Session: Democratizing Knowledge to Understand and Remediate Multiple Co-Occurring Stigmas and Their Harmful Effects on Health and Wellbeing of Multiple-Minority Groups in Southern United States (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)

Background and Purpose: Stigma is a well-documented barrier to desirable social and health outcomes. The co-occurrence of multiple stigmas heightens the risk of adverse effects among populations with multiple minoritized identities, including Black women and Black and Latino sexual minority men. Moreover, persistent stigmatization of health conditions, such as HIV and mental ill-health, imposes additional burdens on multiple-minority groups (MMGs) as their stigmatized identities intersect with stigmatized health conditions. Despite these documented challenges, an intersectionality lens to understand the lived experiences of MMGs and the role of resilience and community assets in stigma reduction and health promotion remains underutilized. This symposium will highlight research that enabled MMGs to join the social construction of knowledge and action to remediate the adverse effects of multiple co-occurring stigmas affecting their health and well-being.

Methods: The studies in this symposium used a mixed-methods approach to explore the intersection of stigma and HIV prevention among MMGs in the U.S. South. Gabbidon used interpretive phenomenology to contextualize the experiences of intersectional stigma and responses to sigma among same-gender loving men in Florida. Masa and colleagues applied a Positive Deviance Approach to identify uncommon behaviors and practices used by young Latino sexual minority men in North Carolina to overcome intersectional stigma and discrimination. In Virginia, Shangani conducted in-depth interviews with community healthcare workers who provide HIV testing and PrEP referral services to explore multilevel barriers to PrEP use among Black women.

Results: Studies reported experiences of intersectional stigma among MMGs. These experiences were cited as barriers to regular access and use of HIV preventive services, such as HIV testing and PrEP (preexposure prophylaxis). Studies also identified potential pathways linking intersectional stigma to a high risk of HIV transmission. SGLM in Florida reported physiological and emotional reactions to stigma, which contributed to long-term disempowerment. YLSMM in North Carolina reported mental ill-health as a common pathway linking their experiences of intersectional stigma and discrimination to risky behaviors that exacerbate their risk of HIV transmission. In Virginia, stigma and medical mistrust were key barriers to PrEP use among Black women. Although all MMGs in the studies reported experiences of intersectional stigma, they also described multilevel resilience behaviors and practices, helping them address stigma and discrimination.

Conclusions and Implications: The studies in this symposium explore stigma experiences and practices resulting from compounding systems of oppression that contribute to adverse outcomes among MMGs. Although stigma and discrimination remain common experiences, MMGs have relied on individual and community-level resilience to overcome stigmas and their negative effects. Using an intersectionality lens illustrates overlapping factors that can be utilized to develop multilevel interventions focused on mitigating risks and harnessing assets. Effective interventions may begin with behaviors and practices that have enabled individuals from MMGs to overcome stigma and remain healthy while facing similar challenges and access to the same resources as others in the community. The symposium will discuss current efforts integrating study findings to inform the structure and implementation of community-based interventions.