{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:50:07Z","timestamp":1783489807374,"version":"3.55.0"},"reference-count":83,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"unspecified","delay-in-days":64,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S2045796024000143_sec1a\"><jats:title>Aims<\/jats:title><jats:p>To cope with homonegativity-generated stress, gay, bisexual and other men who have sex with men (GBM) use more mental health services (MHS) compared with heterosexual men. Most previous research on MHS among GBM uses data from largely white HIV-negative samples. Using an intersectionality-based approach, we evaluated the concomitant impact of racialization and HIV stigma on MHS use among GBM, through the mediating role of perceived discrimination (PD).<\/jats:p><\/jats:sec><jats:sec id=\"S2045796024000143_sec2b\"><jats:title>Methods<\/jats:title><jats:p>We used baseline data from 2371 GBM enrolled in the Engage cohort study, collected between 2017 and 2019, in Montreal, Toronto and Vancouver, using respondent-driven sampling. The exposure was GBM groups:<jats:bold>Group 1<\/jats:bold>(<jats:italic>n<\/jats:italic>= 1376): white HIV-negative;<jats:bold>Group 2<\/jats:bold>(<jats:italic>n<\/jats:italic>= 327): white living with HIV;<jats:bold>Group 3<\/jats:bold>(<jats:italic>n<\/jats:italic>= 577): racialized as non-white HIV-negative;<jats:bold>Group 4<\/jats:bold>(<jats:italic>n<\/jats:italic>= 91): racialized as non-white living with HIV. The mediator was interpersonal PD scores measured using the Everyday Discrimination Scale (5-item version). The outcome was MHS use (yes\/no) in the prior 6 months. We fit a three-way decomposition of causal mediation effects utilizing the imputation method for natural effect models. We obtained odds ratios (ORs) for pure direct effect (PDE, unmediated effect), pure indirect effect (PIE, mediated effect), mediated interaction effect (MIE, effect due to interaction between the exposure and mediator) and total effect (TE, overall effect). Analyses controlled for age, chronic mental health condition, Canadian citizenship, being cisgender and city of enrolment.<\/jats:p><\/jats:sec><jats:sec id=\"S2045796024000143_sec3c\"><jats:title>Results<\/jats:title><jats:p>Mean PD scores were highest for racialized HIV-negative GBM (10.3, SD: 5.0) and lowest for white HIV-negative GBM (8.4, SD: 3.9). MHS use was highest in white GBM living with HIV (GBMHIV) (40.4%) and lowest in racialized HIV-negative GBM (26.9%). Compared with white HIV-negative GBM, white GBMHIV had higher TE (OR: 1.71; 95% CI: 1.27, 2.29) and PDE (OR: 1.68; 95% CI: 1.27, 2.24), and racialized HIV-negative GBM had higher PIE (OR: 1.09; 95% CI: 1.02, 1.17). Effects for racialized GBMHIV did not significantly differ from those of white HIV-negative GBM. MIEs across all groups were comparable.<\/jats:p><\/jats:sec><jats:sec id=\"S2045796024000143_sec4d\"><jats:title>Conclusions<\/jats:title><jats:p>Higher MHS use was observed among white GBMHIV compared with white HIV-negative GBM. PD positively mediated MHS use only among racialized HIV-negative GBM. MHS may need to take into account the intersecting impact of homonegativity, racism and HIV stigma on the mental health of GBM.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s2045796024000143","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T02:53:12Z","timestamp":1709607192000},"source":"Crossref","is-referenced-by-count":1,"title":["Using an intersectionality-based approach to evaluate mental health services use among gay, bisexual and other men who have sex with men in Montreal, Toronto and Vancouver"],"prefix":"10.1017","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8446-9943","authenticated-orcid":false,"given":"Ivan","family":"Marbaniang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica E. M.","family":"Moodie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Latimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayna","family":"Skakoon-Sparling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor A.","family":"Hart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Grace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan J.","family":"Lachowsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jody","family":"Jollimore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Lambert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6696-0640","authenticated-orcid":false,"given":"Terri","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milada","family":"Dvorakova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Cox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Engage