Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

S. Raquel Ramos


Rationale: Acts of racial discrimination impart racism-related stress on the individual and have been linked to decreased psychological well-being and physical health. While there are numerous studies of other groups of sexual minority (SM) men of color in this area, little research has focused on HIV-negative, Asian-identifying SM men. Objectives: This study investigates whether racism-related stress is associated with substance use, general and oral health outcomes, and attitudes towards PrEP in a sample of emerging adult Asian SM men. The study also evaluates whether these behaviors affect the relationships between racism-related stress and the other outcomes. Methods: This secondary data analysis included 70 SM men, 18-34 years of age, who identified as Asian from the HIV Oral Self-Testing Infographic Experiment. Multivariable regression models were used to assess the relationships between Asian American Racism-Related Stress Inventory (AARRSI) score and oral and general health, substance use, and attitudes towards PrEP. Models were adjusted for sociodemographic characteristics. Moderator analysis evaluated existing effect modification between outcome measures. Results: Alcohol consumption had a significant positive association with AARRSI score (R=0.37, p=0.060). AARRSI scores had weak positive associations with e-cigarette use (R=0.25, p=0.050), teeth removal (R=0.09, p=0.484), and PrEP familiarity (R=0.12, p=0.343) and use (R=0.03, p=0.810). Alcohol consumption moderated AARRSI’s relationship with cigarette use (p<0.001) and teeth removal (p<0.001). Cigarette use also moderated the effect that AARRSI score had on oral health (p=0.001). Conclusion: These findings suggest that racism-related stress may be an important factor to consider in designing interventions for the prevention of HIV and the management of substance use and oral health within this population.


This is an Open Access Thesis.

Open Access

This Article is Open Access