The Role of Intersectional Stigma and Social Anxiety in Substance Use and HIV Risk for Young Men of Color

项目摘要/摘要 16-29岁的年轻的性少数族裔男子感染艾滋病毒的风险增加。YSMM发现 他们自己在青春期和成年初期面临着许多生理和心理方面的问题 变化，包括可能因其性别少数身份而受到歧视和偏见的经历 (即，少数族裔压力)。这些经历反过来可能会增加他们从事负面健康的易感性。 使他们感染艾滋病毒的风险更高的行为，如吸毒和无套肛交 (CAS)。初成年也被发现是药物使用率最高的时期，而且 与他们的异性恋同龄人相比，性少数群体使用更多的物质。此外，更高的 物质使用水平与CAS中更高的参与度相关。然而，在少数族裔压力的同时， 已经被用来理解这些差异，这本身并不能解释为什么黑人和拉丁裔YSMM 与白人同龄人相比，尽管总体报告较少，但感染艾滋病毒的风险更高 危险的健康行为。越来越多的文学作品开始强调跨界别的污名--一种 一个人相互关联的边缘化身份造成的耻辱--这是造成这种差异的一个原因。此外，研究 关于跨部门污名和负面健康危险行为之间的潜在机制是 研究不足，但实证研究表明，社交焦虑可能在这种联系中发挥作用。性少数群体 被发现符合社交焦虑症标准的比例高于他们的异性恋者 而少数族裔的压力被认为是这种情况的驱动因素，因为他们高度警惕和 对拒绝的期望这些经历灌输给性少数群体。然而，无论是流行率还是 社交焦虑对黑人和黑人中增加HIV感染风险的负面健康行为的影响 拉丁裔YSMM研究不足。因此，在少数派压力理论和交叉性框架的基础上， 这项多样性-F31研究的主要目标是检查跨部门污名之间的联系， 黑人和拉丁裔YSMM中的物质使用和CAS，并评估社交焦虑的作用 这些关联中的症状学。这项研究主要集中在两个目标上：(1)考察黑人和拉丁裔YSMM 经历临床社交焦虑水平升高的人在以下经历之间有更强的关联性 交叉污名、物质使用和CAS；以及(2)检验日常社交焦虑的机械性作用 在人内层面上的症状学在日常经历的交叉耻辱之间的联系， 物质使用和CAS。拟议的项目将被嵌入到一个更大的每日日记研究中 YSMM(R21-MH121311，PI：Rendina)间柱头相交。拟议的项目将每天增加 社交焦虑的衡量标准。为该项目提出的研究和培训计划也旨在 培养我作为一名健康心理学家和临床科学家的发展，并在交叉学科方面打下坚实的基础 黑人和拉丁裔基督教青年会中的污名、药物使用、艾滋病毒治疗和预防以及社交焦虑。

PROJECT SUMMARY/ABSTRACT Young sexual minority men (YSMM) aged 16-29 are at increased risk of acquiring HIV. YSMM who find themselves in the period of adolescence and emerging adulthood face many physical and psychosocial changes, including potential experiences of discrimination and prejudice due to their sexual minority identity (i.e., minority stress). These experiences in turn may increase their susceptibility to engage in negative health behaviors that place them at higher risk of acquiring HIV, such as substance use and condomless anal sex (CAS). Emerging adulthood has also been found to be the period with the highest reported substance use, and sexual minorities engage in more substance use compared to their heterosexual peers. Furthermore, higher levels of substance use have been associated with higher engagement in CAS. However, while minority stress has been used to understand these disparities, this alone does not explain why Black and Latino YSMM experience an even higher risk of acquiring HIV compared to their White peers despite reporting overall less risky health behaviors. A growing body of literature has begun to highlight intersectional stigma–a form of stigma caused by one's interlocking marginalized identities–as a cause for this disparity. Additionally, research on the underlying mechanisms between intersectional stigma and negative health risk behaviors are understudied, but empirical work suggests social anxiety may play a role in this association. Sexual minorities have been found to meet criteria for social anxiety disorder at higher rates than their heterosexual counterparts, and minority stress has been hypothesized to be a driver of this given the hypervigilance and expectations of rejection these experiences instill on sexual minorities. However, both the prevalence and effects of social anxiety on the negative health behaviors that increase risk of acquiring HIV among Black and Latino YSMM are understudied. Therefore, building off minority stress theory and intersectionality framework, the primary goal of this Diversity-F31 study is to examine the association between intersectional stigma, substance use, and CAS among Black and Latino YSMM, and assess for the role of social anxiety symptomology in these associations. The study focuses on two aims: (1) examine if Black and Latino YSMM who experience clinically elevated levels of social anxiety have stronger associations between experiences of intersectional stigma, substance use, and CAS; and (2) examine the mechanistic role of daily socially anxious symptomology at the within-person level in the association between daily experiences of intersectional stigma, substance use, and CAS. The proposed project will be embedded into a larger daily diary study of intersectional stigma among YSMM (R21-MH121311, PI: Rendina). The proposed project will add daily measures of social anxiety. The research and training plans proposed for this project are also designed to foster my development as a health psychologist and clinical scientist with a solid foundation in intersectional stigma, substance use, HIV treatment and prevention, and social anxiety among Black and Latino YSMM.