Team Members","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"S2045796024000143_ref52","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1891\/LGBTQ-2020-0028","article-title":"Inter-group and intraminority-group discrimination experiences and the coping responses of Latino sexual minority men living with HIV","volume":"2","author":"MacCarthy","year":"2021","journal-title":"Annals of LGBTQ Public and Population Health"},{"key":"S2045796024000143_ref70","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1080\/1550428X.2020.1724125","article-title":"Intersectional microaggressions and social support for LGBTQ persons of color: A systematic review of the Canadian-based empirical literature","volume":"16","author":"Sadika","year":"2020","journal-title":"Journal of GLBT Family Studies"},{"key":"S2045796024000143_ref82","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1177\/135910539700200305","article-title":"Racial differences in physical and mental health: Socio-economic status, stress and discrimination","volume":"2","author":"Williams","year":"1997","journal-title":"Journal of Health Psychology"},{"key":"S2045796024000143_ref35","unstructured":"Government of Canada (2023c) Police-reported hate crime in Canada, 2021. https:\/\/www150.statcan.gc.ca\/n1\/pub\/11-627-m\/11-627-m2023026-eng.htm (accessed 12 April 2023 )."},{"key":"S2045796024000143_ref17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/15574090802226626","article-title":"Effects of perceived discrimination on mental health and mental health services utilization among gay, lesbian, bisexual and transgender persons","volume":"3","author":"Burgess","year":"2007","journal-title":"Journal of LGBT Health Research"},{"key":"S2045796024000143_ref50","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1177\/0962280211403597","article-title":"On weighting approaches for missing data","volume":"22","author":"Li","year":"2013","journal-title":"Statistical Methods in Medical Research"},{"key":"S2045796024000143_ref2","unstructured":"American Psychological Association (2017) APA Working Group on Stress and Health Disparities. Stress and health disparities: Contexts, mechanisms, and interventions among racial\/ethnic minority and low-socioeconomic status populations. http:\/\/www.apa.org\/pi\/health-disparities\/resources\/stress-report.aspx (accessed 12 May 2023 )."},{"key":"S2045796024000143_ref4","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s10461-019-02607-4","article-title":"\u201cThat Guy is Gay and Black. That\u2019s a Red Flag.\u201d How HIV stigma and racism affect perception of risk among young black men who have sex with men","volume":"24","author":"Arscott","year":"2020","journal-title":"AIDS and Behavior"},{"key":"S2045796024000143_ref48","doi-asserted-by":"crossref","DOI":"10.1016\/j.socscimed.2021.114602","article-title":"Intersecting racism and homonegativism among sexual minority men of color: Latent class analysis of multidimensional stigma with subgroup differences in health and sociostructural burdens","volume":"293","author":"Layland","year":"2022","journal-title":"Social Science and Medicine"},{"key":"S2045796024000143_ref42","volume-title":"Intersectionality as critical social theory","author":"Hill Collins","year":"2019"},{"key":"S2045796024000143_ref57","doi-asserted-by":"crossref","first-page":"173","DOI":"10.7870\/cjcmh-2011-0023","article-title":"Systems-level barriers in accessing supportive mental health services for sexual and gender minorities: Insights from the provider\u2019s perspective","volume":"30","author":"McIntyre","year":"2011","journal-title":"Canadian Journal of Community Mental Health"},{"key":"S2045796024000143_ref19","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1177\/0706743717741061","article-title":"Ethnic differences in mental health status and service utilization: A population-based study in Ontario, Canada","volume":"63","author":"Chiu","year":"2018","journal-title":"The Canadian Journal of Psychiatry"},{"key":"S2045796024000143_ref32","unstructured":"Government of Canada (2022) HIV in Canada \u2013 People living with HIV and new HIV infections, 2020. https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/diseases-conditions\/hiv-canada-people-living-with-hiv-new-infections-2020.html (accessed 2 April 2023 )."