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

220.7项目摘要/摘要 污名是导致拉丁裔男男性行为者(LMSM)艾滋病毒差异的主要原因，对 非注射药物使用(如甲基苯丙胺)和PrEP摄取。解决影响PrEP的因素 连锁发展，如交叉耻辱和甲基苯丙胺的使用，对于结束艾滋病毒是必不可少的 流行病。跨部门污名是一种复杂的社会现象，它跨越了各种污名来源。 (即家庭、朋友、他人)、机制(即预期的、实施的)和类型(即种族/民族、性倾向、 男子气概)，这些因素交织在一起，在LMSM中产生和加剧有害的健康后果。社交 可以利用网络分析技术来检查LMSM如何与网络交互并受到网络的影响 成员和告知有意义的干预目标，重点放在哪些网络成员(1)污名化 LMSM和(2)提供社会支持以缓冲跨部门污名对甲基苯丙胺的影响 使用Risk和PrEP级联递增。 这本K01将为候选人Algarin博士提供指导复杂的纵向多层结构的技能 用方程模型检验柱头间的直接和间接效应 甲基苯丙胺的使用风险和PrEP通过应对、抵抗和复原力的级联进展(目标1) 以及社交网络交叉污名的来源如何利用来自以下方面的数据缓和这些途径(目标2 在Nexus注册的500名LMSM：一种新的社会网络方法，研究跨部门污名对 在拉丁裔MSM中预防艾滋病毒(Nexus；R01MH123282；PI：Smith)。使用社区参与式 方法，阿尔加林博士将从这些分析中得出结论，以适应多层次的干预，以解决交叉性 通过应对、抵抗和弹性来降低甲基苯丙胺的使用风险和改善PrEP 级联进展(AIM 3)。 作为一名新兴的拉美裔同性恋学者，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 在医学边缘群体中促进艾滋病毒预防干预的专业独立性和技能， 将他定位为下一代代表不足的少数族裔学者，以结束艾滋病毒在 在美国，有色人种男男性接触者不成比例地背负着艾滋病毒的负担。具体地说，阿尔加林博士寻求通过培训来提升 他的统计能力(T1)，熟练掌握多层次干预理论和概念(T2)和多层次 干预发展和适应(T3)，获得研究伦理行为方面的额外培训(T4)， 并为他的职业发展培养技能(T5)。这款K01将为阿尔加林博士提供必要的培训 和数据来锻造他的研究独立性，并产生一个有竞争力的未来R34来测试社区- 作为这项研究的一部分，他采用了参与式、多层次的干预。

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.