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

项目总结： 年轻的男同性恋者、双性恋者和其他男男性接触者(MSM)感染艾滋病毒的比例更高。 尽管有这种负担，大多数艾滋病毒预防干预措施都是针对成年男男性接触者(他们中的大多数人认为是同性恋)和 异性恋青年，迫切需要对同性恋和双性恋青少年进行干预。更进一步，自我-- 被确认为双性恋的男性，特别是青少年，在研究中被忽视了。这是一个严重的问题 因为：(1)如果不是更多，也是一样多的双性恋青春期男性；(2)双性恋者 青少年男性比他们的同性恋同龄人更多地从事几种艾滋病毒危险行为；(3)双性恋青少年男性 吸食药物的风险增加--这是艾滋病毒的一个重要风险因素；以及(4)双性恋男子面临独特的艾滋病毒 预防问题。鉴于双性恋男性很少被包括在研究和大多数现有的关于双性恋男性的研究中 主要研究“行为上的双性恋”成年男性，对危险行为的驱动因素知之甚少。 在自认为是双性恋的青春期男性中。关注双性恋身份对于减少艾滋病毒和 物质使用，因为双性恋是高度污名化的和与污名相关的压力源(例如，对 透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。 如果针对人群量身定做干预措施也会更有效，这强调了干预的必要性 自认是双性恋的青春期男性。本研究的目标是：(1)考察推动敬业度的因素 在自我认同的双性恋青春期男性中的艾滋病毒危险行为和物质使用方面；和(2)发展和试点 为这一人群测试量身定制的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14-17岁不同的自我认同的双性恋青少年男性进行了调查，重点是性别认同、性 决策、物质使用动机和干预偏好/障碍。在第二阶段，一个定制的 将使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 疗效将在试验性随机试验(N=60)中进行测试，并进行等待名单对照和一个月的随访。这 该奖项将为申请者提供有关青少年健康、定性方法和 西北大学性与性别少数民族健康研究所的干预研究进展 福祉--为培训性和性别少数群体学者提供了一个资源丰富、知识丰富的环境 健康研究。培训和研究活动将有助于申请者过渡到独立的 调查员，有一个研究计划，重点是了解和消除艾滋病毒和药物使用 影响双性恋男性的差异。总而言之，自我认同的双性恋青春期男性感染艾滋病毒的风险增加 和物质使用，但对驱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春期男性--一个代表性不足、健康差距很大的人群--这项研究可以确定 实现预防目标，减少艾滋病毒和药物使用方面的差距。

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.