},{"key":"S2045796024000143_ref33","unstructured":"Government of Canada (2023a) Anti-racism lexicon. https:\/\/www.canada.ca\/en\/department-national-defence\/services\/systemic-racism-discrimination\/anti-racism-toolkit\/anti-racism-lexicon.html (accessed 2 May 2023 )."},{"key":"S2045796024000143_ref29","doi-asserted-by":"crossref","DOI":"10.5771\/9781498582520","volume-title":"Racism and Gay Men of Color: Living and Coping with Discrimination\/Sulaimon Giwa; Foreword by C. Winter Han","author":"Giwa","year":"2022"},{"key":"S2045796024000143_ref44","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1037\/ccp0000489","article-title":"Intersectional experiences, stigma-related stress, and psychological health among Black LGBQ individuals","volume":"88","author":"Jackson","year":"2020","journal-title":"Journal of Consulting and Clinical Psychology"},{"key":"S2045796024000143_ref61","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1037\/a0032943","article-title":"\u201cHard to crack\u201d: Experiences of community integration among first- and second-generation Asian MSM in Canada","volume":"19","author":"Nakamura","year":"2013","journal-title":"Cultural Diversity and Ethnic Minority Psychology"},{"key":"S2045796024000143_ref66","unstructured":"Rau, K (2021) Lesbian, gay, bisexual and transgender rights in Canada. https:\/\/www.thecanadianencyclopedia.ca\/en\/article\/lesbian-gay-bisexual-and-transgender-rights-in-canada (accessed 1 May 2023 )."},{"key":"S2045796024000143_ref51","doi-asserted-by":"crossref","first-page":"S444","DOI":"10.2105\/AJPH.2022.306725","article-title":"Intersectional stigma and prevention among gay, bisexual, and same gender-loving men in New York City, 2020: System dynamics models","volume":"112","author":"Lutete","year":"2022","journal-title":"American Journal of Public Health"},{"key":"S2045796024000143_ref12","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1007\/s11199-008-9400-z","article-title":"When Black + lesbian + woman \u2260 Black lesbian woman: The methodological challenges of qualitative and quantitative intersectionality research","volume":"59","author":"Bowleg","year":"2008","journal-title":"Sex Roles"},{"key":"S2045796024000143_ref47","unstructured":"Kulick, A (2013) How gay stayed white: Millennial white gay men and the production of and resistance to racism, sexism, and heterosexism. Women\u2019s Studies University of Michigan \u2013 Ann Arbor."},{"key":"S2045796024000143_ref58","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1037\/0033-2909.129.5.674","article-title":"Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence","volume":"129","author":"Meyer","year":"2003","journal-title":"Psychological Bulletin"},{"key":"S2045796024000143_ref27","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1080\/09540121.2017.1290762","article-title":"Stigma and suicide among gay and bisexual men living with HIV","volume":"29","author":"Ferlatte","year":"2017","journal-title":"AIDS Care"},{"key":"S2045796024000143_ref11","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1007\/s10903-020-01061-y","article-title":"Willingness to use mental health services for depression among African immigrants and white Canadian-born people in the Province of Quebec, Canada","volume":"23","author":"Boukpessi","year":"2021","journal-title":"Journal of Immigrant and Minority Health"},{"key":"S2045796024000143_ref60","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25699","article-title":"Characteristics of the HIV cascade of care and unsuppressed viral load among gay, bisexual and other men who have sex with men living with HIV across Canada\u2019s three largest cities","volume":"24","author":"Moore","year":"2021","journal-title":"Journal of the International AIDS Society"},{"key":"S2045796024000143_ref24","first-page":"139","article-title":"Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics","volume":"140","author":"Crenshaw","year":"1989","journal-title":"The University of Chicago Legal Forum"},{"key":"S2045796024000143_ref31","unstructured":"Government of Canada (1995) Employment equity act. https:\/\/laws-lois.justice.gc.ca\/eng\/acts\/E-5.401\/page-1.html?txthl=minorities+minorit%C3%A9s+visibles+visible#s-3 (accessed 10 March 2023 )."