Influence of Stigma and Discrimination on HIV Risk among Men in China

耻辱和歧视对中国男性艾滋病毒风险的影响

• 批准号: 8284434
• 负责人: KYUNG HEE CHOI
• 金额: $ 48.92万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-07 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8284434
• 关键词: AIDS prevention; Address; Affect; China; Chinese People; Cognitive; Country; Data; Discrimination; Epidemic; Face; Future; HIV; HIV Infections; Individual; Intervention; Interview; Link; Literature; Measures; Mediating; Mediator of activation protein; Mental Health; Modeling; Outcome; Participant; Phase; Play; Population; Prevalence; Prevention strategy; Public Health; Research; Respondent; Risk; Role; Sampling; Sex Orientation; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Shapes; Social status; Societies; Specific qualifier value; Stigmata; Stigmatization; Surveys; Syphilis; Techniques; Time; Unsafe Sex; Validity and Reliability; Woman; Work; base; coping; evidence base; experience; follow-up; innovation; interest; men; men who have sex with men; next generation; physical conditioning; prevent; psychological distress; sex risk; social stigma; therapy development

PROJECT SUMMARY By the end of 2007, sexual transmission was responsible for more than half (52%) of the estimated 700,000 HIV infections in China and is expected to drive the country's future HIV epidemic. The prevalence of HIV among men who have sex with men (MSM) in China is on the rise (1%-10.4%). Efforts to control the emerging HIV epidemic among these men may be hindered by stigma and discrimination related to sexual orientation. Our work found that experiences of MSM stigma were highly prevalent among Chinese MSM and that those who had had such experiences were more likely to engage in unprotected sex with men or with both men and women. Similarly, studies of MSM in other countries have found a similar relationship between MSM stigma and sexual risk behaviors. However, the exact mechanisms by which such experiences of MSM stigma become linked to sexual risk behaviors remain largely unknown. Accordingly, we propose a three-phase study to identify the specific mechanisms by which MSM stigma affect sexual risk behaviors among MSM in Beijing, China. The proposed study will be guided by Major and O'Brien's identity threat model of stigma that connects stigma to mental and physical health outcomes via a stigma management mechanism. In Phase 1, we will explore the range of management strategies used to cope with MSM stigma via 30 in-depth qualitative interviews with MSM. In Phase 2, we will develop, using Phase 1 qualitative data and adapting existing quantitative scales, culturally-relevant measures of explanatory constructs of interest (e.g., MSM stigma management) to establish reliability and validity (N=170). In Phase 3, we will examine potential mediators (e.g., stigma management strategies, psychological distress, sexual contexts/situations) that explain how MSM stigma are linked to sexual risk for HIV with a respondent-driven sample of 500 MSM who will complete baseline and two follow-up assessments at 6 and 12 months. We will also conduct 20 in-depth qualitative individual interviews with a subset of men selected from the Phase-3 participants to examine the acceptability of potential intervention components to address the link between MSM stigma and HIV risk. This study will break new ground in our understanding of the influence of MSM stigma management strategies on sexual risk for HIV among MSM. It will also advance theoretical understanding of HIV risk by examining potential mechanisms through which MSM stigma and discrimination impact sexual risk.

项目摘要 到2007年底，性传播负责超过一半（52％） 估计在中国有70万名艾滋病毒感染，预计将驱动该国未来的艾滋病毒 流行性。与男性发生性关系（MSM）的男性中艾滋病毒的患病率正在中国 上升（1％-10.4％）。这些男人中控制新兴的艾滋病毒流行的努力可能是 受到污名和与性取向有关的歧视的阻碍。我们的工作发现 在中国MSM中，MSM污名的经历非常普遍，而那些 有这样的经历更有可能与男人或两者之间的无保护性行为 男女。同样，其他国家的MSM研究发现了类似的关系 在MSM污名和性风险行为之间。但是，确切的机制 MSM污名的这种经历与性风险行为有关 未知。因此，我们提出了一项三相研究，以确定由 MSM污名会影响中国北京MSM的性风险行为。提议 研究将受到少校和奥布莱恩的身份威胁模型的指导 通过污名管理机制来进行精神和身体健康结果。在第1阶段，我们 将探讨通过30深入应对MSM污名的管理策略的范围 MSM的定性访谈。在第2阶段，我们将使用1阶段定性数据开发 适应现有的定量量表，与文化相关的解释性结构的衡量标准 利息（例如MSM污名管理）建立可靠性和有效性（n = 170）。在第3阶段， 我们将检查潜在的调解人（例如，污名管理策略，心理 痛苦，性环境/情况）解释了MSM污名如何与性风险联系在一起 艾滋病毒的受访者驱动驱动样本为500 msm，他们将完成基线和两次随访 6个月和12个月的评估。我们还将进行20个深入的定性个人 与从第三阶段参与者中选出的一部分男人的访谈以检查 潜在干预组件的可接受性，以解决MSM污名与 艾滋病毒风险。这项研究将在我们理解MSM污名的影响方面打破新的基础 MSM中有关HIV的性风险的管理策略。它也将推进理论 通过检查MSM污名和MSM污名的潜在机制来了解HIV风险 歧视会影响性风险。