The Association of Positive Intersectionality Latent Classes with Psychosocial Factors and PrEP Outcomes in Black Men Who Have Sex with Men (HPTN 073)

Experiences of discrimination and HIV risk in Black men who have sex with men (MSM) need to be examined from the perspective of strength and resilience and not just risk. Scholars have theorized that a strong connection with one’s sociocultural identities may increase individuals’ ability to cope with discrimination which has been related to positive health outcomes. Scholars have coined the term positive intersectionality to refer to how one’s stigmatized identity(ies) can be used to draw strength and create a positive sense of self. The current study is a secondary data analysis of a study of 225 Black MSM. We utilized Latent Class Analysis to determine profiles of positive intersectionality measured by indicators of racial/ethnic identity, having an integrated sexual orientation and racial/ethnic identity, and levels of internalized homophobia. Fit indices suggested a five-latent class solution: low positive intersectionality (n = 3), ambivalent positive intersectionality (n = 19), moderate positive intersectionality (n = 66), salient/high positive intersectionality (n = 124), and conflict(ed) positive intersectionality (n = 13). Differences were found across classes on key outcomes, broadly individuals in classes with more positive intersectionality tended to report more positive psychosocial outcomes (i.e., more social support and less depression) than those in classes with lower positive intersectionality. Regarding PrEP outcomes, adherence (examined via a biomarker) was highest among those reporting ambivalent or conflict positive intersectionality compared to those with low positive intersectionality. Our findings underscore the need for the development of strengths-based and culturally tailored interventions may help to improve well-being for Black MSM.