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Minority Stress and Relationships  

Robert Carroll

Minority stress for the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) and African American communities has been well documented over the past 30 years. Generally speaking, being a member of a stigmatized community can lead to alienation from social structures, norms, and institutions, all of which can have negative implications for mental health, well-being, and relationships. When speaking about minority stress and its impact on LGBTQ+ relationships, the research is mixed. Although there are findings that show LGBTQ+ individuals face greater discrimination and more negative health impacts than heterosexual couples, other research notes the positive coping mechanisms that highlight the resilient nature of these couples. For African Americans and other racial minorities, the disparities are greater, with research showing that racial identity is linked to an increase in overall external stressors. However, over the last few years, discrimination toward sexual and racial minorities has reached a critical tipping point. Both within the United States and worldwide, social movements are drawing attention to the historical inequalities experienced by minority groups, and demanding change. Considering minority stress research, methods, and analyses are built on the connection between an individual and their social situations, the construct is due for an evolution, one that is representative of what our world looks like today. Although conceptualizations thus far have been productive in understanding the stressors of the LGBTQ+ and African American communities, there is a need to incorporate critical concepts of intersectionality and expand understanding of what it means to be a member of a minority group.

Article

African American Queer Cinema  

Victor Evans

African American queer cinema was born as a reaction to the AIDS/HIV epidemic as well as the blatant homophobia that existed within the Black community in the 1980s. It began with the pioneering works of queer directors Isaac Julien and Marlon Riggs and continued during the new queer cinema movement in the 1990s, particularly including the works of lesbian queer director Cheryl Dunye. However, these works were infinitesimal compared to the queer works featuring primarily White lesbian, gay, bisexual, transgender, and queer (LGBTQ) protagonists during that time. That trend continues today as evidenced by looking at the highest-grossing LGBTQ films of all times: very few included any African American characters in significant roles. However, from the 1980s to the 2020s, there have been a few Black queer films that have penetrated the mainstream market and received critical acclaim, such as The Color Purple (Spielberg, 1982), Set It Off (Gary, 1996), and Moonlight (Jenkins, 2016), which won the 2018 Academy Award for Best Picture. The documentary film genre has been the most influential in exposing audiences to the experiences and voices within the African American queer communities. Since many of these films are not available for viewing at mainstream theaters, Black queer cinema is primarily accessed via various cable, video streaming, and on-demand services, like Netflix, Hulu, and HBO.

Article

The ACT2 Program and Eliminating Racial and Ethnic Disparities in HIV and AIDS Clinical Trials: A Case Study in Health and Risk Messaging  

Marya Gwadz and Amanda S. Ritchie

It is well documented that African American/Black and Hispanic individuals are underrepresented in biomedical research in the United States (U.S.), and leaders in the field have called for the proportional representation of varied populations in biomedical studies as a matter of social justice, economics, and science. Yet achieving appropriate representation is particularly challenging for health conditions that are highly stigmatized such as HIV/AIDS. African American/Black, and Hispanic individuals, referred to here as “people of color,” are greatly overrepresented among the 1.2 million persons living with HIV/AIDS in the United States. Despite this, people of color are substantially underrepresented in AIDS clinical trials. AIDS clinical trials are research studies to evaluate the safety and effectiveness of promising new treatments for HIV and AIDS and for the complications of HIV/AIDS, among human volunteers. As such, AIDS clinical trials are critical to the development of new medications and treatment regimens. The underrepresentation of people of color in AIDS clinical trials has been criticized on a number of levels. Of primary concern, underrepresentation may limit the generalizability of research findings to the populations most affected by HIV/AIDS. This has led to serious concerns about the precision of estimates of clinical efficacy and adverse effects of many treatments for HIV/AIDS among these populations. The reasons for the underrepresentation of people of color are complex and multifaceted. First, people of color experience serious emotional and attitudinal barriers to AIDS clinical trials such as fear and distrust of medical research. These experiences of fear and distrust are grounded largely in the well-known history of abuse of individuals of color by medical research institutions, and are complicated by current experiences of exclusion and discrimination in health care settings and the larger society, often referred to as structural racism or structural violence. In addition, people of color experience barriers to AIDS clinical trials at the level of social networks, such as social norms that do not support engagement in medical research and preferences for alternative therapies. People of color living with HIV/AIDS experience a number of structural barriers to clinical trials, such as difficulty accessing and navigating the trials system, which is often unfamiliar and daunting. Further, most health care providers are not well positioned to help people of color overcome these serious barriers to AIDS clinical trials in the context of a short medical appointment, and therefore are less likely to refer them to trials compared to their White peers. Last, some studies suggest that the trials’ inclusion and exclusion criteria exclude a greater proportion of people of color than White participants. Social/behavioral interventions that directly address the historical and contextual factors underlying the underrepresentation of people of color in AIDS clinical trials, build motivation and capability to access trials, and offer repeated access to screening for trials, hold promise for eliminating this racial/ethnic disparity. Further, modifications to study inclusion criteria will be needed to increase the proportion of people of color who enroll in AIDS clinical trials.