The Role of Intersectional Stigma and Social Anxiety in Substance Use and HIV Risk for Young Men of Color

交叉耻辱和社交焦虑在有色人种年轻男性的药物使用和艾滋病毒风险中的作用

• 批准号: 10436821
• 负责人: Jorge Luis Cienfuegos Szalay
• 金额: $ 0.53万
• 依托单位: HUNTER COLLEGE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-16 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10436821
• 关键词: AIDS prevention; Accounting; Address; Adolescence; Behavior Therapy; Biological; Black race; Chronic; Clinical; Complement; Complex; Consumption; Development; Discrimination; Disease; Distress; Exposure to; Face; Fostering; Foundations; Fright; Gender; Goals; HIV; HIV Infections; HIV risk; Health; Health behavior; Heterosexuals; High Prevalence; Individual; Individual Differences; Infection; Investigation; Latino; Literature; Measures; Mediation; Outcome; Parents; Persons; Play; Predisposition; Prejudice; Prevalence; Prevention; Psychological Theory; Psychologist; Publishing; Reporting; Research; Research Training; Risk; Risk Behaviors; Role; Scientist; Sexuality; Social Anxiety Disorder; Social Change; Social Development; Solid; Statistical Data Interpretation; Stigmatization; Substance Use Disorder; Substance abuse problem; Testing; Training; Work; aged; anxious; condomless anal sex; design; diaries; emerging adulthood; expectation; experience; high risk; improved; intersectionality; men of color; minority stress; negative affect; non-heterosexual; peer; perceived discrimination; pressure; preventive intervention; psychologic; psychosocial; public health relevance; sexual minority; sexual minority men; skills; social; social anxiety; social culture; social stigma; substance use; theories; transmission process; young man

PROJECT SUMMARY/ABSTRACT Young sexual minority men (YSMM) aged 16-29 are at increased risk of acquiring HIV. YSMM who find themselves in the period of adolescence and emerging adulthood face many physical and psychosocial changes, including potential experiences of discrimination and prejudice due to their sexual minority identity (i.e., minority stress). These experiences in turn may increase their susceptibility to engage in negative health behaviors that place them at higher risk of acquiring HIV, such as substance use and condomless anal sex (CAS). Emerging adulthood has also been found to be the period with the highest reported substance use, and sexual minorities engage in more substance use compared to their heterosexual peers. Furthermore, higher levels of substance use have been associated with higher engagement in CAS. However, while minority stress has been used to understand these disparities, this alone does not explain why Black and Latino YSMM experience an even higher risk of acquiring HIV compared to their White peers despite reporting overall less risky health behaviors. A growing body of literature has begun to highlight intersectional stigma–a form of stigma caused by one's interlocking marginalized identities–as a cause for this disparity. Additionally, research on the underlying mechanisms between intersectional stigma and negative health risk behaviors are understudied, but empirical work suggests social anxiety may play a role in this association. Sexual minorities have been found to meet criteria for social anxiety disorder at higher rates than their heterosexual counterparts, and minority stress has been hypothesized to be a driver of this given the hypervigilance and expectations of rejection these experiences instill on sexual minorities. However, both the prevalence and effects of social anxiety on the negative health behaviors that increase risk of acquiring HIV among Black and Latino YSMM are understudied. Therefore, building off minority stress theory and intersectionality framework, the primary goal of this Diversity-F31 study is to examine the association between intersectional stigma, substance use, and CAS among Black and Latino YSMM, and assess for the role of social anxiety symptomology in these associations. The study focuses on two aims: (1) examine if Black and Latino YSMM who experience clinically elevated levels of social anxiety have stronger associations between experiences of intersectional stigma, substance use, and CAS; and (2) examine the mechanistic role of daily socially anxious symptomology at the within-person level in the association between daily experiences of intersectional stigma, substance use, and CAS. The proposed project will be embedded into a larger daily diary study of intersectional stigma among YSMM (R21-MH121311, PI: Rendina). The proposed project will add daily measures of social anxiety. The research and training plans proposed for this project are also designed to foster my development as a health psychologist and clinical scientist with a solid foundation in intersectional stigma, substance use, HIV treatment and prevention, and social anxiety among Black and Latino YSMM.

项目概要/摘要 16-29 岁的年轻性少数男性 (YSMM) 感染艾滋病毒的风险较高。 YSMM谁发现 处于青春期和成年初期的他们面临许多身体和心理社会问题 变化，包括由于性少数群体身份而可能遭受歧视和偏见的经历 （即少数族裔压力）。这些经历反过来可能会增加他们从事负面健康的可能性 使他们感染艾滋病毒的风险较高的行为，例如药物滥用和无套肛交 （CAS）。成年初期也被发现是药物使用报告最多的时期，并且 与异性恋同龄人相比，性少数群体使用更多的药物。此外，更高 物质使用水平与 CAS 参与度较高有关。然而，虽然少数人强调 已被用来理解这些差异，仅此并不能解释为什么黑人和拉丁裔 YSMM 尽管总体报告较少，但与白人同龄人相比，他们感染艾滋病毒的风险更高 有风险的健康行为。越来越多的文献开始强调交叉耻辱——一种形式 一个人相互交织的边缘化身份所造成的耻辱——是造成这种差异的一个原因。此外，研究 关于交叉耻辱与消极健康风险行为之间的潜在机制 研究不足，但实证研究表明社交焦虑可能在这种关联中发挥作用。性少数群体 被发现符合社交焦虑症标准的比例高于异性恋者 鉴于过度警惕和 这些经历向性少数群体灌输了拒绝的期望。然而，无论是患病率还是 社交焦虑对负面健康行为的影响，这些行为增加了黑人和黑人感染艾滋病毒的风险 拉丁裔 YSMM 尚未得到充分研究。因此，建立少数民族压力理论和交叉框架， 这项 Diversity-F31 研究的主要目标是检查交叉耻辱之间的关联， 黑人和拉丁裔 YSMM 中的物质使用和 CAS，并评估社交焦虑的作用 这些协会的症状学。该研究侧重于两个目标：（1）检查黑人和拉丁裔是否是 YSMM 那些在临床上经历过较高水平社交焦虑的人，其经历之间的关联性更强 交叉污名、物质使用和 CAS； (2) 检查日常社交焦虑的机制作用 交叉耻辱的日常经历之间的关联的人内部水平的症状学， 物质使用和 CAS。拟议的项目将被嵌入到更大的日常日记研究中 YSMM 之间的交叉耻辱（R21-MH121311，PI：Rendina）。拟议的项目将每天添加 社交焦虑的测量。本项目提出的研究和培训计划也旨在 促进我作为一名健康心理学家和临床科学家的发展，在交叉学科方面打下坚实的基础 黑人和拉丁裔 YSMM 中的耻辱、药物滥用、艾滋病毒治疗和预防以及社交焦虑。