Although Blacks make up only 13% of the U.S. population, they account for 50% of all new HIV infections.1 Among 20-24 year olds, the incidence of HIV/AIDS is 14 times higher for Blacks than it is for other racial groups within the U.S.2 The main transmission routes for HIV in this population are injection drug use, and high-risk sexual behaviors, which are exacerbated by substance use.1,3 Both risky sex and substance use have been linked in our previous prospective research with perceived racial discrimination.4-6 In fact, the effects of discrimination on health behaviors like these have been suggested by many researchers as a primary reason for Black-White health disparities, including disparities in HIV infection, in the U.S.7-9 We propose to conduct two laboratory (experimental) studies that are based on our previous research examining the relation between discrimination and cognitions associated with HIV-risk (substance use and risky sex). We will examine risk and protective factors that may help explain this relation, and that may reduce it-i.e., buffer against the negative effects of discrimination. Thus, the primary aims of the proposed project are to examine malleable factors that mediate and moderate the associations between discrimination and HIV-risk cognitions. These cognitions will be assessed with both implicit word associations and explicit measures (reports of willingness to engage in the behaviors and HIV-related risk perceptions) that previous research has shown predict substance use and risky sexual behaviors. We will examine feelings of anger and reduced self-control as potential mediators and racial- and self-affirmations as potential moderators (buffers). The proposed studies will use a new, but very effective manipulation of racial discrimination (Cyberball) to examine the emotional and cognitive impact of perceived discrimination immediately following a discriminatory experience. Our design will also allow us to compare the potential protective effects of racial affirmations, which involve affirming the positive feelings and sense of belongin one has for one's racial group, with self-affirmations, which enhance positive feelings about the self in general. This research will address the strong need for experimental studies that examine the impact of these two closely linked behaviors and will examine the similarities and differences between the discrimination substance use response pathway, and the discrimination risky sex response pathway, as well as how these pathways are related to one another. Participants will include 500 Black young adults ages 18-24 from the Washington D.C. area, where rates for HIV and drug use are among the highest in the U.S. and almost 80% of those infected are Black. The proposed research will provide an opportunity to obtain new knowledge to increase our understanding of risky decision making within an at-risk population after stressful experiences (i.e., discrimination). This project is consistent with NIH/NIDA's focus on: examining the interrelated nature of substance use and risky sex as risk factors for HIV, exploring the impact of racial discrimination on the psychological and physical health of vulnerable minority populations, and reducing HIV-related disparities.
In line with the goals of NIH/NIDA, the findings of the proposed research will increase understanding and thereby help reduce the negative impact of racial discrimination on substance use and risky sex cognitions and behaviors, which contribute to the disparities that exist between Black young adults and other racial groups in drug abuse and HIV/AIDS. The proposed studies will examine potentially malleable risk and protective factors that will help lay the groundwork for additional research to help us understand HIV-risk disparities associated with substance use and risky sex among African American young adults. This research will also help inform future studies designed to help reduce HIV-related disparities through preventative interventions that focus on multiple, interactive, HIV-risk cognitions and behaviors. .