Understanding and reducing HIV risk behavior and substance use among self-identified bisexual adolescent men

了解并减少自我认同的双性恋青少年男性的艾滋病毒危险行为和药物使用

• 批准号: 10296548
• 负责人: Brian Feinstein
• 金额: $ 7.13万
• 依托单位: ROSALIND FRANKLIN UNIV OF MEDICINE & SCI
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-11-03 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10296548
• 关键词: Understanding; reducing; HIV; risk; behavior

Project Summary: Young gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. Despite this burden, most HIV prevention interventions target adult MSM (most of whom identify as gay) and heterosexual youth, creating an urgent need for interventions for gay and bisexual adolescents. Further, self- identified bisexual men, especially adolescents, have been neglected in research. This is a critical problem because: (1) there are as many, if not more, bisexual adolescent men than gay adolescent men; (2) bisexual adolescent men engage in several HIV risk behaviors more than their gay peers; (3) bisexual adolescent men are at increased risk for substance use–a robust risk factor for HIV; and (4) bisexual men face unique HIV prevention issues. Given that bisexual men are rarely included in research and most existing research on them focuses on “behaviorally bisexual” adult men, little is known about factors that drive engagement in risk behavior among self-identified bisexual adolescent men. Attending to bisexual identity is critical to reducing HIV and substance use, because bisexuality is highly stigmatized and stigma-related stressors (e.g., concerns about disclosing one’s bisexual identity) impact sexual behavior, substance use, and healthcare utilization. Interventions are also more effective when tailored to populations, underscoring the need for an intervention for self-identified bisexual adolescent men. The goals of this study are to: (1) examine factors that drive engagement in HIV risk behavior and substance use among self-identified bisexual adolescent men; and (2) develop and pilot test a tailored HIV and substance use prevention intervention for this population. In Phase 1, interviews will be conducted with 60 diverse self-identified bisexual adolescent men ages 14-17 focused on sexual identity, sexual decision-making, substance use motivations, and intervention preferences/barriers. In Phase 2, a tailored intervention will be developed using findings from Phase 1. In Phase 3, feasibility, acceptability, and preliminary efficacy will be tested in a pilot randomized trial (N = 60) with a waitlist control and one-month follow-up. This award will provide the applicant with career development training in adolescent health, qualitative methods, and intervention development at Northwestern University’s Institute for Sexual and Gender Minority Health and Wellbeing–a well-resourced, rich intellectual environment for training scholars in sexual and gender minority health research. The training and research activities will facilitate the applicant’s transition to an independent investigator with a program of research focused on understanding and eliminating HIV and substance use disparities affecting bisexual men. In sum, self-identified bisexual adolescent men are at increased risk for HIV and substance use, but little is known about factors that drive their engagement in risk behavior. By focusing on self-identified bisexual adolescent men–an underrepresented, health disparity population–this study can identify prevention targets and reduce disparities in HIV and substance use.

项目概要： 年轻同性恋、双性恋和其他男男性行为者 (MSM) 感染艾滋病毒的比例尤其高。 尽管有这样的负担，大多数艾滋病毒预防干预措施还是针对成年男男性接触者（其中大多数人被认为是同性恋）和 异性恋青少年，迫切需要对同性恋和双性恋青少年进行干预。此外，自 已确定的双性恋男性，尤其是青少年，在研究中被忽视了。这是一个关键问题 因为：（1）双性恋青少年男性的数量与男同性恋青少年男性一样多，甚至更多； (2) 双性恋 青少年男性比同性恋同龄人更多地从事几种艾滋病毒危险行为； (3) 双性恋青春期男性 物质使用的风险增加——这是艾滋病毒的一个重要危险因素； (4) 双性恋男性面临独特的艾滋病毒 预防问题。鉴于双性恋男性很少被纳入研究中，而且大多数现有研究都针对他们 关注“行为双性恋”的成年男性，但人们对推动危险行为的因素知之甚少 在自我认同的双性恋青少年男性中。关注双性恋身份对于减少艾滋病毒和 物质使用，因为双性恋受到高度污名和与污名相关的压力源（例如，对双性恋的担忧） 披露自己的双性恋身份）会影响性行为、物质使用和医疗保健利用。 针对人群制定干预措施也会更加有效，这凸显了干预措施的必要性 自我认同为双性恋的青少年男性。本研究的目标是：(1) 研究推动参与度的因素 自我认同的双性恋青少年男性的艾滋病毒风险行为和药物使用； (2) 开发和试点 测试针对该人群的定制艾滋病毒和药物使用预防干预措施。在第一阶段，面试将是 对 60 名年龄在 14-17 岁之间、自我认同不同的双性恋青少年男性进行了调查，重点关注性别认同、性行为 决策、物质使用动机和干预偏好/障碍。在第二阶段，量身定制 将利用第一阶段的调查结果制定干预措施。在第三阶段，可行性、可接受性和初步 疗效将通过一项试点随机试验（N = 60）进行测试，并进行候补对照和一个月的随访。这 该奖项将为申请人提供青少年健康、定性方法和职业发展方面的培训 西北大学性与性别少数健康研究所的干预发展 福祉——为培养性少数群体学者提供资源充足、丰富的智力环境 健康研究。培训和研究活动将有助于申请人过渡到独立 研究员，其研究计划的重点是了解和消除艾滋病毒和药物滥用 影响双性恋男性的差异。总之，自我认同的双性恋青少年男性感染艾滋病毒的风险增加 和物质使用，但人们对推动他们从事危险行为的因素知之甚少。通过专注于 自我认同的双性恋青少年男性——代表性不足、健康差异的人群——这项研究可以识别 预防目标并减少艾滋病毒和药物使用方面的差异。