Stop-and-Frisk, Arrest, and Incarceration and STI/HIV Risk in Minority MSM

少数男男性接触者中的拦截搜查、逮捕和监禁以及性传播感染/艾滋病毒风险

• 批准号: 9919525
• 负责人: Maria Rabia Khan
• 金额: $ 67.33万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9919525
• 关键词: 20 year old; AIDS prevention; Address; Advocacy; Affect; African American; Alcohol or Other Drugs use; Anxiety; Bisexual; Caring; Cohort Studies; Communicable Diseases; Communities; Computer Simulation; Couples; Criminal Justice; Crowding; Data Sources; Development; Discrimination; Disease; Dose; Employment; Epidemiology; Ethnic Origin; Face; Fees; Gays; HIV; HIV Infections; HIV prevention trials network; HIV risk; HIV/STD; Health; Healthcare; Heterosexuals; Hispanics; Imprisonment; Incidence; Interruption; Intervention; Jail; Lawyers; Life Cycle Stages; Life Experience; Light; Link; Measures; Mediating; Mediation; Mediator of activation protein; Mental Depression; Minority; Minority Groups; Modeling; Mood Disorders; New York City; Outcome; Pathway interactions; Personal Satisfaction; Pharmaceutical Preparations; Play; Police; Policies; Population; Poverty; Prevention approach; Prevention program; Prisons; Process; Program Development; Psyche structure; Race; Research; Risk; Risk Factors; Role; Sex Orientation; Sexually Transmitted Diseases; Social Network; Social isolation; Social support; Structure; Viral Load result; Vulnerable Populations; Work; addiction; base; black men who have sex with men; cohort; comparison intervention; cost; court; design; evidence base; experience; improved; men; men who have sex with men; men' s group; minority health; novel; population based; prevent; programs; recruit; response; sex; sex risk; sexual risk behavior; simulation; social determinants; social stigma; support network; transmission process; young men who have sex with men

ABSTRACT Minority gay, bisexual, or other men who have sex with men (MSM) contend with stigma and discrimination based on sexual orientation and race, resulting social isolation, and poverty risk that disproportionately impacts all minority groups. These factors contribute to mental/drug disorders, sex risk, and disproportionate STI/HIV, with half of black gay men and one-quarter of Hispanic gay men HIV-infected. Another prevalent social determinant of STI/HIV that disproportionately affects minority MSM, yet that remains largely unexamined in this group, is criminal justice involvement (CJI). CJI for many minority MSM begins early in the life course with police stops and searches; our preliminary studies in New York City indicate one-third of minority MSM approximately 20 years of age have been stopped and searched (or “frisked”) in the past 12 months. CJI evolves to arrest and detainment and for many, incarceration, with approximately over half of some minority MSM groups experiencing jail or prison incarceration. Each step of the criminal justice process–being stopped by police, arrested, detained while awaiting trial often in over-crowded conditions, interacting with court-appointed lawyers–can be disempowering, demeaning, and for some may present physical threat. In other populations, CJI has been documented as a determinant of disrupted social and support networks, depression, substance use, and sex risk, in turn, culminating in STI/HIV infection. Our understanding of mediating pathways has informed development of programs for heterosexual minorities affected by CJI. This proposal is motivated by the prospect of developing policies and prevention programs for minority MSM. The effects of CJI on STI/HIV may differ for minority MSM; CJI may work synergistically with low social support, stigma/discrimination, and poverty to have particularly strong effects in this group. In addition, pathways linking CJI and STI/HIV risk also may differ for minority MSM. For example, while disruption of network ties may place minority MSM at risk, as we have observed in heterosexual minorities, other pathways may be equally critical because of high baseline risk of stigma and poverty. To address current critical gaps in our understanding of the effects of CJI on health, we have compiled a compendium of data sources to examine the effect of CJI on STI/HIV risk in minority MSM. Using the HIV Prevention Trials Network 061 (HPTN 061) cohort of black MSM and the Project 18 (P18) Cohorts 1 and 2 of minority MSM, we will evaluate longitudinal associations between multiple levels of CJI (stop-and- frisk, arrest, incarceration) and STI/HIV risk outcomes (e.g., sexual risk behaviors, STI, HIV, and viral load). We will describe the potential mediating roles of CJI-related disruption of social support networks, stigma, poverty, and resulting depression and substance use. In light of recent calls for changes to criminal justice policy, we aim to use computer simulation to model the impact of implementing polices to reduce CJI (e.g., decarceration) and improve correctional settings (e.g., by improving ties to community support networks through reduced costs of prison calls) on HIV transmission in minority MSM and the larger population. Findings will inform evidence-based discussions about how to modify policy and programs to best improve well-being and reduce HIV risk in a highly vulnerable population.

