Correlates of Sexual Minority Stress Profiles in Sexual Minority Men Living with HIV Who Use Stimulants

Sexually minoritized men (SMM) experience sexual minority stress, a product of exposure to prejudice, discrimination, and heterosexism. This study sought to identify the latent profiles of sexual minority stress among SMM with HIV who use methamphetamine and to examine the correlates associated with profile membership. A cross-sectional examination of 104 participants in San Francisco self-reported their experiences with sexual minority stress. A latent profile analysis was used to characterize the underlying "profiles" or subgroups of participants. ANOVA and Chi-square analysis were used to examine sociodemographic characteristics, psychological health, substance use, and HIV-related health associated with each profile. Participants' mean age was 43 years old (SD = 9); most identified as Black, Hispanic, or Other racial and ethnic identities (57%), and had been diagnosed with HIV for 13 years (SD = 9) on average. Our findings revealed four distinct profiles: (1) High Concealment, Moderate Prejudice Events, (2) Low Concealment, High Prejudice Events, (3) Low Sexual Minority Stress, and (4) High Sexual Minority Stress. Members of the High Sexual Minority Stress profile had the highest mean addiction severity scores and the greatest endorsement of feelings of shame and guilt. Notably, each profile had clinically significant PTSD and depression scores, even among those who experienced stressful events to a lesser extent. Our findings suggest that sexual minority stress plays a critical role in substance use and mental health outcomes. Additional research is needed to elucidate the other facets of stress in SMM that use substances.