YBMSM's Sexual Communication with Friends in Two Culturally Distinct U.S. Regions

YBMSM 与美国两个文化不同地区的朋友的性交流

• 批准号: 8329180
• 负责人: Matt Gary Mutchler
• 金额: $ 39.94万
• 依托单位: CALIFORNIA STATE UNIV-DOMINGUEZ HILLS
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-05-01 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8329180
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Affect; Age; Automobile Driving; Behavior; Belief; Communication; Communities; Data; Deep South; Ethnography; Friends; Friendships; Gays; Geographic Locations; Goals; HIV; HIV Infections; Hearing; Homosexuality; Human immunodeficiency virus test; Individual; Infection; Intervention; Interview; Knowledge; Language; Lead; Life; Linguistics; Los Angeles; Methods; Modeling; Participant; Pattern; Perception; Phase; Population; Population Intervention; Prevention; Preventive Intervention; Process; Research; Risk; Risk Behaviors; Risk Reduction; Role; Sexual Health; Social Perception; Stigmata; Structure; Testing; Theoretical model; Trust; Unsafe Sex; condoms; effective intervention; high risk; innovation; men; men who have sex with men; peer; peer influence; population health; risk perception; safer sex; sex; sex risk; social; social stigma; theories; therapy development; young man

DESCRIPTION (provided by applicant): Young Black men who have sex with men (YBMSM) are at extremely high risk for HIV infection in the U.S. If infection rates are not reduced, it is estimated that nearly 60% of YBMSM in the U.S. who are HIV-negative at age 18 will become infected by age 40. Rates of HIV infection among YBMSM in the Deep South are particularly high. The spread of HIV among YBMSM is driven by unprotected sex and unrecognized infections. Thus it is crucial to reduce sexual risk and increase HIV testing by conducting research that will lead to better interventions for YBMSM. The proposed study will support practical intervention development by examining sexual communication and its role in the spread of peer norms - one of the few factors consistently associated with sexual risk among YBMSM. Specifically, it aims to 1) investigate the content and processes of sexual communication among 18-24 year old YBMSM and their friends; 2) explore how sexual communication may influence risk behaviors and perceptions of peer norms regarding sexual risk and HIV testing; 3) explore sexual communication in two culturally distinct geographic regions where YBMSM are heavily impacted by HIV (Los Angeles, CA and Birmingham, AL); 4) and develop a culturally sensitive theoretical model of sexual communication among YBMSM that can be tested in further research and implemented in new and existing HIV prevention and testing interventions. To accomplish these aims, a three-phase qualitative study is proposed. In Phase 1 a team of peer ethnographers will collect field notes on sexual communication in venues where YBMSM socialize, providing an insider perspective on how sex and HIV are discussed. Peer ethnography can convey the linguistic nuances of communication in a more precise manner than other methods, which will also support the refinement of interview questions in the next phase. Phase 2 will utilize semi-structured interviews with 48 pairs of friends to examine the content and processes of conversations about sex and HIV testing as well as how peer norms are generated, transmitted, modified, or reinforced within these conversations. For example, preliminary data suggest that friends often reinforce the assumption that condom use and HIV testing are unnecessary in trusting relationships, even though a significant portion of HIV infections among MSM actually occur within primary partner relationships. In Phase 3, the theoretical model for sexual communication among YBMSM will be developed for implementation in existing and new dyad-level HIV prevention interventions. With a better understanding of peer sexual communication among YBMSM in culturally distinct regions such as Los Angeles and Birmingham, interventions can more effectively target the specific ways that such norms are transmitted and reinforced. Additionally, such interventions could leverage friends' natural concern for each others' well being by encouraging them to reinforce beneficial peer norms favoring condom use and HIV testing through explicit sexual health conversations, thereby drawing on the strengths of YBMSM and their friends to support the health of this population that is vulnerable to HIV infection. PUBLIC HEALTH RELEVANCE: Given that young Black men who have sex with men (YBMSM) are at extremely high risk for and at the forefront of HIV infection in the U.S., it is crucial to conduct research that will lead to better HIV prevention and testing interventions for this population. This innovative study will advance HIV prevention and practical intervention development by examining how communication between friends influences peer norms - the assumptions that individuals hold about how their peers think and behave regarding sexual risk and HIV testing. Existing and new interventions will be able to reduce HIV rates by leveraging this new knowledge to modify the peer norms that have been shown to influence sexual risk and HIV testing behaviors among YBMSM.

描述（由申请人提供）：在美国，与男性发生性行为的年轻黑人男性（YBMSM）感染HIV的风险极高。如果不降低感染率，估计美国18岁时HIV阴性的YBMSM中有近60%会在40岁时感染HIV。在美国南方腹地，男同性恋者的艾滋病毒感染率特别高。艾滋病毒在男同性恋者中的传播是由无保护的性行为和未被识别的感染驱动的。因此，通过开展研究来降低性风险和增加艾滋病毒检测是至关重要的，这将导致更好的干预YBMSM。拟议的研究将通过检查性交流及其在同伴规范传播中的作用来支持实际干预的发展-这是少数几个始终与YBMSM性风险相关的因素之一。具体而言，该研究旨在1)调查18-24岁YBMSM及其朋友之间性交流的内容和过程；2)探讨性交流如何影响风险行为和对性风险和艾滋病毒检测的同伴规范的看法；3)探索两个文化差异明显的地理区域的性交流，其中YBMSM受HIV影响严重（洛杉矶，CA和伯明翰，AL）；4)建立一个具有文化敏感性的YBMSM性交流理论模型，该模型可以在进一步的研究中进行测试，并在新的和现有的艾滋病毒预防和检测干预措施中实施。为了实现这些目标，提出了一个三阶段的定性研究。在第一阶段，一组同行人种学家将在YBMSM社交场所收集性交流的现场记录，为性和艾滋病毒的讨论提供内部视角。同伴民族志可以比其他方法更精确地传达交流的语言细微差别，这也将支持下一阶段访谈问题的细化。第二阶段将利用对48对朋友的半结构化访谈来检查关于性和艾滋病毒检测的谈话内容和过程，以及在这些谈话中同伴规范是如何产生、传播、修改或加强的。例如，初步数据表明，朋友们经常强化这样的假设，即在信任关系中使用安全套和进行艾滋病毒检测是不必要的，尽管男男性接触者中艾滋病毒感染的很大一部分实际上发生在主要伴侣关系中。在第3阶段，将开发YBMSM之间性交流的理论模型，以便在现有和新的两代艾滋病预防干预措施中实施。随着对洛杉矶和伯明翰等文化差异地区的YBMSM之间的同伴性交流有了更好的了解，干预措施可以更有效地针对这些规范传播和加强的具体方式。此外，这种干预措施可以利用朋友们对彼此福祉的天然关注，鼓励他们通过明确的性健康对话加强有利于使用避孕套和艾滋病毒检测的有益同伴规范，从而利用YBMSM及其朋友的优势来支持易受艾滋病毒感染人群的健康。