One Ballroom: Understanding Intersectional Stigma to Optimize the HIV Prevention Continuum among Vulnerable Populations in the United States

一间舞厅：了解交叉耻辱以优化美国弱势群体的艾滋病毒预防连续性

• 批准号: 10729776
• 负责人: Sean Arayasirikul
• 金额: $ 42.07万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10729776
• 关键词: AIDS prevention; Address; Age; Articulation; Awareness; Behavior; Behavioral Sciences; Black race; Capital; Caring; Color; Communities; Complex; Data; Development; Disparity; Ecological momentary assessment; Epidemic; Ethnic Origin; Face; Future; Gays; Gender Identity; Geography; HIV; HIV Infections; HIV risk; Homophobia; Incidence; Infection; Intervention; Knowledge; Latina; Latino; Link; Measures; Methodology; Methods; Minority; Mobile Health Application; Online Systems; Outcome; Participant; Pathway interactions; Phase; Population; Population Study; Populations at Risk; Prevalence; Prevention; Preventive; Process; Race; Research; Research Personnel; Respondent; Risk; Risk Behaviors; Sampling; San Francisco; Sex Orientation; Sexism; Sexual and Gender Minorities; Societies; Surveys; Time; Transcend; Typology; United States; Vulnerable Populations; Work; black men who have sex with men; care outcomes; cis-male; cohort; ethnic minority; experience; gender minority; high risk; innovation; intersectionality; lens; mHealth; member; men who have sex with men; method development; population health; pre-exposure prophylaxis; programs; racial minority; racism; recruit; resilience; response; sexual identity; sexual minority; social; social epidemiology; social stigma; therapy development; transgender men; transgender women; transphobia; uptake; women of color

ABSTRACT Black and Latino trans women and men who have sex with men – or sexual and gender minorities of color (SGMoC) - account for at least half of all new HIV infections in the United States (U.S.). At the same time there is a significant disparity in knowledge of, access to and uptake of pre-exposure prophylaxis (PrEP) among SGMoC is disproportionately low compared to white MSM and trans women. Numerous studies have articulated disparities in HIV among groups under the SGMoC umbrella. However, most research aggregates experiences based on one axis of stigma such as gay or trans identity. Intersectional HIV stigma, or stigma as the result of multiple, intersecting minority identities, offer a complex lens in which to examine the multiplicative effect of experiencing more than one axis of stigma. SGMoC face stigma as sexual, gender and racial/ethnic minorities. SGMoC with these intersecting identities face racism, sexism, transphobia and a host of other stigmas that put them at high risk of HIV and create barriers to HIV prevention. This study will include a 3-year in-depth longitudinal qualitative phase, a 12-month longitudinal social epidemiologic phase, and an intensive longitudinal ecological momentary assessment phase. We propose to use an innovative and culturally relevant sampling strategy of web-based respondent driven sampling (webRDS) to recruit an online cohort of 900 SGMoC. The online cohort will complete 3 survey assessments in six-month intervals. The 200 highest risk cohort participants will participate in EMA phase with to measure the immediate context of intersectional HIV stigma, HIV prevention behaviors and HIV risk. These participants will receive short random ecological momentary assessments daily for 30 days via a mobile health application. Not only will this study examine intersectional HIV stigma in context of the daily lives of SGMoC, the ecological momentary assessment phase will also inform future development of a context aware, ecological momentary intervention to reduce intersectional HIV stigma and optimize the HIV prevention and care continua.

抽象的 与男性发生性关系的黑人和拉丁裔跨性别女性和男性——或有色人种的性少数群体和性别少数群体 (SGMoC) - 至少占美国所有新增艾滋病毒感染者的一半。 不同人群在接触前预防 (PrEP) 的知识、获取和采用方面存在显着差异 许多研究表明，与白人男男性接触者和跨性别女性相比，SGMoC 的比例要低得多。 SGMoC 保护下的群体之间的艾滋病毒差异 然而，大多数研究都汇总了经验。 基于一个耻辱轴，例如同性恋或跨性别者身份的交叉耻辱，或由于艾滋病毒而产生的耻辱。 多重、交叉的少数群体身份，提供了一个复杂的视角来检验 SGMoC 面临着作为性、性别和种族/族裔少数群体的耻辱。 具有这些交叉身份的SGMoC面临着种族主义、性别歧视、跨性别者恐惧症和许多其他耻辱， 这项研究将包括为期 3 年的深入研究。 纵向定性阶段、12 个月纵向社会流行病学阶段和强化阶段 我们建议采用创新且与文化相关的纵向生态瞬时评估阶段。 基于网络的参与者驱动抽样 (webRDS) 的抽样策略，以招募 900 名在线队列 SGMoC。在线队列将每六个月完成 3 次调查评估 200 个最高风险。 队列参与者将参加 EMA 阶段，以衡量交叉 HIV 的直接背景 这些参与者将接受短暂的随机生态瞬时体验。 通过移动健康应用程序进行为期 30 天的每日评估 这项研究不仅会检查交叉性。 SGMoC日常生活背景下的艾滋病毒耻辱，生态瞬时评估阶段也将 为未来发展环境意识、生态瞬时干预措施提供信息，以减少交叉艾滋病毒 耻辱并优化艾滋病毒预防和护理连续性。