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

少数男男性接触者中的拦截搜查、逮捕和监禁以及性传播感染/艾滋病毒风险

基本信息

批准号：
10442045
负责人：
Maria Rabia Khan
金额：
$ 49.15万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2023-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10442045
关键词：
20 year old AIDS prevention Address Administrative Supplement Affect Agriculture Applications Grants Award Bisexual Caring Chicago Communicable Diseases Communities Community Health Networks Computer Simulation Criminal Justice Crowding Data Data Sources Development Discrimination Disease Doctor of Philosophy Education Educational Status Epidemiology Funding Future Gays HIV HIV Infections HIV prevention trials network HIV risk HIV/STD Health Health Personnel Healthcare Heterosexuals Hispanics Historically Black Colleges and Universities Homophobia Human immunodeficiency virus test Imprisonment Individual Institution Intervention Intervention Studies Interview Jail Knowledge Lawyers Life Cycle Stages Light Link Manuscripts Maryland Mediating Mental Depression Methods Minority Minority Groups Modeling National Institute of Drug Abuse New York New York City North Carolina Outcome Parents Pathway interactions Pharmaceutical Preparations Pilot Projects Police Policies Population Poverty Preparation Prevention Prevention approach Prevention program Prisons Process Program Development Provider Psyche structure Qualitative Methods Race Recording of previous events Research Research Personnel Risk Role Sampling Sex Orientation Sexual and Gender Minorities Site Social Work Social isolation Social support Structure Students Training Universities Violence Vulnerable Populations Work addiction base black men who have sex with men care systems cohesion cohort college community organizations community setting court design distrust epidemiology study evidence base experience geographic risk healthcare community implementation determinants improved meetings member men men who have sex with men men&apos s group novel pre-exposure prophylaxis prevent preventive intervention primary care services programs racial and ethnic racism recruit screening service organization sex risk sexual minority social stigma substance use transgender women transmission process undergraduate student

项目摘要

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.

家长奖摘要少数族裔男同性恋者、双性恋者或其他性少数族裔男子与基于性别的污名和歧视作斗争取向和种族，导致社会孤立和贫困风险，对所有少数群体造成不成比例的影响组。这些因素导致精神/药物障碍、性风险和不成比例的性传播感染/艾滋病毒，其中一半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。另一个流行的结构性决定因素 STI/HIV对少数族裔MSM的影响不成比例，但在这一群体中基本上仍未得到检查，是刑事司法介入(CJI)。对于许多少数族裔MSM来说，CJI在生命过程的早期就开始了，警察会阻止他们和搜查；我们在纽约市的初步研究表明，三分之一的少数民族MSM约有20% 在过去的12个月里，许多儿童被拦截并搜查(或“搜身”)。CJI演变为逮捕和拘留，对许多人来说，是监禁，超过一半的少数族裔男男性接触者群体经历了监狱或监狱监禁。刑事司法程序的每一步--被警察拦截、逮捕、拘留等待审判通常是在拥挤的条件下，与法院指定的律师互动-可能是剥夺权力、贬低身份，对一些人来说可能会构成身体上的威胁。在其他人群中，CJI一直是被记录为社交和支持网络中断、抑郁、药物使用和性行为的决定因素风险(导致性传播感染/艾滋病毒感染增加)。我们对中介联系的途径的理解 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制定了方案。这提案的动机是制定针对少数族裔MSM的政策和预防计划的前景。这个 CJI对STI/HIV的影响可能因少数MSM不同而不同；CJI可能与低社会支持协同作用，耻辱/歧视和贫穷对这一群体的影响尤其强烈。此外，连接路径的路径少数族裔男男性行为者的CJI和STI/HIV风险也可能不同。例如，虽然网络联系的中断可能会少数族裔MSM处于危险之中，正如我们在异性少数群体中观察到的那样，其他途径可能也同样关键因为高基线风险的耻辱和贫困。要解决目前我们对 CJI对健康的影响，我们编写了一份数据来源概要，以检查CJI对健康的影响少数民族男男性接触者性传播感染/艾滋病风险。使用HIV预防试验网络061(HPTN 061)的黑人MSM队列和项目18(P18)队列1和2，我们将评估少数民族MSM之间的纵向关联多个级别的CJI(截查、逮捕、监禁)和性传播感染/艾滋病毒风险结果。我们将描述与CJI相关的社会支持网络中断、耻辱、贫困和由此产生的潜在中介作用抑郁和药物使用。鉴于最近要求改变刑事司法政策的呼声，我们打算利用计算机模拟模拟实施政策对减少CJI和改善矫正的影响少数民族男男性接触者和较大人群中艾滋病毒传播的环境。调查结果将为以证据为基础的讨论如何修改政策和计划，以降低高度脆弱人群中的艾滋病毒风险。