Measuring resilience to intersectional stigma for people who inject drugs in need of HIV prevention

项目总结 俄亥俄州面临艾滋病毒严重爆发的风险，特别是在注射毒品(PWID)的人中。耻辱，包括 内在化和预期的耻辱，阻碍艾滋病毒预防用于PWID。阿巴拉契亚的PWID 俄亥俄州经历了深刻的吸毒耻辱；然而，人们对艾滋病毒预防耻辱和 与吸毒污名的交集。解决普遍存在的阻碍艾滋病毒预防的跨部门污名 利用、复原力可能是对抗PWID创伤性污名化事件的一个重要过程。PWID 有独特的耻辱经历，需要经过充分验证的跨部门药物使用弹性测量 和预防艾滋病毒的耻辱。然而，对于跨部门污名的恢复力还没有量化的衡量标准。 专为PWID量身定做。如果没有适当的复原力衡量，未来的干预措施将无法 以解决PWID中的交叉污名问题。这项拟议的研究的目标是探索 PWID对跨部门药物使用和艾滋病毒预防污名的复原力。我们将在现有基础上再接再厉 NIDA和NCATS资助了俄亥俄州阿巴拉契亚农村地区的研究基础设施。建议的工作直接 阐述了NIDA RFA(RFA-DA-21-002)，因为它支持形成性研究，以支持 减少污名干预“，并开发了一种新的结果衡量标准，为干预提供信息 解决多层次因素(自我、提供者和/或环境)以解决交叉污名以改善艾滋病毒 预防连续不断的成果“。其具体目的是：1)了解药物抵抗的机制 在俄亥俄州农村地区PWID的使用和HIV污名2)开发和验证PWID复原力量表以 衡量对跨部门污名的复原力，以加强艾滋病毒预防的连续体。要做到这一点，在- 将在阿巴拉契亚农村地区的PWID中进行深度访谈。这些采访将探索弹性如何 展示、在同行中共享并制定程序，以对抗艾滋病毒和艾滋病的交叉耻辱 PWID患者的药物使用情况。来自这些访谈的数据将有助于发展PWID复原力 比例。我们将采用Conner-Davidson复原量表，该量表具有良好的信度、效度和 在不那么耻辱的人群中的实用性。还将与PWID进行认知访谈，以 确保内容在概念上与此上下文相关。然后，我们将使用以下方法招募250名PWID 受访者驱动抽样(RDS)，以验证俄亥俄州阿巴拉契亚的PWID复原力量表。……的高潮 这项工作将对一种新的衡量标准--PWID中的复原力--提供深刻的理解和测量 预防艾滋病毒的需要。最终，PWID复原力量表将为解决 跨部门吸毒与艾滋病预防、耻辱和艾滋病病毒传播。

PROJECT SUMMARY Ohio is at risk for a severe HIV outbreak, especially among people who inject drugs (PWID). Stigma, including internalized and anticipated stigma, obstructs the utilization of HIV prevention for PWID. PWID in Appalachia Ohio experience profound drug use stigma; however, less is known of the extent of HIV prevention stigma and the intersection with drug use stigma. To address pervasive intersectional stigma inhibiting HIV prevention utilization, resilience may be an essential process to counter traumatic stigmatizing events for PWID. PWID have unique experiences of stigma and need a well-validated measure of resiliency to intersectional drug use and HIV prevention stigma. Yet, there are no quantitative measures of resilience to intersectional stigma tailored explicitly for PWID. Without an appropriate resilience measurement, future interventions will be unable to address intersectional stigma among PWID. The goal of this proposed study is to explore mechanisms of resilience to intersectional drug use and HIV prevention stigma among PWID. We will build upon our existing NIDA and NCATS funded research infrastructure in rural Appalachia Ohio. The proposed work directly addresses the NIDA RFA (RFA-DA-21-002) as it “supports formative research to support the development of stigma reduction interventions” and develops a novel outcome measure that will inform an intervention addressing “multi-level factors (self, provider, and /or setting) to address intersectional stigmas to improve HIV prevention continuum outcomes”. The specific aims are to 1) Understand the mechanisms of resilience to drug use and HIV stigma among PWID in rural Ohio and 2) Develop and validate a PWID Resilience Scale to measure resilience to intersectional stigma for enhancing the HIV prevention continuum. To achieve this, in- depth interviews will be conducted among PWID in rural Appalachia. The interviews will explore how resilience processes are displayed, shared among peers, and enacted to counter the intersectional stigma of HIV and drug use among PWID. The data from these interviews will aid in the development of a PWID Resilience Scale. We will adapt the Conner-Davidson Resilience Scale, which has excellent reliability, validity, and practicality among less stigmatized populations. Cognitive interviews will also be conducted with PWID to ensure that the content is conceptually relevant in this context. Then, we will enroll a cohort of 250 PWID using respondent-driven sampling (RDS) to validate a PWID Resilience Scale in Appalachia Ohio. The culmination of this work will provide a deep understanding and measurement of a novel measure—resilience among PWID in need of HIV prevention. Ultimately, the PWID Resilience Scale will provide the groundwork to address intersectional drug use and HIV prevention stigma and HIV transmission among PWID.