The Effect of Intersecting Stigmas on PrEP Outcomes for Young Black MSM

交叉耻辱对年轻黑人 MSM 的 PrEP 结果的影响

• 批准号: 9749968
• 负责人: Katherine G Quinn
• 金额: $ 13.5万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-19 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9749968
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adolescent; Affect; African American; Age; Anti-Retroviral Agents; Anus; Awareness; Behavior Therapy; Centers for Disease Control and Prevention (U.S.); Color; Communities; Complex; Continuity of Patient Care; Data; Development; Educational Background; Educational workshop; Ensure; Face; Family; Focus Groups; Future; Goals; Grant; HIV; HIV Infections; HIV Seropositivity; Hispanics; Human immunodeficiency virus test; Individual; Infection; Intervention; Knowledge; Manuscripts; Medical; Mentored Research Scientist Development Award; Mentorship; Methods; Outcome; Pattern; Perception; Phase; Population; Preparation; Prevalence; Prevention; Prevention strategy; Preventive Intervention; Research; Research Activity; Research Methodology; Research Personnel; Science; Shapes; Social support; Socioeconomic Status; Statistical Models; Structure; Testing; Time; Training; Ursidae Family; Writing; adherence rate; adverse outcome; base; biobehavior; black men who have sex with men; career; community based participatory research; evidence base; experience; health care service utilization; high risk; high risk population; improved; indicated prevention; intersectionality; men; men who have sex with men; negative affect; peer; pre-exposure prophylaxis; prevention service; racism; resilience; response; skills; social; social stigma; success; symposium; tool; treatment services; uptake; willingness

Abstract Despite recent progress, Black Americans continue to bear the most severe burden of HIV/AIDS in the nation, and young Black men who have sex with men (YBMSM) continue to be most affected. Antiretroviral pre- exposure prophylaxis (PrEP) has been endorsed as a potentially effective part of HIV combination prevention strategies and an opportunity to reduce new infections among YBMSM. However, without significant efforts to develop age and culturally-tailored PrEP interventions for YBMSM, PrEP use may only be accessible and utilized by older, White, more affluent MSM, further exacerbating HIV disparities. Through the framework of intersectionality, the proposed research examines how various, intersectional stigmas may limit YBMSM’s ability and willingness to use PrEP. Various stigmas experienced by Black MSM (homonegativity, racism) are associated with adverse outcomes along the HIV care continuum and there is reason to believe these stigmas may also negatively affect PrEP outcomes. The proposed study aims to address the current lack of research on YBMSM’s barriers to using PrEP and gather the data necessary to inform a tailored intervention for YBMSM. The study will take place in Milwaukee, WI. In phase I, we will conduct 9 focus groups (n=72-90) with YBMSM ages 16-25 to explore YBMSM’s knowledge and perceptions of PrEP, identify individual, community and structural level factors likely to affect PrEP uptake among YBMSM, and examine YBMSM’s general healthcare utilization patterns and barriers. Additionally, we will employ a quantitative study to examine the relationship between various stigmas (racism, medical mistrust, homonegativity) and examine the effects of intersecting stigmas on knowledge and acceptance of PrEP among 300 YBMSM. We hypothesize that racism, homonegativity, and the intersection of those stigmas will predict lower knowledge of PrEP, reduced likelihood of using PrEP, and greater PrEP stigma. We also hypothesize that the relationships between various stigmas and PrEP outcomes will be moderated by resiliency and social support. In Phase II, we will use findings from Phase I and community-based participatory research methods to develop an evidence-based multi-level intervention tailored to YBMSM to be tested in a future R34. Findings from this study may not only be useful in increasing PrEP use among YBMSM, but may also be generalized to other outcomes along the care continuum. The training plan in this Mentored Research Scientist Development Award (K01) application will provide the training and research experience necessary to support Dr. Katherine Quinn’s transition to an independent HIV prevention and intervention researcher. Training includes four primary goals: build content expertise in intersectional stigma, develop mastery of complex statistical modeling for intersectionality and mixed-methods research, build expertise in intervention science, and enhance career and professional development. The training acquired by Dr. Quinn includes didactic coursework, academic conferences, manuscript preparation, independent study, grant writing workshops and other research activities.

抽象的 尽管最近取得了进展，但黑人美国人仍继续承担全国最严重的艾滋病毒/艾滋病负担 与男性发生性关系的年轻黑人（YBMSM）仍然受到最大的影响 暴露预防（PREP）已被称为预防HIV组合的有效有效的有效部分 策略和开放式 - YBMSM之间的新新感染。 为YBMSM开发年龄和文化规定的准备干预措施，Prop使用只能访问，并且 通过较旧的，白色，更痛苦的MSM使用，通过框架的框架进一步加剧了艾滋病毒差异。 交叉性，支撑研究研究了各种，交叉的污名如何限制YBMSM的污名如何 黑人MSM经历的各种污名（种族主义）的能力和愿意 与Hib Care Care Care Coninuum沿着不良结果有关，有理由相信这些污名 可能会影响预期的旨在解决目前的研究 关于YBMSM使用PREP的障碍，并收集所需的数据，以告知量身定制的干预措施 YBMSM。 YBMSM 16-25岁以探索YBMSM对Pro的知识和看法，确定个人，社区 结构级别的因素可能会影响YBMSM之间的准备吸收，并检查YBMSM'SM的一般性 医疗保健利用模式和障碍。 各种污名（种族主义，医学不信任，同义）之间的关系，并检查 在300 YBMSM中的知识和接受方面相交。我们假设种族主义， 同性恋和这些污名的交集将预测较低的准备知识，降低。 使用准备和更大的污名。 在第二阶段的弹性和社会支持中，准备结果将得到调节。 第一阶段和基于社区的参与研究方法，以开发基于证据的多层次。 针对YBMSM量身定制的干预措施将在未来的R34中进行测试。 YBMSM之间的准备使用量增加，但也可以推广到沿心的结果 连续研究。 提供支持Katherine Quinn博士过渡到一个的培训和研究经验 独立的HIV预防和INT干预研究人员包括四个主要目标：建立内容 专业知识交叉污名，掌握了国际化复杂统计建模的掌握 混合方法研究，建立干预科学方面的专业知识，并增强职业和专业 开发。奎因博士获得的培训包括教学课程 手稿准备，独立研究，赠款研讨会和其他研究活动。