},{"key":"S2045796024000143_ref20","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1086\/669608","article-title":"Toward a field of intersectionality studies: Theory, applications, and praxis","volume":"38","author":"Cho","year":"2013","journal-title":"Signs"},{"key":"S2045796024000143_ref76","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/EDE.0b013e318281a64e","article-title":"A three-way decomposition of a total effect into direct, indirect, and interactive effects","volume":"24","author":"VanderWeele","year":"2013","journal-title":"Epidemiology"},{"key":"S2045796024000143_ref59","doi-asserted-by":"crossref","DOI":"10.1016\/j.socscimed.2022.114997","article-title":"Vicarious experiences of major discrimination, anxiety symptoms, and mental health care utilization among Black adults","volume":"316","author":"Moody","year":"2023","journal-title":"Social Science and Medicine"},{"key":"S2045796024000143_ref62","first-page":"890","volume-title":"Oxford Handbook of Psychotherapy Ethics","author":"Nayak","year":"2021"},{"key":"S2045796024000143_ref77","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1146\/annurev-publhealth-032315-021402","article-title":"Mediation analysis: A practitioner\u2019s guide","volume":"37","author":"VanderWeele","year":"2016","journal-title":"Annual Review of Public Health"},{"key":"S2045796024000143_ref69","doi-asserted-by":"crossref","DOI":"10.1080\/20008198.2021.1990527","article-title":"HIV\/AIDS stigma and psychological well-being after 40 years of HIV\/AIDS: A systematic review and meta-analysis","volume":"12","author":"Rzeszutek","year":"2021","journal-title":"European Journal of Psychotraumatology"},{"key":"S2045796024000143_ref64","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1080\/00918369.2017.1311552","article-title":"Patterns of mental health care utilization among sexual orientation minority groups","volume":"65","author":"Platt","year":"2018","journal-title":"Journal of Homosexuality"},{"key":"S2045796024000143_ref5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0249074","article-title":"A review of reported network degree and recruitment characteristics in respondent driven sampling implications for applied researchers and methodologists","volume":"16","author":"Avery","year":"2021","journal-title":"PLoS One"},{"key":"S2045796024000143_ref9","first-page":"1","article-title":"Racial and ethnic disparities in men\u2019s use of mental health treatments","volume":"206","author":"Blumberg","year":"2015","journal-title":"NCHS Data Brief"},{"key":"S2045796024000143_ref26","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1007\/s10903-018-0836-0","article-title":"The relationships between perceived discrimination and utilization of mental health services among African Americans and Caribbean Blacks","volume":"21","author":"Evans","year":"2019","journal-title":"Journal of Immigrant and Minority Health"},{"key":"S2045796024000143_ref74","first-page":"53","article-title":"Health care use among gay, lesbian and bisexual Canadians","volume":"19","author":"Tjepkema","year":"2008","journal-title":"Health Reports"},{"key":"S2045796024000143_ref53","doi-asserted-by":"crossref","first-page":"2333","DOI":"10.1007\/s00127-022-02362-3","article-title":"Mental health services use and depressive symptom scores among gay and bisexual men in Canada","volume":"57","author":"Marbaniang","year":"2022","journal-title":"Social Psychiatry and Psychiatric Epidemiology"},{"key":"S2045796024000143_ref45","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1080\/00918369.2021.1945339","article-title":"A double-edged sword: Dual-identity centrality and the health of Asian American sexual minority individuals","volume":"70","author":"Kim","year":"2023","journal-title":"Journal of Homosexuality"},{"key":"S2045796024000143_ref39","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.17269\/s41997-021-00546-z","article-title":"Prevalence of HIV and sexually transmitted and blood-borne infections, and related preventive and risk behaviours, among gay, bisexual and other men who have sex with men in Montreal, Toronto and Vancouver: Results from the Engage Study","volume":"112","author":"Hart","year":"2021","journal-title":"Canadian Journal of Public Health"},{"key":"S2045796024000143_ref28","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1146\/annurev-statistics-031017-100704","article-title":"Methods for inference from respondent-driven sampling data","volume":"5","author":"Gile","year":"2018","journal-title":"Annual Review of Statistics and Its