An Examination of State-Level Factors on HIV Infection Rate: The Case of MSM

• In Event: 2234 - Social Dimensions of AIDS

Abstract

How social and state-level factors influence lesbian, gay, and bisexual (LGB) health has largely been unaddressed in the social determinants of health literature. As a result, this study applies a social determinant of health approach to explore how rates of HIV infection among gay, bisexual, and other men who have sex with men (MSM) are affected by state-level social climate using state-level data. This study examines the direct effect of three state-level factors: LGB social climate, economic inequality and access to HIV-testing. LGB social climate is measured by the LGB social climate index developed by the Williams Institute, and assess the level of social acceptance of LGB people at the state level. Economic inequality is measured by state-level Gini index and access to HIV-testing is measured by the number of HIV-testing events at the state level. Results show evidence for a negative association between state-level climate and rates of HIV infection. States with more favorable climate towards LGB people have reduced rates of HIV infection. Results also show a negative association between access to HIV-testing and HIV-infection. States with more CDC funded events, per the adult population have reduced rates of HIV infection. In contrast, there is a positive association between economic inequality and HIV infection rates. States with greater income inequality have increasing rates of HIV infection. Finally, the negative effect of HIV infection on HIV infection rates among MSM is reduced for states with more favorable climates towards LGB people. Findings illuminate the importance of considering the unique role of state-level factors, which create the conditions for increased rates of HIV infection among MSM.

Author

• Philip J. Pettis, Vanderbilt University