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

项目摘要/摘要 性和性别少数(SGM)人群的艾滋病毒和其他性传播感染的比率更高， 自杀念头和自杀企图、肥胖、癌症、心理健康差和吸烟，患上自杀的风险增加。 与非SGM人群相比，健康状况较差。然而，如何缓解这些差距，以及 预防尚不清楚，部分原因是在SGM人群中进行的研究在捕获 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 收集并使用能引起特别大会和非特别大会人士共鸣和理解的问题。这个 现有关于准确获取SGM地位的证据缺乏种族/民族多样性，倾向于 白色SGM样品。此外，艾滋病毒的预防和治疗研究工作已演变为针对“关键”的 人群“，如男男性行为者(MSM)和易性女性，他们患上 艾滋病毒的传播和获取。因此，变性女性和男男性接触者可能更熟悉调查 与其他被认为感染艾滋病毒风险较低的SGM个人和群体相比，寻求评估SOGI的问题 (例如，女同性恋者、双性恋者、变性人、非双性恋者)。此外，变性人恐惧症和 同性恋恐惧症通常在艾滋病毒污名的背景下经历并可能导致这种情况，并可能影响 在这种情况下，在艾滋病毒特定环境中感知和捕获SGM状态。种族主义和种族主义的交集 变性人恐惧症和/或同性恋恐惧症会加剧艾滋病毒相关的污名，也会造成测量障碍。 跨美国地区和文化的SGM个人认同方式的差异代表了另一种 在数据收集中捕获准确的SGM状态的障碍。确定区分SGM的最佳方法 在人口研究中，评估这些措施是至关重要的 种族/民族多样化的人口和独特的背景。本补充资料利用了数据和 美国国立卫生研究院资助的两项研究的基础设施(父母资助：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，一项地理和种族/民族多样化的前瞻性队列研究，与人同住或在 艾滋病病毒在美国的风险。本补编的目的是：(1)评估特别报告员的职能和表现 身份筛选问题和SOGI问题设置在种族/民族多元化的美国生活队列中 通过MWCCS感染或感染艾滋病毒的风险；以及(2)确定SGM和非SGM之间的功能和表现 (A)艾滋病毒阴性和艾滋病毒阳性和(B)艾滋病毒特异性和非艾滋病毒特异性研究中的SGM人群 MWCCS、平等身份和差异人口研究(PROID)研究中的环境，以及 健康电子心脏(Heh)研究。本附录的目的与NHLBI的目标一致，即“调查 造成人群健康差异的因素“和NIH SGM高度优先的研究领域。

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.