抽象的 少数同性恋，双性恋或其他与男人发生性关系的男人（MSM）与污名和基于歧视的歧视 性取向和种族，导致的社会隔离以及贫困风险不成比例地影响所有少数民族 组。这些因素有助于精神/药物疾病，性风险和不成比例的性病/艾滋病毒，一半是黑色 同性恋者和三分之一的西班牙裔男同性恋者艾滋病毒感染者。 STI/HIV的另一个普遍的社会决定者 不成比例地影响少数民族MSM，但在这个小组中仍然没有尚未对此进行审查，这是刑事司法 参与（CJI）。许多少数MSM的CJI在生活课程的初期开始，警察停下来搜查。我们的 纽约市的初步研究表明，大约20岁的少数MSM中有三分之一 在过去的12个月中，停下来搜索（或“陷入困境”）。 CJI演变为逮捕和细节，对于许多人来说， 监禁，大约有一半以上的少数MSM团体经历了监狱或监禁。 刑事司法程序的每一步 - 被警察停止，被捕，陷入困境，同时等待审判 过度拥挤的条件，与法院指定的律师互动 - 是否可以剥夺，贬低，而对于某些人来说 可能会带来身体威胁。在其他人群中，CJI已被记录为被破坏社会的确定 以及支持网络，抑郁症，药物使用和性风险，进而达到STI/HIV感染。我们的 了解中介途径的理解已为受影响的异性少数群体的计划发展 CJI。该提案是由为少数MSM制定政策和预防计划的前景。 少数MSM的CJI对STI/HIV的影响可能有所不同。 CJI可能会在社会支持较低的情况下协同工作， 污名/歧视和贫困在这一组中具有特别强大的影响。此外，连接CJI的途径 STI/HIV风险在少数MSM中也可能有所不同。例如，虽然网络纽带的破坏可能会使少数群体置于 正如我们在异性恋少数族裔中所观察到的那样，MSM处于危险中，其他途径可能同样至关重要 污名和贫困的高基线风险。在我们对CJI影响的理解中解决当前的关键差距 关于健康，我们编制了数据源的汇编，以检查CJI对STI/HIV风险对少数族裔的影响 MSM。使用HIV预防试验网络061（HPTN 061）黑色MSM和项目18（P18） 少数MSM的队列1和2，我们将评估多个CJI级别之间的纵向关联 Frisk，逮捕，监禁）和STI/HIV风险结果（例如，性风险行为，性传播感染，艾滋病毒和病毒负荷）。我们将 描述社会支持网络，污名，贫困和 产生的抑郁症和药物使用。鉴于最近呼吁改变刑事司法政策，我们的目标是使用 计算机模拟以建模实施政策以减少CJI的影响（例如，脱牙）并改进 更正环境（例如，通过降低监狱呼叫的成本改善与社区支持网络的联系） 少数MSM和较大人口的HIV传播。调查结果将为基于证据的讨论提供信息 如何修改政策和计划，以最好地改善福祉，并降低高度脆弱的人群中的艾滋病毒风险。