Coping with Rural Community HIV Stigma: Sexual Risk and Psychological Well-Being

应对农村社区艾滋病毒耻辱：性风险和心理健康

• 批准号: 7552484
• 负责人: Carol Therese Miller
• 金额: $ 70.68万
• 依托单位: UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-01-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7552484
• 关键词: AIDS/HIV problem; Abstinence; Affect; Anxiety; Area; Behavior; Clinical; Communication; Communities; Consequences of HIV; Daily; Data; Ecology; Face; Goals; HIV; Individual; Individual Differences; Lead; Life; Longitudinal Studies; Measures; Mental Depression; Methods; Modeling; Motivation; Outcome; Participant; Play; Population Study; Prejudice; Public Health; Risk; Risk Behaviors; Role; Rural; Rural Community; Sampling; Sex Behavior; Sexual Abstinence; Sexual Partners; Social Interaction; Stigmata; Stigmatization; Surveys; Symptoms; Testing; Theoretical model; Thinking; Virus; Well in self; Withdrawal; base; coping; design; diaries; experience; high risk sexual behavior; member; metropolitan; perpetrators; psychologic; research study; rural area; safer sex; sex; social; social integration; social stigma; stressor; therapy design; transmission process; AIDS/HIV problem; Abstinence; Affect; Anxiety; Area; Behavior; Clinical; Communication; Communities; Consequences of HIV; Daily; Data; Ecology; Face; Goals; HIV; Individual; Individual Differences; Lead; Life; Longitudinal Studies; Measures; Mental Depression; Methods; Modeling; Motivation; Outcome; Participant; Play; Population Study; Prejudice; Public Health; Risk; Risk Behaviors; Role; Rural; Rural Community; Sampling; Sex Behavior; Sexual Abstinence; Sexual Partners; Social Interaction; Stigmata; Stigmatization; Surveys; Symptoms; Testing; Theoretical model; Thinking; Virus; Well in self; Withdrawal; base; coping; design; diaries; experience; high risk sexual behavior; member; metropolitan; perpetrators; psychologic; research study; rural area; safer sex; sex; social; social integration; social stigma; stressor; therapy design; transmission process

DESCRIPTION (provided by applicant): The aims of the proposed project emerged from the findings of our current project (MH R01 066848) and are guided by a theoretical model that melds approaches that conceptualize stigma as a stressor with an approach that describes prejudice from the perspective of its perpetrators. The integrated model suggests that the consequences of HIV/AIDS stigma (e.g., psychological symptoms and sexually risky behavior) depend on both the manner in which community members express prejudice (subtle or blatant) and on individual differences in vulnerability to stigma and coping with stigma among people with HIV/AIDS living in these communities. This model, which was used to interpret the findings of the current project, suggests three hypotheses that will be examined in the proposed project. The first is that coping with high levels of perceived HIV/AIDS stigma with disengagement (i.e., avoidance) coping will be related to the social integration of people with HIV/AIDS into their communities and their sexual behavior. The second hypothesis is that psychological symptoms may be both a consequence of perceived HIV/AIDS stigma and/or may make people with HIV/AIDS vulnerable to perceiving that they are stigmatized. The third hypothesis is that perceived HIV/AIDS stigmatization by people with HIV/AIDS will depend on the type of prejudice (implicit/subtle or blatant) that is expressed by the community in which they live, and on their individual vulnerability to stigmatization. These hypotheses will be tested with 250 participants with HIV/AIDS who will complete a longitudinal study to assess perceived stigma, coping with stigma, psychological symptoms, and sexual risk behavior, a diary measure in which they record their daily experiences with stigmatization, and an experiment in which they interpret how prejudiced people from the community are based on a sample of their behavior. Community subtle and blatant prejudice toward people with HIV/AIDS will be assessed by a survey of residents of the communities in which participants with HIV/AIDS live. Findings of this project will be useful in designing interventions by increasing understanding of the type and the amount of HIV/AIDS stigma people with HIV/AIDS face in their communities, the role that individual vulnerability plays in the experience of HIV/AIDS stigmatization, and the role that coping with stigma plays in influencing the relationship between experienced stigma and important outcomes (e.g., sexually risky behavior and psychological symptoms). Findings also will indicate whether reductions in stigma may have unintended results (i.e., paradoxical increases in risky sexual behavior) unless there is a better understanding of how community context, individual vulnerabilities to stigmatization, and coping with stigma affect the outcomes of people with HIV/AIDS. PUBLIC HEALTH RELEVANCE HIV/AIDS stigma has been identified as a critical issue for people with HIV/AIDS, particularly those living outside of metropolitan areas. The goal is to identify individual differences and community level variables that make people with HIV/AIDS vulnerable or resilient to the adverse consequences of HIV/AIDS stigma. The public health consequences to be examined are psychological symptoms, including clinical levels of anxiety and depression that characterize the study population, and sexual behaviors that risk the transmission of the virus.

描述（由申请人提供）：拟议项目的目的来自我们当前项目的发现（MH R01 066848），并以一种理论模型为指导，该理论模型融合了将污名化为压力源的方法，该方法将其用一种方法描述了从其代表者的角度来描述偏见的方法。综合模型表明，艾滋病毒/艾滋病污名（例如，心理症状和性危险行为）的后果取决于社区成员表达偏见（微妙或公然）的方式，以及在这些社区中患有艾滋病毒/艾滋病的污名和应对污名的脆弱性和应对污名的个体差异。该模型用于解释当前项目的发现，提出了三个假设，这些假设将在拟议的项目中进行检查。首先是，应对高水平的艾滋病毒/艾滋病污名与脱离接触（即避免）应对将与患有艾滋病毒/艾滋病的人的社会融合有关，与他们的社区及其性行为有关。第二个假设是，心理症状可能既是感知的艾滋病毒/艾滋病污名和/或可能使艾滋病毒/艾滋病患者容易受到污名化的结果。第三个假设是，患有艾滋病毒/艾滋病患者的艾滋病毒/艾滋病污名化将取决于他们所居住的社区表达的偏见类型（隐式/微妙或公然），以及他们的个人易受污名化的偏见。这些假设将与250名患有艾滋病毒/艾滋病的参与者进行测试，他们将完成一项纵向研究，以评估感知到的污名，应对污名，心理症状和性风险行为，这是一场日记措施，其中记录了他们的日常经历，并通过污名化以及一项实验，在这些实验中，他们可以根据自己的偏见来基于他们的偏见，这些人是基于自己的行为的偏见。社区微妙而公然对艾滋病毒/艾滋病患者的偏见将通过对艾滋病毒/艾滋病居住的社区的居民进行的调查来评估。该项目的发现将通过增加对艾滋病毒/艾滋病的艾滋病毒/艾滋病污名人士在其社区中面对的艾滋病毒/艾滋病人群的了解，这将在设计干预措施中有用。调查结果还将表明污名的减少是否可能产生意想不到的结果（即，风险性行为的矛盾增加），除非对社区环境，个人对污名化的个人脆弱性有更好的了解以及应对耻辱感如何影响艾滋病毒/艾滋病患者的结果。 对于患有艾滋病毒/艾滋病的人，尤其是居住在大都市地区以外的人来说，公共卫生相关性艾滋病毒/艾滋病的污名已被确定为关键问题。目的是确定个体差异和社区级别变量，使艾滋病毒/艾滋病患者容易受到艾滋病毒/艾滋病污名的不利影响。要检查的公共卫生后果是心理症状，包括特征研究人群的焦虑和抑郁水平以及风险传播病毒的性行为。