Application"},{"key":"S2045796024000143_ref73","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1080\/09540121.2011.613910","article-title":"HIV-related stigma within communities of gay men: A literature review","volume":"24","author":"Smit","year":"2012","journal-title":"AIDS Care"},{"key":"S2045796024000143_ref38","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.socscimed.2019.05.011","article-title":"Measuring perceived mistreatment across diverse social groups: An evaluation of the Everyday Discrimination Scale","volume":"232","author":"Harnois","year":"2019","journal-title":"Social Science and Medicine"},{"key":"S2045796024000143_ref81","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1177\/0962280216628900","article-title":"Correcting for dependent censoring in routine outcome monitoring data by applying the inverse probability censoring weighted estimator","volume":"27","author":"Willems","year":"2018","journal-title":"Statistical Methods in Medical Research"},{"key":"S2045796024000143_ref46","unstructured":"Kinitz, DJ , Gould, WA , Shahidi, FV , MacEachen, E , Mitchell, C , Craig-Venturi, D and Ross, LE (2023) Addressing knowledge gaps about skills of 2SLGBTQ+ people in Canada: A scoping review and qualitative inquiry. A report for Employment and Social Development Canada. https:\/\/lgbtqhealth.ca\/projects\/foundationaltransferableskills.php (accessed 10 March 2023 )."},{"key":"S2045796024000143_ref15","first-page":"219","volume-title":"The Oxford Handbook of Stigma, Discrimination, and Health","author":"Brondolo","year":"2018"},{"key":"S2045796024000143_ref37","first-page":"110","volume-title":"The Oxford Handbook of Multimethod and Mixed Methods Research Inquiry","author":"Hankivsky","year":"2015"},{"key":"S2045796024000143_ref25","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1037\/vio0000218","article-title":"The effects of intersecting stigma: A longitudinal examination of minority stress, mental health, and substance use among Black, Latino, and multiracial gay and bisexual men","volume":"8","author":"English","year":"2018","journal-title":"Psychology of Violence"},{"key":"S2045796024000143_ref22","unstructured":"CIHR Canadian HIV Trials Network CTN 300: The Engage Cohort Study. https:\/\/www.hivnet.ubc.ca\/study\/ctn-300-the-engage-cohort-study\/ (accessed 30 July 2023)."},{"key":"S2045796024000143_ref68","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.socscimed.2013.12.029","article-title":"Self-regulatory processes underlying structural stigma and health","volume":"103","author":"Richman","year":"2014","journal-title":"Social Science and Medicine"},{"key":"S2045796024000143_ref43","unstructured":"Hyman, I , O\u2019Campo, P , Ansara, DL , Siddiqi, A , Forte, T , Smylie, J , Mahabir, DF and McKenzie, K (2019) Prevalence and predictors of everyday discrimination in Canada: Findings from the Canadian Community Health Survey. Wellesley Institute."},{"key":"S2045796024000143_ref13","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.2105\/AJPH.2012.300750","article-title":"The problem with the phrase women and minorities: Intersectionality\u2014An important theoretical framework for public health","volume":"102","author":"Bowleg","year":"2012","journal-title":"American Journal of Public Health"},{"key":"S2045796024000143_ref36","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1017\/S1537592707070065","article-title":"When multiplication doesn\u2019t equal quick addition: Examining intersectionality as a research paradigm","volume":"5","author":"Hancock","year":"2007","journal-title":"Perspectives on Politics"},{"key":"S2045796024000143_ref21","doi-asserted-by":"crossref","first-page":"868","DOI":"10.2105\/AJPH.2012.301052","article-title":"Experiences of discrimination and their impact on the mental health among African American, Asian and Pacific Islander, and Latino men who have sex with men","volume":"103","author":"Choi","year":"2013","journal-title":"American Journal of Public Health"},{"key":"S2045796024000143_ref71","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/0277-9536(91)90150-B","article-title":"The MOS social support survey","volume":"32","author":"Sherbourne","year":"1991","journal-title":"Social Science and Medicine"},{"key":"S2045796024000143_ref18","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1086\/669573","article-title":"Identity categories as potential