The purpose of this dissertation was to identify the distinct risk and protective factors that are associated with psychological distress among Black MSMW. Black MSMW encounter a host of stressors in their daily lives that impact their mental and physical health, including HIV prevention and HIV care engagement. Through three studies, the dissertation aimed to address critical gaps in knowledge about the relationships among stress exposure, health and sexual risk factors, social and personal resources, and sociodemographic and individuals-level factors that shape psychological distress among Black MSMW.

The results of Study #1, Stress exposure and psychological distress among Black MSMW, suggested that Black MSMW with histories of childhood sexual abuse faced greater adult stress exposure, which contributed to greater odds of psychological distress. The results of Study #2, Health and sexual risks associated with psychological distress among Black MSMW, demonstrated that sexual risk from placing a greater importance of privacy regarding sex with men was significantly associated with greater odds of psychological distress, after controlling for health risks, sociodemographic and individual-level characteristics, and stress exposures. The results of Study #3, Psychosocial resources associated with psychological distress among Black MSMW, demonstrated that social support was significantly associated with distress, above and beyond all other covariates.

These studies, by examining the correlates of psychological distress among Black MSMW in Los Angeles, may guide future research on these relationships and interventions aimed at engaging Black MSMW in the HIV prevention continuum and the HIV continuum of care.