0255 Associations Between Coping with Discrimination, Sleep, and Mental Health Among Black Sexual Minority Men

Abstract Introduction Black sexual minority men (SMM) suffer disproportionately from health inequities, including high rates of HIV, as well as poor mental and physical health. In addition to intersectional stigma and discrimination, sleep health, an understudied factor, may contribute to these health inequities. We examined the associations between coping with discrimination, sleep disturbances, and mental and behavioral health outcomes among Black SMM. Methods We recruited 191 Black SMM participants both in person at community-based events and organizations and online. Sleep disturbance, depression, anxiety, alcohol use, and quality of life were measured using PROMIS-Sleep Disturbance, Physical Health Questionnaire, Generalized Anxiety Disorder, Alcohol Use Disorders Identification Test, and PROMIS global health items. Experience of and coping with discrimination were measured using validated questionnaires. Regression and mediation analysis were conducted, controlling for age. Results One-quarter of the sample reported elevated levels of sleep disturbance. Experiences of racial discrimination were marginally associated with greater sleep disturbances (b = 0.59, p = 0.07). Effective coping (e.g., getting emotional support, thinking about steps to take) (b = -2.62, p = 0.03) and higher coping self-efficacy (b = -2.00, p < 0.001) were associated with fewer sleep disturbances. Less effective coping (e.g., self-blame, denial) was associated with more sleep disturbances (b = 4.70, p = 0.009). Greater sleep disturbance was associated with higher ratings of depression (b = 0.04, p < 0.001), anxiety (b = 0.03, p < 0.001) and lower ratings of quality of life (b = -0.04, p < 0.001), and marginally with greater alcohol use disturbances (b = 0.12, p = 0.06). Indirect paths via sleep disturbance were significant for the effects of effective coping or ineffective coping on depression, anxiety, alcohol use (for ineffective coping only), and quality of life. Conclusion Effective coping strategies appeared to mitigate sleep disturbances and other health challenges, underscoring the need for culturally congruent interventions that address both sleep and mental health to improve overall wellbeing in this population. Additionally, it is imperative to actively address intersectional stigma and discrimination. Mediation analysis was based on cross-sectional data and should be interpreted with caution. Support (if any) This work is supported by NIMHD R01MD014722 (LMB)