June 25, 2020
Xiaoming Li and Shan Qiao, faculty members of the Department of Health Promotion, Education, and Behavior (HPEB) and the South Carolina SmartState Center for Healthcare Quality (CHQ) have been awarded a competitive supplement grant from the National Institutes of Mental Health. They will use the $100K award to study the HIV-related health outcomes among men who have sex with men living with HIV in China.
Created in response to a notice of special interest from the NIH Sexual & Gender Minority Research Office and nearly 20 other NIH institutes/centers, this study was designed to examine health disparities in HIV treatment trajectories between men who have sex with men and men who do not have sex with men in China. It also examines the effects of intersectional stigma (e.g., HIV-related stigma, sexual and gender-related stigma) on physical, psychosocial, and clinical outcomes among men who have sex with men living with HIV as well as the roles of cultural and contextual factors in moderating such effects among this highly vulnerable sexual and gender minority population. This new study will be embedded in an existing five-year NIH-funded project (R01MH0112376) that has been conducted in Guangxi, China with a longitudinal cohort of 1,200 men and women living with HIV.
As a sexual and gender minority, men who have sex with men living with HIV are stigmatized and marginalized in China and many other societies because of their multiple stigmatized identities, such as same-sex sexual behavior, HIV infection, or sexual and gender minority status. To foster a deeper understanding of their unique health vulnerabilities due to their sexual and gender minority status, both scientific community members and healthcare providers need better evidence in terms of the disparities of health outcomes between men who have sex with men living with HIV and other men living with HIV. They also need more information about the synergistic effects of multiple or layered stigma (i.e., intersectional stigma) on health outcomes of men who have sex with men living with HIV.
“Although the collective knowledge of manifestations of and contributors to health disparities among sexual and gender minorities has grown rapidly, several knowledge gaps still exist in these regards among men who have sex with men living with HIV,” says Li, who is the SmartState Endowed Chair for Clinical Translational Research/director of the Center for Healthcare Quality and has been studying HIV stigma and other social and psychological aspects of HIV for almost three decades in both domestic and international settings. “For example, many existing studies on sexual and gender minorities are limited to small sample sizes, non-representative samples, or specific but limited domains of health outcomes. In addition, few studies have examined the effects of multiple stigma on HIV-related health outcomes among this group through the framework of intersectionality.”
To address these knowledge gaps, Li and Qiao will work with their collaborators in Guangxi to collect quantitative data and biological specimens from an additional 400 men who have sex with men living with HIV in the same region and integrate the data into their existing five-year study. They hope that the findings from this study will have the potential to advance the current knowledge base, including cross-cultural evidence, on whether and how sexual and gender minority status affects HIV-related health outcomes among men who have sex with men living with HIV and inform future intervention strategies that can reduce stigma, increase resilience, and improve wellbeing among sexual and gender minority populations in China and across the globe.