Developing and Validating New Measures of Multilevel Intersectional Stigma to Improve the HIV Prevention Continuum for Young Black Gay Bisexual and Other Men who Have Sex with Men in the South

制定和验证多层次交叉耻辱的新措施，以改善南方年轻黑人同性恋双性恋和其他男男性行为者的艾滋病毒预防连续性

• 批准号: 10599709
• 负责人: Ingrid Alisa Bowleg
• 金额: $ 21.81万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10599709
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Age; Award; Bisexual; Black race; COVID-19; COVID-19 pandemic effects; Censuses; Church; Cities; Communities; Data; Development; Discrimination; Ecology; Epidemic; Funding; Future; Gays; Gender; Group Structure; HIV; HIV Seronegativity; HIV diagnosis; HIV risk; Health; Heterosexuals; Human immunodeficiency virus test; Incidence; Individual; Interview; Knowledge; Laws; Literature; Maps; Measures; Methodology; Methods; National Institute of Mental Health; National Institute on Minority Health and Health Disparities; Outcome; Parents; Participant; Patient Self-Report; Phase; Policies; Population; Positioning Attribute; Poverty; Prevention Research; Property; Psychometrics; Race; Religion and Spirituality; Research; Sampling; Self Assessment; Sexual and Gender Minorities; Social Processes; Stigmatization; Surveys; Validation; Visualization; Washington; Woman; base; cognitive interview; data space; design; experience; follow-up; improved; innovation; intersectionality; member; men; men who have sex with men; multidisciplinary; pre-exposure prophylaxis; preventive intervention; programs; recruit; sexual minority; social; social media; social stigma; social structure; sociodemographics

PROJECT SUMMARY/ABSTRACT The disproportionate impact of the HIV/AIDS epidemic among U.S. Black gay, bisexual, and other men who have sex with men (GBMSM) is staggering, especially among young Black GBMSM who live in the South. Black GBMSM between ages 13 to 34 and those who live in the South accounted for 75% and 63% of HIV diagnoses among Black GBMSM in 2016, respectively. Most conceptualizations of intersectional stigma have been almost exclusively individualistic. Consequently, substantial gaps exist about how multilevel intersectional stigma — individual (e.g., internalized HIV stigma, interpersonal discrimination), community (e.g., anti-gay stigma at church) and social-structural (e.g., criminal HIV exposure laws) — interconnects to hinder HIV testing and PrEP use for young Black GBMSM in the South. There is also a dearth of validated measures of multilevel intersectional stigma for HIV prevention research. To address these critical empirical gaps, a longitudinal exploratory-sequential mixed methods study (QUAL  QUANT) is proposed to refine and validate the Multilevel Intersectional Stigma Measure developed during Phase I of the parent study for young Black GBMSM in two high HIV incidence southern cities: Washington, DC and Jackson, MS. Purposive sampling will be used to recruit 150 HIV-negative young Black GBMSM, ages 15 to 34. Phase I, completed during the original funding period of the parent study, involved: (1) literature and policy reviews to identify existing measures of intersectional stigma and stigma-related laws and policies; (2) 60 in-depth individual interviews (30/city) to gain a rich and contextually-grounded understanding of multilevel intersectional stigma; and (3) content validity assessments of the self-report measures by expert judges (n = 5 to 7) and Community Advisory Board (CAB) members (n = 24; 2 CABs/city). Phase II and III in the proposed supplement remain unchanged from the parent study. Phase II involves: (1) cognitive interviews with 20 participants (10/city) to refine the self-report measures; and (2) baseline and 3-month follow-up surveys of 130 participants (65/city) for psychometric analyses. Phase III involves the synthesis of the qualitative and quantitative results and validity assessments of the synthesized results with CAB members in each city. The significance of the parent study lies in the development of new Multilevel Intersectional Stigma measures and the proposed supplement will facilitate the completion of the psychometric assessment and validation of the measures as planned despite the project experiencing COVID-19 related delays. The study makes an innovative multilevel paradigmatic shift from the status quo with its theoretical and methodological fidelity to intersectionality’s core tenets. The expected outcome is the development of new self-report and objective/non-self-report measures of multilevel intersectional stigma that reflect the “specific and particular” experiences of young Black GBMSM who live in two distinct southern cities. These measures will inform future HIV prevention research and interventions to improve the HIV prevention continuum for young Black GBMSM in the South.

项目摘要/摘要 艾滋病毒/艾滋病流行的美国黑人同性恋，双性恋和其他男人的影响不成比例 与男人发生性关系（GBMSM）令人震惊，尤其是在居住在南部的年轻黑人GBMSM中。 13至34岁的黑色GBMSM和居住在南方的黑人GBMSM占艾滋病毒的75％和63％ 2016年黑色GBMSM的诊断。交叉污名的大多数概念都有 几乎是个人主义的。因此，关于多级交叉的存在很大的差距 污名 - 个人（例如，内在的HIV污名，人际歧视），社区（例如，反同性恋 教会的污名和社会结构（例如刑事艾滋病毒暴露法） - 互连以阻碍艾滋病毒测试 并准备南部的年轻黑色GBMSM。也有验证的多级措施死亡 艾滋病毒预防研究的交叉污名。为了解决这些关键的经验差距，纵向 提出了探索性序列的混合方法研究（质量量）来完善和验证 在父母研究期间，年轻黑人的I阶段开发了多级交叉污名测量 在两个高艾滋病毒事件中，GBMSM南部城市：华盛顿特区和杰克逊，硕士。有目的的抽样 用于招募15至34岁的15至34岁的150名HIV阴性的年轻黑色GBMSM。 父母研究的原始资金期，涉及：（1）文献和政策评论以确定现有 交叉污名和与污名相关的法律和政策的度量； （2）60个深入的个人访谈 （30/City），以获得对多层次交叉污名的丰富和上下文的理解； （3） 专家法官（n = 5至7）和社区对自我报告措施的内容有效性评估 顾问委员会（CAB）成员（n = 24; 2个出租车/城市）。拟议的补充剂中的第二阶段和III仍然存在 与父母研究没有变化。第二阶段涉及：（1）与20名参与者（10/城市）的认知访谈 完善自我报告措施； （2）130名参与者（65/城市）的基线和3个月的随访调查 心理测量分析。第三阶段涉及定性和定量结果的合成和有效性 在每个城市中与CAB会员的合成结果评估。父母研究的意义 在于开发新的多层交叉污名测量值和拟议的补充剂 有助于完成心理测量评估和验证这些措施作为计划的目的地 经历了COVID-19的项目相关延迟。这项研究使创新的多层次范式转变 从现状及其理论和方法论忠诚度到交叉性的核心宗旨。这 预期的结果是开发新的自我报告和客观/非自我报告多级别的措施 居住在中的年轻黑人GBMSM的“特定和特殊”经历 两个不同的南部城市。这些措施将为未来的HIV预防研究和干预措施提供信息 改善南部年轻的黑色GBMSM的艾滋病毒预防连续性。