Stop-and-Frisk, Arrest, and Incarceration and STI/HIV Risk in Minority MSM

获奖作品摘要 少数同性恋者，双性恋者或其他性少数群体男子与基于性的耻辱和歧视作斗争。 种族和倾向，导致社会孤立，贫困风险对所有少数群体的影响不成比例 组这些因素导致精神/毒品障碍、性风险和不成比例的性传播感染/艾滋病毒， 黑人男同性恋者和四分之一的西班牙裔男同性恋者感染了艾滋病毒。另一个普遍的结构决定因素是 性传播感染/艾滋病毒，不成比例地影响少数男男性行为者，但在这一群体中仍然基本上没有得到审查， 刑事司法参与（CJI）。CJI对于许多少数民族男男性接触者来说，在生命的早期就开始了警察的拦截 我们在纽约市的初步研究表明，三分之一的少数男男性接触者约20 在过去12个月内，曾截停并搜查（或“搜身”）10岁或以上的儿童。CJI发展到逮捕和 拘留，对许多人来说，监禁，超过一半的少数MSM群体经历监狱或监狱 监禁。刑事司法程序的每一步-被警察拦住，逮捕，拘留， 等待审判往往在拥挤的条件下，与法院指定的律师互动， 剥夺权力，贬低，对一些人来说可能会造成人身威胁。在其他人群中，CJI已经 被证明是破坏社会和支持网络、抑郁、物质使用和性的决定因素 风险（导致性病/艾滋病毒感染增加）。我们对调节 CJI和性传播感染/艾滋病毒风险为受CJI影响的异性恋少数群体的方案制定提供了信息。这 该提案的动机是为少数男男性行为者制定政策和预防计划的前景。的 CJI对STI/HIV的影响可能与少数MSM不同; CJI可能与低社会支持协同工作， 耻辱/歧视和贫困对这一群体的影响特别大。此外，连接 CJI和STI/HIV风险也可能与少数MSM不同。例如，虽然网络关系的中断可能会 正如我们在异性恋少数群体中观察到的那样，处于风险中的少数MSM，其他途径可能同样重要 这是因为耻辱和贫困的基线风险很高。为了解决我们目前在理解 CJI对健康的影响，我们编制了一份数据来源汇编，以研究CJI对 少数男男性行为者的性传播感染/艾滋病毒风险。使用HIV预防试验网络061（HPTN 061）黑人MSM队列 和项目18（P18）队列1和2的少数男男性接触者，我们将评估纵向关联， 多层次的CJI（拦截搜身、逮捕、监禁）和STI/HIV风险结果。我们将描述 CJI相关的社会支持网络，耻辱，贫困的破坏的潜在中介作用， 抑郁症和物质使用。鉴于最近有人呼吁改变刑事司法政策，我们的目标是利用 计算机模拟，以模拟实施政策的影响，以减少CJI和改善矫正 艾滋病毒在少数男男性接触者和更大的人群中传播的情况。调查结果将为基于证据的 讨论如何修改政策和方案，以减少高度脆弱人群的艾滋病毒风险。

PARENT AWARD ABSTRACT Minority gay, bisexual, or other sexual minority men contend with stigma and discrimination based on sexual orientation and race, resulting in social isolation, and poverty risk that disproportionately impacts all minority groups. These factors contribute to mental/drug disorders, sex risk, and disproportionate STI/HIV, with half of black gay men and one-quarter of Hispanic gay men HIV-infected. Another prevalent structural determinant of STI/HIV that disproportionately affects minority MSM, yet that remains largely unexamined in this group, is criminal justice involvement (CJI). CJI for many minority MSM begins early in the life course with police stops and searches; our preliminary studies in New York City indicate one-third of minority MSM approximately 20 years of age have been stopped and searched (or “frisked”) in the past 12 months. CJI evolves to arrest and detainment and for many, incarceration, with over half of some minority MSM groups experiencing jail or prison incarceration. Each step of the criminal justice process–being stopped by police, arrested, detained while awaiting trial often in over-crowded conditions, interacting with court-appointed lawyers–can be disempowering, demeaning, and for some may present physical threat. In other populations, CJI has been documented as a determinant of disrupted social and support networks, depression, substance use, and sex risk (leading to increased STI/HIV infection). Our understanding of pathways mediating associations between CJI and STI/HIV risk has informed development of programs for heterosexual minorities affected by CJI. This proposal is motivated by the prospect of developing policies and prevention programs for minority MSM. The effects of CJI on STI/HIV may differ for minority MSM; CJI may work synergistically with low social support, stigma/discrimination, and poverty to have particularly strong effects in this group. In addition, pathways linking CJI and STI/HIV risk also may differ for minority MSM. For example, while disruption of network ties may place minority MSM at risk, as we have observed in heterosexual minorities, other pathways may be equally critical because of high baseline risk of stigma and poverty. To address current critical gaps in our understanding of the effects of CJI on health, we have compiled a compendium of data sources to examine the effect of CJI on STI/HIV risk in minority MSM. Using the HIV Prevention Trials Network 061 (HPTN 061) cohort of black MSM and the Project 18 (P18) Cohorts 1 and 2 of minority MSM, we will evaluate longitudinal associations between multiple levels of CJI (stop-and-frisk, arrest, incarceration) and STI/HIV risk outcomes. We will describe the potential mediating roles of CJI-related disruption of social support networks, stigma, poverty, and resulting depression and substance use. In light of recent calls for changes to criminal justice policy, we aim to use computer simulation to model the impact of implementing polices to reduce CJI and improve correctional settings on HIV transmission in minority MSM and the larger population. Findings will inform evidence-based discussions about how to modify policy and programs to reduce HIV risk in a highly vulnerable population.