Stop-and-Frisk, Arrest, and Incarceration and STI/HIV Risk in Minority MSM

少数男男性接触者中的拦截搜查、逮捕和监禁以及性传播感染/艾滋病毒风险

• 批准号: 9919525
• 负责人: Maria Rabia Khan
• 金额: $ 67.33万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9919525
• 关键词: 20 year old; AIDS prevention; Address; Advocacy; Affect; African American; Alcohol or Other Drugs use; Anxiety; Bisexual; Caring; Cohort Studies; Communicable Diseases; Communities; Computer Simulation; Couples; Criminal Justice; Crowding; Data Sources; Development; Discrimination; Disease; Dose; Employment; Epidemiology; Ethnic Origin; Face; Fees; Gays; HIV; HIV Infections; HIV prevention trials network; HIV risk; HIV/STD; Health; Healthcare; Heterosexuals; Hispanics; Imprisonment; Incidence; Interruption; Intervention; Jail; Lawyers; Life Cycle Stages; Life Experience; Light; Link; Measures; Mediating; Mediation; Mediator of activation protein; Mental Depression; Minority; Minority Groups; Modeling; Mood Disorders; New York City; Outcome; Pathway interactions; Personal Satisfaction; Pharmaceutical Preparations; Play; Police; Policies; Population; Poverty; Prevention approach; Prevention program; Prisons; Process; Program Development; Psyche structure; Race; Research; Risk; Risk Factors; Role; Sex Orientation; Sexually Transmitted Diseases; Social Network; Social isolation; Social support; Structure; Viral Load result; Vulnerable Populations; Work; addiction; base; black men who have sex with men; cohort; comparison intervention; cost; court; design; evidence base; experience; improved; men; men who have sex with men; men' s group; minority health; novel; population based; prevent; programs; recruit; response; sex; sex risk; sexual risk behavior; simulation; social determinants; social stigma; support network; transmission process; young men who have sex with men

ABSTRACT Minority gay, bisexual, or other men who have sex with men (MSM) contend with stigma and discrimination based on sexual orientation and race, resulting social isolation, and poverty risk that disproportionately impacts all minority groups. These factors contribute to mental/drug disorders, sex risk, and disproportionate STI/HIV, with half of black gay men and one-quarter of Hispanic gay men HIV-infected. Another prevalent social determinant of STI/HIV that disproportionately affects minority MSM, yet that remains largely unexamined in this group, is criminal justice involvement (CJI). CJI for many minority MSM begins early in the life course with police stops and searches; our preliminary studies in New York City indicate one-third of minority MSM approximately 20 years of age have been stopped and searched (or “frisked”) in the past 12 months. CJI evolves to arrest and detainment and for many, incarceration, with approximately over half of some minority MSM groups experiencing jail or prison incarceration. Each step of the criminal justice process–being stopped by police, arrested, detained while awaiting trial often in over-crowded conditions, interacting with court-appointed lawyers–can be disempowering, demeaning, and for some may present physical threat. In other populations, CJI has been documented as a determinant of disrupted social and support networks, depression, substance use, and sex risk, in turn, culminating in STI/HIV infection. Our understanding of mediating pathways has informed development of programs for heterosexual minorities affected by CJI. This proposal is motivated by the prospect of developing policies and prevention programs for minority MSM. The effects of CJI on STI/HIV may differ for minority MSM; CJI may work synergistically with low social support, stigma/discrimination, and poverty to have particularly strong effects in this group. In addition, pathways linking CJI and STI/HIV risk also may differ for minority MSM. For example, while disruption of network ties may place minority MSM at risk, as we have observed in heterosexual minorities, other pathways may be equally critical because of high baseline risk of stigma and poverty. To address current critical gaps in our understanding of the effects of CJI on health, we have compiled a compendium of data sources to examine the effect of CJI on STI/HIV risk in minority MSM. Using the HIV Prevention Trials Network 061 (HPTN 061) cohort of black MSM and the Project 18 (P18) Cohorts 1 and 2 of minority MSM, we will evaluate longitudinal associations between multiple levels of CJI (stop-and- frisk, arrest, incarceration) and STI/HIV risk outcomes (e.g., sexual risk behaviors, STI, HIV, and viral load). We will describe the potential mediating roles of CJI-related disruption of social support networks, stigma, poverty, and resulting depression and substance use. In light of recent calls for changes to criminal justice policy, we aim to use computer simulation to model the impact of implementing polices to reduce CJI (e.g., decarceration) and improve correctional settings (e.g., by improving ties to community support networks through reduced costs of prison calls) on HIV transmission in minority MSM and the larger population. Findings will inform evidence-based discussions about how to modify policy and programs to best improve well-being and reduce HIV risk in a highly vulnerable population.

