settings mediated structural effects. After controlling for age, HIV status, and race, we found structural HIV stigma had deleterious indirect effects on youth's participation in HIV-risky sexual partnerships. Concentrated disadvantage and structural sexual and gender minority stigma had direct negative effects on youth's perceptions of their communities as supportive and on their participation in prosocial activity. Support perceptions had direct, protective effects on avoidance of HIV-risky sexual partnerships. Structural stigma undermines youth's belief that their communities invest in their safety and well-being.</p>

DOI10.1007/s10461-018-2031-7
Alternate JournalAIDS Behav
PubMed ID29340914
PubMed Central IDPMC6047939
Grant ListU01 HD040474 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States
U01 HD 040474 / / Eunice Kennedy Shriver National Institute of Child Health and Human Development /
U01 HD 040533 / / Eunice Kennedy Shriver National Institute of Child Health and Human Development /