African American Young Mens Study

描述(由申请人提供)：这份修订后的申请是对美国国立卫生研究院题为“艾滋病毒/艾滋病中的健康差异：关注非裔美国人”(PA-06-069，再版为PA-07-116)的计划公告的回应，该公告承认“非裔美国人[代表]经历了比这个国家其他民族/种族群体异常高的艾滋病毒新感染率和更差的存活率的群体。”可以肯定的是，由于我们现在正处于艾滋病毒流行的第三个十年，与男性发生性行为的非裔美国男性仍然受到美国艾滋病毒/艾滋病疫情的不成比例的影响。也许这一人群中最隐蔽的部分是非裔美国青年男男性行为者(AAYMSM)，他们现在是男男性行为者(MSM)中新感染病例的最大比例。尽管利用酒吧或以同性恋社区为目标的社区组织预防艾滋病毒的努力取得了成功，但研究表明，许多高危AYMSM并不经常出现在这些场所。取而代之的是，可以通过Ball and House社区接触到大量的AAYMSM。鲍尔社区围绕着被称为“房子”的集体，这是种族、民族和性少数群体定义的社区，其特征是一群年轻男子创建了一个家庭结构，有一个指定的“母亲”、“父亲”和其他被称为“孩子”的成员。之家为成员提供了一个朋友网络和一个寻求支持的地方，积极的肯定规范，集体认同，以及AAYMSM之间的联系。通常，年轻男子在被自己的家庭拒绝后加入众议院。舞会每月举行几次，是为有色人种男男性行为者，特别是AAYMSM提供社交活动的奢华庆祝/比赛。我们自己的研究表明，Ball and House社区可能是与AAYMSM一起进行艾滋病毒预防研究的理想环境。因此，我们建议进行人种学和调查研究，以更好地了解和检查：1)Ball and House社区的结构、社会和文化特征；2)Ball and House成员使用非法药物和参与艾滋病毒风险和保护性行为的情况，以及他们的社会和性网络；以及3)拒绝、歧视和内在化的同性恋恐惧症在鼓励使用毒品和HIV风险方面所起的作用。与公共卫生相关：由于我们现在正处于艾滋病毒流行的第三个十年，与男性发生性行为的非裔美国男性仍然受到美国艾滋病毒/艾滋病疫情的不成比例的影响。也许这一人群中最隐蔽的部分是非裔美国青年男男性行为者(AAYMSM)，他们现在是男男性行为者中新感染病例的最大比例。我们自己的研究表明，Ball and House社区可能是提供针对AAYMSM的艾滋病毒预防干预的理想环境。因此，我们建议进行人种学和调查研究，以确定这些社区成员的危险行为的特征，并确定预防艾滋病毒的机会。

DESCRIPTION (provided by applicant): This revised application is being resubmitted in response to the National Institutes of Health's Program Announcement entitled, "Health Disparities in HIV/AIDS: Focus on African Americans" (PA-06-069, reissued as PA-07-116), which recognizes that "African Americans [represent] a group that has experienced exceptionally high rates of new HIV infections and worse survival rates than other ethnic/racial groups in this country." To be sure, as we are now in the third decade of the HIV epidemic, African American men who have sex with men remain disproportionately affected by the HIV/AIDS epidemic in the US. Perhaps the most hidden segment of this population are African American young men who have sex with men (AAYMSM), who now represent the largest proportion of new infections among men who have sex with men (MSM). Though HIV prevention efforts using bar settings or community-based organizations targeting the gay community have been met with success, research indicates that many at-risk AAYMSM do not frequent these venues. Instead, large numbers of AAYMSM can be reached through the Ball and House communities. The Ball community revolves around collectives called "Houses," which are racial, ethnic, and sexual minority defined communities that are characterized by groups of young men who create a family structure with an appointed "mother," "father" and other members called "the children." The Houses offer members a network of friends and a place to turn to for support, positive affirming norms, collective identity, and connectedness among AAYMSM. Often young men join a House after having been rejected by their own family. The Balls, which are held several times a month, are lavish celebrations/competitions that serve as a social event for MSM of color, particularly AAYMSM. Our own research suggests that the Ball and House communities could be ideal settings in which to conduct HIV prevention research with AAYMSM. We are therefore proposing to conduct ethnographic and survey research to better understand and examine: 1) the structural, social, and cultural characteristics of the Ball and House communities; 2) Ball and House members' use of illicit drugs and involvement in HIV risk and protective behaviors, and their social and sexual networks; and 3) the role that rejection, discrimination, and internalized homophobia play with respect to encouraging drug use and HIV risk. PUBLIC HEALTH RELEVANCE: As we are now in the third decade of the HIV epidemic, African American men who have sex with men remain disproportionately affected by the HIV/AIDS epidemic in the US. Perhaps the most hidden segment of this population are African American young men who have sex with men (AAYMSM), who now represent the largest proportion of new infections among men who have sex with men. Our own research suggests that the Ball and House communities could be ideal settings in which to deliver HIV prevention interventions targeted to AAYMSM. We are therefore proposing to conduct ethnographic and survey research designed to characterize the risk behaviors of members of these communities, as well as identify opportunities for HIV prevention.