"Stay strong! keep ya head up! move on! it gets better!!!!": resilience processes in the healthMpowerment online intervention of young black gay, bisexual and other men who have sex with men
"Stay strong! keep ya head up! move on! it gets better!!!!": resilience processes in the healthMpowerment online intervention of young black gay, bisexual and other men who have sex with men
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DOI：
10.1080/09540121.2018.1510106
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发表时间：
2018-08-23
影响因子：
1.7
通讯作者：
Muessig, Kathryn E.
中科院分区：
文献类型：
--
作者：
Barry, Megan C.;Threats, Megan;Muessig, Kathryn E.
与性少数群体、种族/族裔和艾滋病毒状况有关的相互重叠的污名构成了艾滋病毒预防和护理的障碍，也阻碍了为年轻人、黑人、同性恋者、双性恋者和其他男男性行为者建立支持性社交网络。基于风险的艾滋病毒流行病防治办法侧重于所缺乏的东西，并强化了对已被边缘化的人口的负面定型观念。相比之下，基于优势的方法建立在黑人GBMSM现有优势的基础上，认识到他们克服艾滋病毒预防和护理障碍的显着方式。健康赋权（HMP）是一个在线的，移动的手机优化干预，旨在减少无套肛交和促进年轻的黑人GBMSM（18-30岁）的社区。应用弹性框架，我们分析了48名HMP参与者（22/48艾滋病毒感染者）在干预网站上提供的322次对话。这些对话提供了一个独特的机会，观察和分析动态的，人际弹性的过程中共享的耻辱，歧视，年轻的黑人GBMSM经历的生活挑战。我们利用现有的框架与四个弹性过程，并确定了新的子主题，显示在这些在线互动：（1）交换社会支持发生通过分享情感和信息的支持。(2)参与促进健康的认知过程表现为重构、自我接纳、认可积极的前景、代理和对结果负责。(3)制定健康的行为规范集中在性行为阳性规范的建模，减少感染或传播艾滋病毒的风险，以及与艾滋病毒一起生活。(4)最后，通过树立榜样、促进自我宣传和提供鼓励，赋予其他同性恋和双性恋青年权力。未来的在线干预措施可以通过故意建立在黑GBMSM现有的弹性过程中，在艾滋病毒预防和护理方面推进基于优势的方法。在线空间的可访问性和匿名性可能提供了一个特别强大的干预模式，以放大年轻的黑人GBMSM的弹性。
Overlapping stigmas related to sexual minority-, race/ethnicity-, and HIV-status pose barriers to HIV prevention and care and the creation of supportive social networks for young, Black, gay, bisexual, and other men who have sex with men (GBMSM). A risk-based approach to addressing the HIV epidemic focuses on what is lacking and reinforces negative stereotypes about already-marginalized populations. In contrast, a strengths-based approach builds on Black GBMSM's existing strengths, recognizing the remarkable ways in which they are overcoming barriers to HIV prevention and care. HealthMpowerment (HMP) is an online, mobile phone optimized intervention that aimed to reduce condomless anal intercourse and foster community among young Black GBMSM (age 18-30). Applying a resilience framework, we analyzed 322 conversations contributed by 48 HMP participants (22/48 living with HIV) on the intervention website. These conversations provided a unique opportunity to observe and analyze dynamic, interpersonal resilience processes shared in response to stigma, discrimination, and life challenges experienced by young Black GBMSM. We utilized an existing framework with four resilience processes and identified new subthemes that were displayed in these online interactions: (1) Exchanging social support occurred through sharing emotional and informational support. (2) Engaging in health-promoting cognitive processes appeared as reframing, self-acceptance, endorsing a positive outlook, and agency and taking responsibility for outcomes. (3) Enacting healthy behavioral practices clustered into modeling sex-positive norms, reducing the risk of acquiring or transmitting HIV, and living well with HIV. (4) Finally, empowering other gay and bisexual youth occurred through role modeling, promoting self-advocacy, and providing encouragement. Future online interventions could advance strengths-based approaches within HIV prevention and care by intentionally building on Black GBMSM's existing resilience processes. The accessibility and anonymity of online spaces may provide a particularly powerful intervention modality for amplifying resilience among young Black GBMSM.