One Ballroom

摘要 与男性发生性关系的黑人和拉丁美洲跨性别女性和男性-或有色人种的性和性别少数群体 （SGMoC）-占美国所有新艾滋病毒感染的至少一半（美国）。同时也 在接触前预防（PrEP）的知识、获取和使用方面存在显著差异， 与白色男男性接触者和跨性别妇女相比，SGMoC不成比例地低。许多研究表明， SGMoC保护伞下的群体之间的艾滋病毒差异。然而，大多数研究都将经验 基于一个耻辱轴，如同性恋或跨性别身份。交叉的艾滋病毒污名化，或污名化的结果， 多重、交叉的少数民族身份，提供了一个复杂的透镜，可以用来考察 经历了不止一个耻辱轴。SGMoC面临性、性别和种族/族裔少数的污名。 SGMoC与这些交叉的身份面临种族主义，性别歧视，跨性别恐惧症和一系列其他污名， 他们面临着艾滋病毒的高风险，并为艾滋病毒的预防造成障碍。这项研究将包括一项为期3年的深入研究， 纵向定性阶段，12个月的纵向社会流行病学阶段，以及一个密集的 纵向生态瞬时评估阶段。我们建议使用一种创新的、与文化相关的 基于网络的受访者驱动抽样（webRDS）的抽样策略，招募900名在线队列 SGMoC。在线队列将在6个月内完成3次调查评估。200最高风险 队列参与者将参加EMA阶段，以测量交叉HIV的直接背景 污名、艾滋病预防行为和艾滋病风险。这些参与者将获得短暂的随机生态瞬间 每天通过移动的健康应用程序进行评估，持续30天。这项研究不仅将研究 在SGMoC的日常生活背景下，生态瞬时评估阶段还将 为未来开发环境感知、生态瞬时干预以减少交叉HIV提供信息 艾滋病毒的预防和护理工作持续不断地得到优化。

ABSTRACT Black and Latino trans women and men who have sex with men – or sexual and gender minorities of color (SGMoC) - account for at least half of all new HIV infections in the United States (U.S.). At the same time there is a significant disparity in knowledge of, access to and uptake of pre-exposure prophylaxis (PrEP) among SGMoC is disproportionately low compared to white MSM and trans women. Numerous studies have articulated disparities in HIV among groups under the SGMoC umbrella. However, most research aggregates experiences based on one axis of stigma such as gay or trans identity. Intersectional HIV stigma, or stigma as the result of multiple, intersecting minority identities, offer a complex lens in which to examine the multiplicative effect of experiencing more than one axis of stigma. SGMoC face stigma as sexual, gender and racial/ethnic minorities. SGMoC with these intersecting identities face racism, sexism, transphobia and a host of other stigmas that put them at high risk of HIV and create barriers to HIV prevention. This study will include a 3-year in-depth longitudinal qualitative phase, a 12-month longitudinal social epidemiologic phase, and an intensive longitudinal ecological momentary assessment phase. We propose to use an innovative and culturally relevant sampling strategy of web-based respondent driven sampling (webRDS) to recruit an online cohort of 900 SGMoC. The online cohort will complete 3 survey assessments in six-month intervals. The 200 highest risk cohort participants will participate in EMA phase with to measure the immediate context of intersectional HIV stigma, HIV prevention behaviors and HIV risk. These participants will receive short random ecological momentary assessments daily for 30 days via a mobile health application. Not only will this study examine intersectional HIV stigma in context of the daily lives of SGMoC, the ecological momentary assessment phase will also inform future development of a context aware, ecological momentary intervention to reduce intersectional HIV stigma and optimize the HIV prevention and care continua.