Addressing intersectional stigma through coping, resistance, and resilience to improve methamphetamine use and factors influencing PrEP uptake among Latino MSM: a step towards ending HIV by 2030

通过应对、抵抗和恢复力来解决交叉耻辱，以改善甲基苯丙胺的使用以及影响拉丁美洲男男性接触者中 PrEP 吸收的因素：迈向 2030 年终结艾滋病毒的一步

• 批准号: 10484721
• 负责人: Angel B Algarin
• 金额: $ 18.85万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10484721
• 关键词: AIDS prevention; Address; Adherence; Affect; Behavior; Buffers; Color; Communities; Complex; Data; Development; Enrollment; Epidemic; Equation; Ethics; Ethnic Origin; Face; Family; Family member; Friends; Future; Gays; Gender Identity; Goals; HIV; HIV Infections; HIV diagnosis; HIV risk; Health; Human immunodeficiency virus test; Incidence; Intervention; Laboratories; Latino; Link; Mediation; Mediator of activation protein; Medical; Methamphetamine; Methods; Modeling; NIH Office of AIDS Research; Outcome; Pathway Analysis; Pathway interactions; Positioning Attribute; Process; Race; Research; Research Priority; Resistance; Risk; Risk Behaviors; Sexuality; Social Environment; Social Network; Social support; Source; Stigmatization; Techniques; Testing; Training; Training and Infrastructure; Underrepresented Minority; base; coping; cultural values; ethnic identity; experience; improved; innovation; marginalized population; member; men; men who have sex with men; methamphetamine use; negative affect; next generation; novel; pre-exposure prophylaxis; preventive intervention; prospective; resilience; sexual identity; skills; social; social stigma; stimulant use; substance use; theories; therapy development; uptake

220.7 PROJECT SUMMARY/ABSTRACT Stigma is a main driver of HIV disparities among Latino men who have sex with men (LMSM), negatively affecting non-injection substance use (e.g. methamphetamine) and PrEP uptake. Addressing factors that influence PrEP cascade progression, such as intersectional stigma and methamphetamine use, are essential to ending the HIV epidemic. Intersectional stigma is a complex social phenomenon experienced across various stigma sources (i.e. family, friends, others), mechanisms (i.e. anticipated, enacted), and types (i.e. race/ethnicity, sexuality, masculinity), which intersect to produce and exacerbate deleterious health outcomes among LMSM. Social network analysis techniques can be leveraged to examine how LMSM interact with and are affected by network members and inform targets for meaningful interventions focused on which network members (1) stigmatize LMSM and (2) provide social support to buffer against the effects of intersectional stigma on methamphetamine use risk and PrEP cascade progression. This K01 will provide the candidate, Dr. Algarin, with skills to conduct complex longitudinal multi-level structural equation modeling to examine the direct and indirect effects between intersectional stigma and methamphetamine use risk and PrEP cascade progression through coping, resistance, and resilience (AIM 1) and how sources of social network intersectional stigma moderate these pathways (AIM 2) leveraging data from 500 LMSM enrolled in NEXUS: a novel social network approach to study the effects of intersectional stigma on HIV prevention among Latino MSM (NEXUS; R01MH123282; PI: Smith). Using a community-engaged approach, Dr. Algarin will draw from these analyses to adapt a multi-level intervention to address intersectional stigma through coping, resistance, and resilience to decrease methamphetamine use risk and improve PrEP cascade progression (AIM 3). As an emerging gay Latino scholar, Dr. Algarin will leverage the UCSD training infrastructure to build his professional independence and skills to promote HIV prevention interventions in medically marginalized groups, positioning him as the next generation of under-represented minority scholars to end the HIV epidemic among MSM of color disproportionately burdened by HIV in the US. Specifically, Dr. Algarin seeks training to advance his statistical capacities (T1), gain proficiency multi-level intervention theories and concepts (T2) and multi-level intervention development and adaptation (T3), gain additional training in the ethical conduct of research (T4), and build skills for his professional development (T5). This K01 will provide Dr. Algarin with the necessary training and data to forge his research independence and produce a competitive future R34 to test the community- engaged, multi-level intervention he adapts as part of this study.

220.7项目概要/摘要 污名化是与男性发生性关系的拉丁裔男性（LMSM）艾滋病毒差异的主要驱动因素， 非注射物质使用（如甲基苯丙胺）和PrEP摄取。解决影响PrEP的因素 级联进展，如交叉耻辱和甲基苯丙胺的使用，是必不可少的结束艾滋病毒 疫情交叉污名是一种复杂的社会现象，涉及到不同的污名来源 (i.e.家庭，朋友，其他人），机制（即预期，制定）和类型（即种族/民族，性， 男性气质），这些因素相互交织，在LMSM中产生和加剧有害的健康结果。社会 网络分析技术可用于研究LMSM如何与网络交互以及如何受网络影响 成员并向目标通报网络成员（1）污名化的有意义的干预措施 LMSM和（2）提供社会支持，以缓冲交叉污名对甲基苯丙胺的影响 使用风险和PrEP级联进展。 该K 01将为候选人Algarin博士提供进行复杂纵向多层结构分析的技能。 方程模型，以检查交叉污名和 甲基苯丙胺使用风险和通过应对，抵抗和恢复力（AIM 1）的PrEP级联进展 以及社会网络交叉污名的来源如何调节这些途径（AIM 2）， 500名LMSM参加了NEXUS：一种新的社会网络方法来研究交叉污名对 拉丁裔男男性行为者的艾滋病毒预防（NEXUS; R 01 MH 123282; PI：Smith）。使用社区参与的 Algarin博士将从这些分析中借鉴，以适应多层次的干预，以解决交叉问题。 通过应对，抵抗和恢复力来降低甲基苯丙胺使用风险并改善PrEP 级联进展（AIM 3）。 作为一个新兴的同性恋拉丁裔学者，阿尔加林博士将利用UCSD的培训基础设施，建立他的 专业独立性和技能，以促进在医学边缘化群体中的艾滋病毒预防干预措施， 将他定位为下一代代表性不足的少数民族学者，以结束艾滋病毒的流行， 在美国，有色人种的MSM不成比例地受到艾滋病毒的影响。具体来说，阿尔加林博士寻求培训， 他的统计能力（T1），获得熟练的多层次干预理论和概念（T2）和多层次 干预措施的制定和适应（T3），获得研究伦理行为方面的额外培训（T4）， 并为他的专业发展培养技能（T5）。K 01将为阿尔加林博士提供必要的培训 和数据来建立他的研究独立性，并产生一个有竞争力的未来R34来测试社区- 参与，多层次的干预，他适应作为这项研究的一部分。