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

基本信息

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
项目类别：
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&apos 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

项目摘要

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、双性恋或其他男男性行为者 (MSM) 面临着基于以下原因的耻辱和歧视：性取向和种族，由此产生的社会孤立，以及对所有少数群体造成不成比例影响的贫困风险这些因素导致精神/药物障碍、性风险和不成比例的性传播感染/艾滋病毒，其中一半是黑人。男同性恋者和四分之一的西班牙裔男同性恋者感染了艾滋病毒，这是性传播感染/艾滋病毒的另一个普遍的社会决定因素。刑事司法对少数男男性行为者的影响尤其严重，但这一群体在很大程度上仍未得到审查参与 (CJI) 对于许多少数族群 MSM 来说，CJI 在生命历程的早期就开始于警察拦截和搜查；纽约市的初步研究表明，大约 20 岁的少数族裔男男性接触者中，有三分之一曾在过去 12 个月中，CJI 演变为逮捕和拘留，对许多人来说，监禁，大约一半以上的少数 MSM 群体经历过监狱或监狱监禁。刑事司法程序的每一步——经常在等待审判时被警察拦截、逮捕、拘留过度拥挤的环境、与法院指定的律师互动——可能会削弱他们的能力、贬低他们的身份，对某些人来说在其他人群中，CJI 已被记录为社会混乱的决定因素。和支持网络、抑郁、药物滥用和性风险，最终导致性传播感染/艾滋病毒感染。对调解途径的了解为制定针对受到影响的异性恋少数群体的方案提供了信息 CJI。该提案的动机是为少数 MSM 制定政策和预防计划。 CJI 对性传播感染/艾滋病毒的影响对于少数 MSM 可能会有所不同；CJI 可能与低社会支持协同作用，耻辱/歧视和贫困对该群体产生特别强烈的影响此外，连接 CJI 的途径。对于少数男男性行为者来说，性传播感染/艾滋病毒风险也可能不同，例如，网络关系的中断可能会导致少数群体受到影响。正如我们在异性恋少数群体中观察到的，MSM 面临风险，其他途径可能同样重要，因为耻辱和贫困的高基线风险旨在解决我们目前对 CJI 影响的理解中的重大差距。在健康方面，我们编制了一份数据源概要，以研究 CJI 对少数族裔性传播感染/艾滋病毒风险的影响 MSM。使用 HIV 预防试验网络 061 (HPTN 061) 黑人 MSM 队列和项目 18 (P18) 对于少数民族 MSM 的队列 1 和队列 2，我们将评估多个 CJI 水平之间的纵向关联（停止并- 搜查、逮捕、监禁）和性传播感染/艾滋病毒风险结果（例如，性危险行为、性传播感染、艾滋病毒和病毒载量）。描述与 CJI 相关的社会支持网络破坏、耻辱、贫困和社会支持网络的潜在中介作用鉴于最近要求改变刑事司法政策的呼声，我们的目标是使用计算机模拟来模拟实施政策的影响，以减少 CJI（例如，解除监禁）并改善惩教环境（例如，通过减少监狱呼叫费用来改善与社区支持网络的联系）少数男男性接触者和更多人群中的艾滋病毒传播研究结果将为基于证据的讨论提供信息。如何修改政策和计划，以最好地改善高度脆弱人群的福祉并降低艾滋病毒风险。