Intersectional Stigma, Mental Health, and HIV Risk Among US Gay and Bisexual Men of Color

项目摘要/摘要 在美国，艾滋病毒的负担远未平均分配。艾滋病毒流行的关键指标仍然是 根据人口统计因素(如种族、性别、性取向、地理位置)进行预测。在…的交叉口 这些决定因素是世界上感染艾滋病毒风险最高的群体之一，该项目的 关注人群：黑人和拉丁裔同性恋、双性恋和其他与男性发生性行为的男性(GBM) 美国南部。这些人忍受着多种形式的耻辱(例如种族主义、同性恋恐惧症)，这会增加压力 并侵蚀健康。因此，将交叉性和少数民族压力理论应用于流行病学和 干预研究可能会提供新的见解和工具来支持这一弱势群体的健康。 拟议的培训计划将为斯凯勒·杰克逊博士提供必要的知识和技能 有必要发展独立性并建立职业生涯，促进关于以下方面的科学知识 在黑人和拉丁裔GBM中，跨部门污名是心理和性健康风险的决定因素。这个 这个导师奖的目标概括为三个不同的培训目标：(1)通过使用 现代流行病学方法，(2)学习定性、社区参与的最佳做法 干预发展；(3)培养临床试验方法学的基本技能。杰克逊博士会 通过三个新的、相互关联的研究项目将这些目标付诸实践，他将在其中：(1)使用 来自一项前瞻性队列研究的纵向数据，以确定关联的调解人和主持人 在美国不同地域的有色人种人群中，交叉耻辱与心理/性健康之间的关系， (2)将这些发现与形成性研究的数据结合起来(例如，对有色人种和 田纳西州中部的社区利益相关者)修改现有的基于证据的污名应对健康 对GBM的干预--使用8阶段适应-ITT模式--从而增加其文化和地理 与南方黑人和拉丁裔GBM的心理和性健康的相关性，以及(3)试点这一交叉部分， 对年轻的南方黑人和拉丁裔GBM进行文化响应型健康干预(n=30；跨越两人 序列队列)与田纳西州中部的一个社区合作伙伴合作。发展他的HIS 作为一名独立的科学家，杰克逊博士将得到约翰·帕钱基斯博士(耶鲁大学博士)的指导， 来自其他联合导师的支持：Lisa Bowleg，博士(乔治华盛顿大学)，Dustin Duncan，ScD 和Mark Hatzenbuehler博士(哥伦比亚大学)。在仍然存在知识差距的地方， 杰克逊博士将参与精心挑选的培训活动--例如，拨款撰写、课程作业、会议、 和手稿准备。这种培训的很大一部分将由现有的机构支持来实现。 通过杰克逊博士与耶鲁大学艾滋病跨学科研究中心的联合关系 公共卫生研究所(YSPH)和纽约市YSPH尊重研究实验室。杰克逊博士的K01训练计划是 优化以弥补他的培训差距，并为他作为一名独立科学家的富有成效的职业生涯做好准备。

PROJECT SUMMARY/ABSTRACT The burden of HIV is far from equally distributed in the US. Key metrics of the HIV epidemic continue to be predicted by demographic factors (e.g., race, gender, sexual orientation, geography). At the intersection of these determinants is one of the highest-risk groups for HIV infection in the world, and this project's population of interest: Black and Latino gay, bisexual, and other men who have sex with men (GBM) in the US South. Such individuals endure multiple forms of stigma (e.g., racism, homophobia), which elevate stress and erode health. Thus, applying theories of intersectionality and minority stress to epidemiological and intervention research may provide novel insights and tools to support the health of this vulnerable subgroup. The proposed training plan will provide Skyler Jackson, PhD, with the essential knowledge and skills necessary to develop independence and forge a career advancing scientific knowledge concerning intersectional stigma as a determinant of mental and sexual health risk among Black and Latino GBM. The goals of this mentored award are summarized by three distinct training objectives: (1) to gain skills using contemporary epidemiological methods, (2) to learn best practices in qualitative, community-engaged intervention development, and (3) to develop foundational skills in clinical trials methodology. Dr. Jackson will put these aims into practice via three novel, interrelated research projects, in which he will: (1) use longitudinal data from a prospective cohort study to identify mediators and moderators of the association between intersectional stigma and mental/sexual health among GBM of color across distinct US geographies, (2) combine these findings with data from formative research (e.g., 30 interviews with GBM of color and community stakeholders in Middle Tennessee) to modify an existing evidence-based stigma-coping health intervention for GBM—using the 8-phase ADAPT-ITT model—thereby increasing its cultural and geographic relevance to the mental and sexual health of Southern Black and Latino GBM, and (3) pilot this intersectional, culturally-responsive health intervention for young Southern Black and Latino GBM (n = 30; across two sequential cohorts) in collaboration with a community partner in Middle Tennessee. To develop his independence as a scientist, Dr. Jackson will be mentored by John Pachankis, PhD (Yale University), with support from additional co-mentors: Lisa Bowleg, PhD (George Washington University), Dustin Duncan, ScD (New York University), and Mark Hatzenbuehler, PhD (Columbia University). Where knowledge gaps remain, Dr. Jackson will engage in carefully selected training activities—e.g., grant writing, coursework, conferences, and manuscript preparation. Much of this training will be made possible by institutional support available through Dr. Jackson's joint affiliation with the Yale Center for Interdisciplinary Research on AIDS, Yale School of Public Health (YSPH), and YSPH Esteem Research Lab in New York City. Dr. Jackson's K01 training plan is optimized to address his training gaps and prepare him for a productive career as an independent scientist.