coalitions","volume":"38","author":"Carastathis","year":"2013","journal-title":"Signs"},{"key":"S2045796024000143_ref83","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1177\/09622802211032713","article-title":"General regression methods for respondent-driven sampling data","volume":"30","author":"Yauck","year":"2021","journal-title":"Statistical Methods in Medical Research"},{"key":"S2045796024000143_ref56","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1097\/EDE.0b013e31823ac17c","article-title":"Evaluation of respondent-driven sampling","volume":"23","author":"McCreesh","year":"2012","journal-title":"Epidemiology"},{"key":"S2045796024000143_ref14","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1007\/s11199-012-0152-4","article-title":"\u201cOnce you\u2019ve blended the cake, you can\u2019t take the parts back to the main ingredients\u201d: Black gay and bisexual men\u2019s descriptions and experiences of intersectionality","volume":"68","author":"Bowleg","year":"2013","journal-title":"Sex Roles"},{"key":"S2045796024000143_ref6","doi-asserted-by":"crossref","DOI":"10.1016\/j.ssmph.2021.100798","article-title":"Intersectionality in quantitative research: A systematic review of its emergence and applications of theory and methods","volume":"14","author":"Bauer","year":"2021","journal-title":"SSM - Population Health"},{"key":"S2045796024000143_ref34","unstructured":"Government of Canada (2023b) Ethnocultural diversity among lesbian, gay and bisexual people in Canada: An overview of educational and economic outcomes. https:\/\/www150.statcan.gc.ca\/n1\/pub\/89-28-0001\/2022001\/article\/00005-eng.htm (accessed 1 May 2023 )."},{"key":"S2045796024000143_ref79","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1515\/2161-962X.1014","article-title":"Imputation strategies for the estimation of natural direct and indirect effects","volume":"1","author":"Vansteelandt","year":"2012","journal-title":"Epidemiologic Methods"},{"key":"S2045796024000143_ref78","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/EDE.0000000000000105","article-title":"On the causal interpretation of race in regressions adjusting for confounding and mediating variables","volume":"25","author":"VanderWeele","year":"2014","journal-title":"Epidemiology"},{"key":"S2045796024000143_ref23","doi-asserted-by":"crossref","first-page":"E529","DOI":"10.9778\/cmajo.20200198","article-title":"Use of HIV pre-exposure prophylaxis among urban Canadian gay, bisexual and other men who have sex with men: A cross-sectional analysis of the Engage cohort study","volume":"9","author":"Cox","year":"2021","journal-title":"CMAJ Open"},{"key":"S2045796024000143_ref55","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1037\/sgd0000265","article-title":"Multiple minority stress and LGBT community resilience among sexual minority men","volume":"5","author":"McConnell","year":"2018","journal-title":"Psychology of Sexual Orientation and Gender Diversity"},{"key":"S2045796024000143_ref41","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1037\/a0016441","article-title":"How does sexual minority stigma \u201cget under the skin\u201d? A psychological mediation framework","volume":"135","author":"Hatzenbuehler","year":"2009","journal-title":"Psychological Bulletin"},{"key":"S2045796024000143_ref30","unstructured":"The Globe and Mail (2022) Canada invests $100-million into action plan for LGBTQ2S+ communities. https:\/\/www.theglobeandmail.com\/canada\/article-canada-invests-100-million-into-historic-action-plan-for-lgbtq2s\/ (accessed 3 July 2023 )."},{"key":"S2045796024000143_ref3","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1080\/13691058.2014.905706","article-title":"\u2018Triply cursed\u2019: Racism, homophobia and HIV-related stigma are barriers to regular HIV testing, treatment adherence and disclosure among young Black gay men","volume":"16","author":"Arnold","year":"2014","journal-title":"Culture, Health and Sexuality"},{"key":"S2045796024000143_ref63","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0138511","article-title":"Racism as a determinant of health: A systematic review and meta-analysis","volume":"10","author":"Paradies","year":"2015","journal-title":"PLoS One"},{"key":"S2045796024000143_ref75","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.psychres.2007.01.006","article-title":"An abbreviated version of the Connor-Davidson Resilience Scale (CD-RISC), the CD-RISC2: Psychometric properties and applications in psychopharmacological