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

交叉耻辱和社交焦虑在有色人种年轻男性的药物使用和艾滋病毒风险中的作用

• 批准号: 10161369
• 负责人: Jorge Luis Cienfuegos Szalay
• 金额: $ 3.2万
• 依托单位: HUNTER COLLEGE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-16 至 2023-06-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10161369
• 关键词: AIDS prevention; Accounting; Address; Adolescence; Behavior Therapy; Biological; Chronic; Clinical; Color; Complement; Complex; Consumption; Development; Discrimination; Disease; Distress; Exposure to; Face; Fostering; Foundations; Fright; Gender; Goals; HIV; HIV Infections; HIV risk; Health; Health behavior; Heterosexuals; High Prevalence; Individual; Individual Differences; Infection; Investigation; Latino; Literature; Measures; Mediation; Minority; Outcome; Parents; Persons; Play; Predisposition; Prejudice; Prevalence; Prevention; Psychological Theory; Psychologist; Publishing; Reporting; Research; Research Training; Risk; Risk Behaviors; Role; Scientist; Sexuality; Social Anxiety Disorder; Social Change; Social Development; Solid; Statistical Data Interpretation; Stigmatization; Stress; Structure; Substance Use Disorder; Substance abuse problem; Testing; Training; Work; aged; anxious; condomless anal sex; design; diaries; emerging adulthood; expectation; experience; high risk; improved; intersectionality; men; negative affect; non-heterosexual; peer; pressure; preventive intervention; psychologic; psychosocial; public health relevance; sexual minority; skills; social; social anxiety; social culture; social stigma; substance use; theories; transmission process; young man

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.

项目总结/摘要 16-29岁的性少数青年男子感染艾滋病毒的风险增加。YSMM发现 在青少年时期和成年初期，他们自己面临许多身体和心理社会问题， 变化，包括因其性少数群体身份而可能遭受歧视和偏见的经历 (i.e.,少数民族压力）。这些经历反过来可能会增加他们从事负面健康的易感性 使他们处于更高感染艾滋病毒风险的行为，如药物使用和无避孕套的肛交 （CAS）。成人初显期也被发现是报告使用药物最多的时期， 与异性恋同龄人相比，性少数群体使用更多的药物。此外，更高 物质使用水平与更高的CAS参与度有关。然而，尽管少数人强调， 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 与他们的白色同龄人相比，他们经历了更高的感染艾滋病毒的风险，尽管总体报告较少 危险的健康行为。越来越多的文献开始强调交叉性污名--一种 一个人的边缘化身份造成的耻辱-这是造成这种差异的原因。此外，研究 交叉污名与负面健康风险行为之间的潜在机制， 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 符合社交焦虑障碍标准的比例高于异性恋者 同行，少数民族的压力已被假设为是一个驱动程序，这鉴于高度警惕， 这些经历灌输给性少数群体的拒绝期望。然而，无论是流行率和 社交焦虑对黑人和黑人中增加感染艾滋病毒风险的消极健康行为的影响， 拉丁裔YSMM是understudied。因此，建立少数民族压力理论和交叉性框架， 这项多样性-F31研究的主要目标是检查交叉污名之间的关联， 物质使用和CAS在黑人和拉丁裔YSMM中，并评估社交焦虑的作用 在这些协会中，本研究主要有两个目的：（1）研究黑人和拉丁裔YSMM是否 在临床上经历社交焦虑水平升高的人， 交叉污名，物质使用和CAS;（2）检查日常社交焦虑的机械作用 在人的内部水平上，交叉污名的日常经历之间的关联， 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， YSMM（R21-MH 121311，PI：Rendina）的交叉柱头。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还旨在 培养我作为一个健康心理学家和临床科学家的发展，在交叉学科方面有坚实的基础。 耻辱，物质使用，艾滋病毒治疗和预防，以及黑人和拉丁美洲YSMM的社会焦虑。