Abstract
The health and well-being of older sexual and gender minorities (SGM) have been greatly shaped by structural
forces, namely discrimination and, for older SGM of color, racism. Their contemporary history and life course
have been defined by exodus from hostile environments and the formation of supportive communities. The
overall goal of this research is to shed light on the extent and the manner in which structural racism and
discrimination shapes older SGM’s health. This study will assess the relationships among health, stigma,
structural racism and discrimination, resources, and biomarkers of health and aging in older SGM of four
racial/ethnic groups— African American, Latinx, Asian American, and White— and across HIV status. This
research is needed because older SGM’s health fares worse than that of their heterosexual counterparts, their
exposure to structural discrimination is higher, and they have less access to supportive resources than older
heterosexual men. Notably, 40 years after we first faced HIV, we continue to learn about the consequences of
HIV, including aging with HIV. Gay men comprise the majority of older people living with HIV. Older SGM face
unique health risks and protective factors, yet they constitute a very diverse and complex population. What we
know about their health comes from mostly white, well-educated, and convenient samples. Hence, the need to
collect data from diverse and valid samples. This is a cross sectional study based on San Francisco Bay Area.
Quantitative and Qualitative data will be collected from a sample of 600 older gay men and 150 transgender
women. We will collect structural, individual, and biological data to test hypotheses regarding the associations
among structural racism and discrimination, resources, and health (e.g., mental health, HIV risk, cognitive
function). Our team is multidisciplinary and includes our community partner, The Elizabeth Taylor 50-Plus
Network (of the San Francisco AIDS Foundation). This proposal is in response to NIH’s RFA Understanding
and Addressing the Impact of Structural Racism and Discrimination on Minority Health and Health Disparities.
It addresses the Office of AIDS Research Strategic Plan of tackling HIV comorbidities and health disparities.
The data and findings from this study are intended to constitute the baseline for a longitudinal study.