抽象的 少数同性恋、双性恋或其他男男性行为者 (MSM) 面临着基于以下原因的耻辱和歧视： 性取向和种族、由此产生的社会孤立以及对所有少数族裔造成不成比例影响的贫困风险 组。这些因素导致精神/药物障碍、性风险和不成比例的性传播感染/艾滋病毒，其中一半的黑人 男同性恋者和四分之一的西班牙裔男同性恋者感染了艾滋病毒。性传播感染/艾滋病毒的另一个普遍的社会决定因素是 刑事司法对少数男男性行为者的影响尤其严重，但这一群体在很大程度上仍未得到审查 参与（CJI）。对于许多少数民族 MSM 来说，CJI 在生命历程的早期就开始于警察拦截和搜查；我们的 纽约市的初步研究表明，大约 20 岁的少数族裔男男性接触者中，有三分之一曾 在过去 12 个月内被拦截并搜查（或“搜身”）。 CJI 演变为逮捕和拘留，对许多人来说， 监禁，大约一半以上的少数 MSM 群体经历过监狱或监狱监禁。 刑事司法程序的每一步——经常在等待审判时被警察拦截、逮捕、拘留 过度拥挤的环境、与法院指定的律师互动——可能会削弱他们的能力、贬低他们的身份，对某些人来说 可能会造成人身威胁。在其他人群中，CJI 已被记录为社会混乱的决定因素 和支持网络、抑郁、药物滥用和性风险，最终导致性传播感染/艾滋病毒感染。我们的 对调解途径的了解为制定针对受到影响的异性恋少数群体的方案提供了信息 CJI。该提案的动机是为少数男男性接触者制定政策和预防计划的前景。 对于少数 MSM 来说，CJI 对 STI/HIV 的影响可能有所不同； CJI 可以在社会支持较低的情况下协同工作， 耻辱/歧视和贫困对这一群体的影响尤为强烈。此外，连接 CJI 的途径 对于少数男男性接触者来说，性传播感染/艾滋病毒的风险也可能有所不同。例如，虽然网络联系的中断可能会使少数人 正如我们在异性恋少数群体中观察到的，MSM 面临风险，其他途径可能同样重要，因为 耻辱和贫困的基线风险较高。解决目前我们对 CJI 影响的理解中的关键差距 在健康方面，我们编制了一份数据源概要，以研究 CJI 对少数族裔性传播感染/艾滋病毒风险的影响 男同性恋者。使用艾滋病毒预防试验网络 061 (HPTN 061) 黑人 MSM 队列和项目 18 (P18) 对于少数民族 MSM 的队列 1 和队列 2，我们将评估多个 CJI 水平之间的纵向关联（停止并- 搜查、逮捕、监禁）和性传播感染/艾滋病毒风险结果（例如，性危险行为、性传播感染、艾滋病毒和病毒载量）。我们将 描述与 CJI 相关的社会支持网络破坏、耻辱、贫困和社会支持网络的潜在中介作用 由此产生的抑郁和药物滥用。鉴于最近要求改变刑事司法政策的呼声，我们的目标是利用 计算机模拟来模拟实施政策的影响，以减少 CJI（例如，解除监禁）并改善 惩教环境（例如，通过减少监狱呼叫费用来改善与社区支持网络的联系） HIV 在少数 MSM 和较大人群中传播。研究结果将为基于证据的讨论提供信息 如何修改政策和计划，以最好地改善高度脆弱人群的福祉并降低艾滋病毒风险。