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Structural Stigma and HIV Prevention Outcomes

结构性耻辱和艾滋病毒预防成果

基本信息

批准号：
10300578
负责人：
Brian Mark Dodge
金额：
$ 47.46万
依托单位：
HARVARD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-07-19 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10300578
关键词：
AIDS prevention AIDS/HIV problem Address Affect Area Attention Attitude Bisexual Buffers Cognitive Communities Data Data Collection Development Diagnosis Discrimination Environment Fright Funding Gays General Population Goals HIV HIV Infections HIV risk Health Health behavior Homosexuality Human immunodeficiency virus test Incidence Individual Institutional Policy Intervention Interview Knowledge Laws Lesbian Gay Bisexual Measures Mediating Mediator of activation protein Mentored Research Scientist Development Award Methodology Methods Minority Outcome Participant Pathway interactions Personal Satisfaction Phase Policies Population Prevention Prevention strategy Process Prophylactic treatment Prospective Studies Psyche structure Public Health Qualitative Research Research Research Personnel Research Priority Resources Risk Risk Factors Safe Sex Sampling Self Efficacy Services Sex Orientation Sexual Health Sexuality Social Conditions Social Environment Social support Stigmatization Stress Structure Surveys United States United States National Institutes of Health Unsafe Sex Update Variant behavioral health cohort condomless anal sex depressive symptoms design disparity reduction family support indexing informant insight men men who have sex with men novel pre-exposure prophylaxis preventive intervention prospective resilience secondary outcome sexual identity sexual risk behavior social social determinants social stigma substance use transmission process

项目摘要

PROJECT SUMMARY Gay and bisexual men (GBM), and other men who have sex with men (MSM), represent the largest group of individuals infected with HIV in the U.S. At current rates, 1 in 6 MSM will be diagnosed with HIV in their lifetime. Extant research has largely focused on identifying individual- and interpersonal-level risk factors for HIV infection among GBM; however, accumulating evidence also points to structural determinants of HIV outcomes in this population. In particular, recent research has demonstrated that structural stigma—defined as societal- level conditions, cultural norms, and institutional policies that constrain the resources and opportunities of stigmatized individuals—is associated with adverse health outcomes, including HIV risk, among GBM. For example, pilot data from our research group showed that 4,098 GBM living in states with high levels of structural stigma—measured with a composite index of discriminatory state laws and negative social attitudes towards homosexuality—had lower levels of post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) knowledge and use, lower odds of HIV testing, and greater odds of condomless anal sex compared with those living in low structural stigma states. While promising, the few existing studies of structural stigma and HIV outcomes among GBM have been limited by a reliance on cross-sectional designs, a small number of structural covariates, little attention to mediators/moderators of the structural stigma-HIV risk association, and non-probability samples of GBM. To address these limitations, we will create a new, prospective, nationally representative study of HIV-uninfected/unknown status GBM who will be followed for 5 waves of data collection over a 24-month period (N=500). With a representative sample of participants from across the U.S., we will have substantial variation in the social context surrounding GBM. This will be the first and largest prospective study with a nationally representative sample of GBM specifically designed to: (1) examine whether structural forms of stigma related to sexual identity increase vulnerability to adverse HIV prevention outcomes (e.g., less HIV testing and PEP/PrEP use); (2) identify mutable mechanisms (e.g., self-stigma, depressive symptoms, safer-sex self efficacy) through which structural stigma influences HIV outcomes; and (3) evaluate resilience processes (e.g., LGB community connectedness) that may mitigate the negative effects of structural stigma on HIV outcomes. In the final phase of the project, we will conduct qualitative interviews with 30 key informants and 30 GBM. We will use data from these interviews, together with the quantitative results, to inform the development of multi-level HIV intervention strategies that are maximally responsive to the structural conditions in which GBM are embedded. We have assembled a team of experts in structural stigma, HIV prevention among GBM, qualitative research, and survey research with nationally representative samples to address our study aims. This project stands to make important contributions to research on reducing disparities in the incidence of HIV infections among GBM, identified as a high NIH HIV/AIDS research priority.

项目总结

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

A Contextual Approach to the Psychological Study of Identity Concealment: Examining Direct, Interactive, and Indirect Effects of Structural Stigma on Concealment Motivation Across Proximal and Distal Geographic Levels.

身份隐藏心理学研究的情境方法：检验结构耻辱对近端和远端地理层面的隐藏动机的直接、交互和间接影响。

DOI：
10.1177/09567976211018624
发表时间：
2021
期刊：
Psychological science
影响因子：
8.2
作者：
Lattanner,MicahR;Ford,Jessie;Bo,Na;Tu,Wanzhu;Pachankis,JohnE;Dodge,Brian;Hatzenbuehler,MarkL
通讯作者：
Hatzenbuehler,MarkL

Incorporating macro-social contexts into emotion research: Longitudinal associations between structural stigma and emotion processes among gay and bisexual men.

将宏观社会背景纳入情感研究：同性恋和双性恋男性的结构耻辱与情感过程之间的纵向关联。