Study points to negative impact of racism on gay Asian men

A study published in Nature today by researchers from the Yale School of Public Health found a correlation between stress from societal racism and certain health outcomes among gay Asian men.

They found that those who experienced greater racism-related stress had a higher incidence of substance abuse, in particular, tobacco and alcohol.

The study did not find a correlation between racism-related stress and other health-related behaviors, such as, the use of the HIV prevention drug PrEP, visiting the dentist, or health in general. However, the authors point out that alcohol use itself may lead to irresponsible behaviors, such as skipping out PrEP doses.

The study was published by Lauren L. Chin, Trace Kershaw, Raul U. Hernandez-Ramirez and S. Raquel Ramos, all affiliated with the Yale School of Public Health.

The authors point out that gay Asians, being a niche group, have been omitted from similar studies performed in the past, while this work centers them.

They caution that the correlation between racism-related stress and heightened substance abuse does not necessarily mean that one caused the other. In order to sort out whether it is indeed the stress experienced due to societal discrimination that leads to greater substance abuse as a coping strategy, they recommend further studies that follow a set of subjects over time, to see which factor came first.

Since this study was based on only 62 individuals, the study could not be as granular as they would have preferred, for example on racial subcategories, or extent of smoking. But it could form the basis for future, larger studies.

In order to choose their target sample of 62 men, the researchers began with a set of 322 minority gay men who had responded to a randomized control study from 2017-2019, the HIV Oral Self-Testing Infographic Experiment (HOTIE), which tested the efficacy of infographics that explain how to administer HIV tests to oneself.

From that base of 322 men, the researchers recruited 62 who identified as Asian.

The set of 62 subjects were tested on how much stress they faced from negative events in daily life that they ascribed to discrimination based on their race. They were given a questionnaire where they were asked to denote how bothered they felt upon imagining hypothetical situations, such as watching a TV show where Asian characters are shown as subservient to non-Asian characters.

Lower scores denoted that they were not bothered at all, while higher scores denoted that they were, all the way to “extremely upset”. They were also asked if they ascribed the negative interaction to race or something else.

These scores, called the Asian American racism-related stress inventory (AARRSI), where higher numbers showed greater stress, where then tested against a number of questionnaires where the 62 respondents provided their health information.

One questionnaire, based on the Behavioral Risk Factor Surveillance System (BRFSS), surveys participants on tobacco use and general health.

Another, based on the National Survey on Drug Use and Health (NSDUH), asked about cigarette, e-cigarette, and alcohol use and frequency.

A third questionnaire tested the 62 respondents’ familiarity with the PrEP protocol and their attitudes towards it.

The final tabulated results show a distinct correlation between substance use, including cigarettes, e-cigarettes, and alcohol, with higher AARRSI scores, which points to greater racism-related stress. However, other factors of health behaviors, such as oral health and PrEP, use do not show any marked difference in the subjects’ AARRSI scores.