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 耻辱是拉丁裔男男性行为者 (LMSM) 中艾滋病毒差异的主要驱动因素，对 非注射物质的使用（例如甲基苯丙胺）和 PrEP 的摄入。解决影响 PrEP 的因素 级联进展，例如交叉耻辱和甲基苯丙胺的使用，对于结束艾滋病毒至关重要 流行性。交叉耻辱是一种复杂的社会现象，跨越各种耻辱源 （即家人、朋友、其他人）、机制（即预期的、已制定的）和类型（即种族/民族、性取向、 男性气质），它们交叉产生并加剧了 LMSM 中有害的健康结果。社会的 可以利用网络分析技术来检查 LMSM 如何与网络交互以及如何受网络影响 成员并告知有意义的干预措施目标，重点关注网络成员 (1) 所污蔑的内容 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。 这 K01 将为候选人 Algarin 博士提供进行复杂的纵向多层次结构的技能 方程模型来检查交叉耻辱之间的直接和间接影响 甲基苯丙胺使用风险和 PrEP 通过应对、抵抗和复原力级联进展 (AIM 1) 以及社交网络交叉耻辱的来源如何调节这些路径（AIM 2） 500 名 LMSM 加入了 NEXUS：一种新颖的社交网络方法，用于研究交叉耻辱对人的影响 拉丁裔 MSM 中的艾滋病毒预防（NEXUS；R01MH123282；PI：Smith）。使用社区参与的 阿尔加林博士将从这些分析中吸取教训，采取多层次干预措施来解决交叉问题 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）。 作为一名新兴的拉丁裔同性恋学者，阿尔加林博士将利用加州大学圣地亚哥分校的培训基础设施来建立他的 专业独立性和技能，以促进医疗边缘群体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族裔学者，以结束艾滋病毒在人群中的流行 在美国，有色人种男男性行为者感染艾滋病毒的比例不成比例。具体来说，阿尔加林博士寻求培训以推进 统计能力（T1），熟练掌握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），获得研究道德行为方面的额外培训（T4）， 并为他的职业发展培养技能（T5）。这台 K01 将为 Algarin 博士提供必要的培训 和数据来打造他的研究独立性并产生具有竞争力的未来 R34 来测试社区 - 作为这项研究的一部分，他采用了积极的、多层次的干预措施。