Developing and Testing a Novel Multidimensional Stigma-Resilience Measure for Stigma Reduction Research with Black Men Who Have Sex with Men

开发和测试一种新颖的多维耻辱弹性测量，以减少与男性发生性行为的黑人的耻辱研究

• 批准号: 10838125
• 负责人: Yu Liu
• 金额: $ 26.48万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-25 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10838125
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adult; Anxiety; Area; Behavior; Black race; Collaborations; Communities; Community Healthcare; County; Dimensions; Discrimination; Disparity; Environment; Face; Funding; Future; Gays; Goals; HIV; HIV Seronegativity; HIV Seropositivity; HIV diagnosis; Health Personnel; Healthcare; Hispanic; Homophobia; Homosexuality; Human immunodeficiency virus test; Individual; Institution; Intervention; Interview; Latino; Maps; Measurement; Measures; Mediator; Mental Depression; Methodology; Minority; Modeling; National Institute on Minority Health and Health Disparities; Neighborhoods; Outcome; Personal Satisfaction; Population; Prevention strategy; Process; Psychometrics; Race; Research; Same-sex; Sexuality; Stigmatization; Strategic Planning; Stress; Subgroup; Tennessee; Testing; United States National Institutes of Health; Universities; Variant; Violence; Work; black men who have sex with men; cognitive interview; community engagement; design; experience; health disparity; health disparity populations; improved; insight; intersectionality; marginalized population; medical schools; men who have sex with men; novel; peer; pre-exposure prophylaxis; programs; promote resilience; psychologic; psychological distress; racism; resilience; resilience factor; resilience scale; response; social stigma; testing uptake; theories; transgender women; uptake; women of color

ABSTRACT Black men who have sex with men (BMSM) continue to experience disproportionate burdens of HIV compared to other MSM subgroups in the US. This disparity is exacerbated by the multilevel intersectional stigmas that BMSM face, including those based on race, same-sex attraction/behavior, and presumed HIV-positive status, which results in high levels of psychological distress and poor HIV prevention outcomes. Resilience is a critical component in studies to mitigate the negative impact of multilevel intersectional stigmas on HIV prevention uptake among BMSM. However, existing resilience measures are designed for non-marginalized populations and are inadequate for assessing BMSM's resilience to multilevel intersectional stigmas. To address this gap, we propose to develop a novel, BMSM-specific, multidimensional stigma-resilience scale that captures the nuanced resiliency mechanisms countering intersectional stigmas across multiple socioecological levels. The proposed study will be conducted in Nashville, an HIV hotspot in the Southern US, where growing HIV burdens and intersectional stigmas among BMSM have been identified. The study has two specific aims. In Aim 1, we will define the mechanisms of multidimensional resilience that BMSM use to counter intersectional stigmas. We will conduct in-depth interviews with 30 HIV-negative BMSM in Nashville, guided by a conceptual framework that integrates the Socioecological Model, Resilience Theory, and Intersectionality Framework. We will explore how resilience is developed, manifested, and implemented to overcome intersecting forms (e.g., internalized, enacted, experienced, and anticipated) and types (e.g., stigma against racism, homosexuality, and presumed HIV status) of stigmas across multiple socioecological levels (e.g., individual, interpersonal, community and healthcare). Aim 2 will necessitate an iterative and systematic BMSM community engagement process to develop and validate a new multidimensional stigma-resilience measure tailored for BMSM. Insights from Aim 1 will help inform the adaptation of an existing scale (e.g., Multilevel Resilience Measure for Black Adults Living with HIV) to be contextually appropriate and stigma-focused for BMSM. We will then assess face validity and cultural relevancy through cognitive interviews with 10 BMSM, followed by conducting psychometric analyses with 250 BMSM to test the new scale's reliability (e.g., internal consistency) and validity (e.g., convergent, divergent, and predictive validity). The proposed study is significant in providing a robust, culturally-tailored stigma-resilience measure, which will inform our future R34/R01 study to develop and evaluate a multilevel resilience-based intervention to mitigate intersectional stigmas and HIV prevention uptake among BMSM. Additionally, the new BMSM Multidimensional Stigma-Resilience Scale will provide the groundwork for future studies to refine and adapt the scale for resilience-focused research conducted with other marginalized populations (e.g., Latino/Hispanic MSM; transwomen of color).

抽象的 与男性发生性关系的黑人 (BMSM) 继续承受不成比例的艾滋病毒负担 美国其他 MSM 亚群体。多层次的交叉耻辱加剧了这种差距 BMSM 面孔，包括基于种族、同性吸引力/行为以及假定的 HIV 阳性状况的面孔， 这会导致严重的心理困扰和艾滋病毒预防效果不佳。韧性是关键 减轻多层次交叉耻辱对艾滋病毒预防的负面影响的研究的组成部分 BMSM 的吸收。然而，现有的复原力措施是为非边缘化人群设计的 且不足以评估 BMSM 对多层次交叉耻辱的恢复能力。为了解决这一差距， 我们建议开发一种新颖的、针对 BMSM 的、多维的耻辱弹性量表，该量表可以捕获 细致入微的弹性机制，对抗多个社会生态层面的交叉耻辱。这 拟议的研究将在美国南部的艾滋病毒热点纳什维尔进行，那里的艾滋病毒负担不断增加 BMSM 之间的交叉污名已被识别。该研究有两个具体目标。在目标 1 中，我们 将定义 BMSM 用于对抗交叉耻辱的多维弹性机制。我们 将在概念框架的指导下，对纳什维尔的 30 名 HIV 阴性 BMSM 进行深入访谈 整合了社会生态模型、复原力理论和交叉框架。我们将探讨如何 韧性的发展、表现和实施是为了克服交叉形式（例如，内化的、制定的、 经历过的和预期的）和类型（例如，针对种族主义、同性恋和假定的艾滋病毒状况的耻辱） 跨多个社会生态层面（例如个人、人际、社区和医疗保健）的耻辱。目的 2 将需要一个迭代和系统的 BMSM 社区参与流程来开发和验证 为 BMSM 量身定制的新的多维耻辱弹性测量。目标 1 的见解将有助于告知 调整现有量表（例如，感染艾滋病毒的黑人成人的多级复原力措施） BMSM 适合具体情况且注重耻辱。然后我们将评估表面有效性和文化相关性 通过对 10 名 BMSM 进行认知访谈，然后对 250 名 BMSM 进行心理测量分析， 测试新量表的信度（例如，内部一致性）和效度（例如，收敛性、发散性和预测性） 有效性）。拟议的研究对于提供稳健的、针对文化的污名恢复措施具有重要意义， 这将为我们未来的 R34/R01 研究提供信息，以开发和评估基于复原力的多层次干预措施 减轻 BMSM 之间的交叉耻辱和艾滋病毒预防的接受度。此外，新的 BMSM 多维耻辱-弹性量表将为未来的研究提供基础，以完善和适应 与其他边缘化人群（例如拉丁裔/西班牙裔男男性行为者）进行的以复原力为重点的研究规模； 有色变性女性）。