Multiple Discrimination, Substance-Related Coping, and Depression Among Sexual Minority Men with HIV

Sexual minority men (SMM) with HIV who use substances experience multiple forms of stigma (e.g., experienced discrimination) related to aspects of themselves and their behaviors and are disproportionately affected by depression. More research is needed to examine the interrelations between multiple discrimination, including substance-related discrimination, and depression, and the intervening role of substance-related coping among SMM with HIV who use drugs. Self-report data (N = 195) collected between 2017-2018 included experienced discrimination (categories included HIV, sexual orientation, race/ethnicity, substance use), substance-related coping, and depressive symptoms. ANCOVA results revealed significant differences in depressive symptoms based on the number of discrimination categories endorsed, F(6,188) = 11.71, p < .001, with groups that endorsed discrimination across more stigmatized categories reporting higher depressive symptoms. Supplemental ANCOVA results also indicated differences in depressive symptoms based on endorsement of substance use discrimination, F(4,190) = 19.16, p < .001. Analysis of indirect associations revealed substance-related coping partially accounted for the relation between multiple discrimination and depressive symptoms, b = 1.19, 95%CI [0.58, 1.91]. Results suggest that there is a cumulative association between multiple discrimination and depressive symptoms, and substance-related discrimination and substance-related coping may be particularly important influencers on this association. Multi-level intervention efforts that target multiple discrimination could help ameliorate the high rates of depression in this community.