New research has found that Black, nonheterosexual males with a recent history of incarceration, arrest, or “stop and search” face a higher risk of HIV and become less willing to take preexposure prophylaxis.
The study is the work of Rutgers School of Public Health in Piscataway, NJ, the City University of New York (CUNY), George Washington University in Washington, DC, and Morehouse School of Medicine in Atlanta, GA.
The researchers came together to weigh the impact of arrest and incarceration on the health of nonheterosexual Black men.
The team reports its findings in the journal Social & Science Medicine.
“Evidence suggests Black sexual minority men in the United States may face some of the highest rates of policing and incarceration in the world,” notes lead author Devin English, Ph.D.
“Despite this,” English points out, “research examining the health impacts of the [United States] carceral system rarely focuses on their experiences. This study helps to address this gap.”
In the current study, the investigators surveyed 1,172 Black males who identify their sexual orientation of gay, bisexual, or queer.
All were aged 16 years or above and came from regions across the U.S. “The majority of participants was gay-identified, single, and had some college education,” the researchers write.
The goal of the survey and ensuing analysis was to look at how, in this cohort, arrest or incarceration history had links to health risks and behaviors, such as HIV infection risk, willingness to take preexposure prophylaxis (PrEP) — the drugs that help prevent HIV infection — and psychological distress.
“We examined how incarceration and police discrimination, which have roots in enforcing white supremacy and societal heterosexism, are associated with some of the most pressing health crises among Black sexual minority men like depression, anxiety, and HIV,” English explains.
As many as 43% of respondents reported having experienced police discrimination in the previous year. These events were most frequently reported by those who had experienced incarceration.
Those who reported having experienced high levels of discrimination in the context of law enforcement also reported high levels of psychological distress.
The study also associated past-year police and law enforcement discrimination with a higher likelihood of engaging in behaviors the researchers linked to a heightened risk of HIV infection.
Moreover, participants who had experienced incarceration or police discrimination also showed a lower degree of willingness to take PrEP in comparison with peers who had not had these experiences.
“These findings transcend individual-level only explanations to offer structural-level insights about how we think about Black sexual minority men’s HIV risk,” notes study co-author Prof. Lisa Bowleg.
“The study rightly directs attention to the structural intersectional discrimination that negatively affects Black sexual minority men’s health,” Prof. Bowleg adds.
From their findings, the investigators urge policy changes, more research into — and advocacy against — U.S. police enforcement elements that authorities connect with anti-Blackness and homophobia.
“Despite experiencing a disproportionate burden of violence and discrimination at the hands of the police, and extremely high carceral rates, Black queer men are largely invisible in discourse on anti-Black policing and incarceration,” says study co-author Joseph Carter.
“Our study provides empirical support for the intersectional health impacts of police and carceral discrimination that have been systemically perpetrated onto Black queer men.”
– Joseph Carter