trials","volume":"152","author":"Vaishnavi","year":"2007","journal-title":"Psychiatry Research"},{"key":"S2045796024000143_ref8","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/0277-9536(86)90016-X","article-title":"Unemployment stress: Loss of control, reactance and learned helplessness","volume":"22","author":"Baum","year":"1986","journal-title":"Social Science and Medicine"},{"key":"S2045796024000143_ref49","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1146\/annurev-clinpsy-032814-112728","article-title":"Self-reported experiences of discrimination and health: Scientific advances, ongoing controversies, and emerging issues","volume":"11","author":"Lewis","year":"2015","journal-title":"Annual Review of Clinical Psychology"},{"key":"S2045796024000143_ref54","doi-asserted-by":"crossref","first-page":"2942","DOI":"10.1007\/s10461-020-02845-x","article-title":"A scoping review of employment and HIV","volume":"24","author":"Maulsby","year":"2020","journal-title":"AIDS and Behavior"},{"key":"S2045796024000143_ref40","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1037\/sah0000295","article-title":"At the intersection of homophobia and racism: Sociocultural context and the sexual health of South Asian Canadian gay and bisexual men","volume":"8","author":"Hart","year":"2023","journal-title":"Stigma and Health"},{"key":"S2045796024000143_ref7","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.socscimed.2018.12.015","article-title":"Methods for analytic intercategorical intersectionality in quantitative research: Discrimination as a mediator of health inequalities","volume":"226","author":"Bauer","year":"2019","journal-title":"Social Science and Medicine"},{"key":"S2045796024000143_ref65","unstructured":"Public Health Agency of Canada (2022) How to integrate intersectionality theory in quantitative health equity analysis? A rapid review and checklist of promising practices. In: PHAC (ed). Ottawa, ON."},{"key":"S2045796024000143_ref16","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1007\/s10865-008-9193-0","article-title":"Coping with racism: A selective review of the literature and a theoretical and methodological critique","volume":"32","author":"Brondolo","year":"2009","journal-title":"Journal of Behavioral Medicine"},{"key":"S2045796024000143_ref10","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1037\/a0024056","article-title":"Perceived discrimination and mental health symptoms among Black men with HIV","volume":"17","author":"Bogart","year":"2011","journal-title":"Cultural Diversity and Ethnic Minority Psychology"},{"key":"S2045796024000143_ref1","doi-asserted-by":"crossref","DOI":"10.1037\/pst0000152","article-title":"Intersectionality in psychotherapy: The experiences of an AfroLatinx queer immigrant","volume":"55","author":"Adames","year":"2018","journal-title":"Psychotherapy"},{"key":"S2045796024000143_ref72","doi-asserted-by":"crossref","first-page":"S356","DOI":"10.2105\/AJPH.2022.306718","article-title":"An expanded definition of intersectional stigma for public health research and praxis","volume":"112","author":"Sievwright","year":"2022","journal-title":"American Journal of Public Health"},{"key":"S2045796024000143_ref80","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0223372","article-title":"A systematic review and thematic synthesis of Canada\u2019s LGBTQ2S+ employment, labour market and earnings literature","volume":"14","author":"Waite","year":"2019","journal-title":"PLoS One"},{"key":"S2045796024000143_ref67","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1521\/jscp.2007.26.8.960","article-title":"The role of discrimination and racial identity for mental health service utilization","volume":"26","author":"Richman","year":"2007","journal-title":"Journal of Social and Clinical Psychology"}],"container-title":["Epidemiology and Psychiatric Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2045796024000143","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T20:22:58Z","timestamp":1731529378000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2045796024000143\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":83,"alternative-id":["S2045796024000143"],"URL":"https:\/\/doi.org\/10.1017\/s2045796024000143","relation":{},"ISSN":["2045-7960","2045-7979"],"issn-type":[{"value":"2045-7960","type":"print"},{"value":"2045-7979","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024]]},"article-number":"e10"}}