Assessing Function and Performance of Population Sexual Orientation and Gender Identity (SOGI) Research Measures in a Racially Diverse HIV-Specific National Cohort

项目概要/摘要 性和性别少数群体（SGM）的艾滋病毒和其他性传播感染率较高， 自杀意念和企图，肥胖，癌症，精神健康状况不佳，吸烟， 与非SGM人群相比，健康状况较差。然而，如何缓解这些差距， 防止是不清楚的，部分原因是SGM人群中的研究在捕获方面遇到了挑战， 性取向和性别认同（SOGI）。这些挑战包括在以下情况下实现准确性的能力 收集并使用能引起SGM和非SGM人员共鸣和理解的问题。的 现有的关于准确获取SGM状态的证据缺乏种族/民族多样性， 白色SGM样品。此外，艾滋病毒预防和治疗的研究工作已经发展到针对"关键"， 人口，"如男性与男性发生性关系的男性（MSM）和变性妇女谁是高风险的， 艾滋病毒的传播和感染。因此，跨性别女性和MSM可能更熟悉调查 寻求评估SOGI比其他SGM个人和群体被认为艾滋病毒风险较低的问题 (e.g.,女同性恋者、双性恋女性、变性男性、非二元人群）。此外，跨性别恐惧症和 同性恋恐惧症往往经历，并可能有助于艾滋病毒的耻辱感的背景下，并可能影响的方式， 其中SGM状态在艾滋病毒特定环境中被感知和捕获。种族主义和 仇视变性者和/或仇视同性恋者会加剧与艾滋病毒有关的耻辱感，也会造成衡量方面的障碍。 SGM个体在美国不同地区和文化中的识别方式的差异代表了另一个 在数据收集中捕获准确SGM状态的障碍。确定区分SGM的最佳方法 在人口研究中，从非SGM人群中分离出人，至关重要的是评估这些措施， 种族/民族多样化的人口和独特的背景。该补充利用了数据， 两项NIH资助研究的基础设施（家长资助：U01HL146242; PI：Tien和R21MD015878; PI： Obedin-Maliver），主要目标是将测量测试扩展到MACS-WIHS组合 队列研究，一项前瞻性队列研究，研究对象为地理位置和种族/族裔不同的个体， 美国艾滋病的风险。本附录的目的是：（1）评估SGM的功能和表现 状态筛选问题和SOGI问题集在一个种族/民族多样化的美国人群中的生活 通过MWCCS确定艾滋病毒感染者或有感染艾滋病毒风险者的功能和表现;以及（2）确定SGM和非SGM之间的功能和表现。 （a）HIV阴性和HIV阳性以及（B）HIV特异性和非HIV特异性研究中的SGM人群 妇女、儿童和社区服务部的《平等认同和差异人口研究》（PRIDE）， health eheart（heh）研究本补充材料的目标与NHLBI的“调查”目标一致 解释人群健康差异的因素”和NIH SGM高优先研究领域。

PROJECT SUMMARY / ABSTRACT Sexual and gender minority (SGM) people have higher rates of HIV and other sexually transmitted infections, suicidal ideation and attempts, obesity, cancer, poor mental health, and smoking and are at increased risk for poor health outcomes compared to non-SGM people. Yet how these disparities might be mitigated and prevented is unclear, in part because research among SGM populations suffers from challenges in capturing sexual orientation and gender identity (SOGI). These challenges include the ability to achieve accuracy when collected and to use questions that resonate and are understood by both SGM and non-SGM people. The existing evidence on accurately capturing SGM status lacks racial/ethnic diversity and skews toward mostly white SGM samples. Further, HIV prevention and treatment research efforts have evolved to target “key populations,” such as men who have sex with men (MSM) and transgender women who are at elevated risk for HIV transmission and acquisition. Transgender women and MSM, therefore, may be more familiar with survey questions that seek to assess SOGI than other SGM individuals and groups considered less at risk for HIV (e.g., lesbians, bisexual women, transgender men, non-binary people). Additionally, transphobia and homophobia are often experienced in and can contribute to a context of HIV stigma and may impact the ways in which SGM status is perceived and captured in HIV-specific settings. The intersections of racism and transphobia and/or homophobia can exacerbate HIV-related stigma, also contributing to measurement hurdles. Differences in the ways in which SGM individuals identify across US regions and cultures represent another barrier to capturing accurate SGM status in data collection. To determine the best way to differentiate SGM people from non-SGM people in population research, it is essential to assess such measures in racially/ethnically diverse populations and unique contexts. This supplement leverages the data and infrastructure of two NIH-funded studies (parent grant: U01HL146242; PI: Tien and R21MD015878; PI: Obedin-Maliver) with the primary goal of expanding measurement testing to the MACS-WIHS Combined Cohort Study, a prospective cohort of geographically and racially/ethnically diverse individuals living with or at risk of HIV in the US. This supplement's aims are to: (1) Assess the function and performance of an SGM status screening question and SOGI question sets in a racially/ethnically diverse US cohort of people living with or at risk for HIV via the MWCCS; and (2) Determine the function and performance among SGM and non- SGM people who are (a) HIV-negative and HIV-positive and (b) in HIV-specific and non-HIV-specific study settings in the MWCCS, The Population Research in Identities and Disparities for Equality (PRIDE) Study, and the Health eHeart (HeH) Study. The aims of this supplement are aligned with NHLBI's objective to “investigate factors that account for differences in health among populations” and NIH SGM high priority research areas.