Validation of Stigma Metrics for Marginalized Men

边缘化男性耻辱指标的验证

• 批准号: 10133472
• 负责人: Stefan David Baral
• 金额: $ 60.28万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-05 至 2024-08-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10133472
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Affect; Africa South of the Sahara; African; Alcohol consumption; American; Biological Markers; Caring; Categories; Chlamydia; Chronic stress; Collaborations; DNA; Data; Data Analyses; Data Set; Development; Diagnostic Reagent Kits; Equation; Ethnic Origin; Factor Analysis; Future; Gender; Goals; Gonorrhea; HIV; HIV Infections; HIV Seropositivity; HIV prevention trials network; HIV risk; HIV/STD; Health Services Accessibility; Healthcare; High Prevalence; Home; Incidence; International; Internet; Intervention; Length; Measurement; Measures; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Methods; Michigan; Modeling; Outcome; Participant; Pathway interactions; Population; Population Programs; Prevention; Public Health Schools; Race; Recommendation; Research Personnel; Research Priority; Research Project Grants; Risk; Saliva; Sex Behavior; Sexual Health; Sexually Transmitted Diseases; Specimen; Stress; Structure; Surveys; Testing; Treatment outcome; United States; United States National Institutes of Health; Universities; Urine; Ursidae Family; Validation; Validity and Reliability; Viral Load result; Work; World Health Organization; base; care systems; comparative; experience; health disparity; intersectionality; men; men who have sex with men; prevention service; recruit; rectal; response; sex; sexual role; social stigma; telomere; therapy development; transmission process; treatment services; uptake

The overarching goal of this proposed study is to leverage existing and ongoing data to examine the role of sexual behavior stigma on access to HIV healthcare as well as sexual and mental health outcomes among men who have sex with men (MSM). Worldwide MSM are a key population that bear a disproportionate burden of HIV with high prevalence and incidence yet they have low uptake and/or access to treatment and prevention. Consistent with NIH HIV/AIDS research priorities, the proposed project aims to reduce health disparities in HIV infection and treatment outcomes by addressing stigma towards MSM in the context of intersecting stigmas and potentially modifiable mediators (e.g., depression). In particular, validated measures of sexual behavior stigma are needed to effectively measure stigma-related interventions and to better understand the mechanisms of how stigma potentiates HIV risks among this key population. We propose to leverage existing data collected from over 15,000 MSM across 7 different Sub-Saharan African nations, the American Men's Internet Survey (AMIS), the UCLA mSTUDY, and the HIV Prevention Trials Network (HPTN) 078 study on Enhancing Recruitment, Linkage to Care and Treatment for HIV-Infected MSM in the US. The specific aims of the work are: Aim 1) Develop validated measures used to assess sexual behavior stigma among MSM using factor analysis and validity and reliability testing. This will result in finalized stigma metrics and recommendations for integration of MSM stigma items that can be used in future studies. Aim 2) Identify specific mediated associations between stigma and HIV-related outcomes using structural equation modeling. In addition, test for intersectionality of multiple forms of stigma (e.g., gender, HIV status, race/ethnicity) using an inter- and intra-categorical approach. The delivered outcomes will include quantified associations of sexual behavior stigma with HIV-related outcomes that can be used to inform HIV intervention planning by setting feasible targets for stigma mitigation interventions. Aim 3) Include final validated stigma metrics in an upcoming cycle of AMIS and bio-validate the stigma metrics. Bio-validation will consist of testing associations of sexual behavior stigma with testing positive for sexually transmitted infections (chlamydia and gonorrhea), and with chronic stress measured using telomere DNA length. Participants will self-collect urine, rectal, and saliva specimens using home-based STI test kits. Overall, the proposed study will result in a thorough assessment of a sexual behavior stigma scale for MSM and how it operates comparatively with other types of stigma. The validated stigma metrics will provide recommendations for future studies that seek to measure stigma and its relation to HIV among this key population.

这项拟议研究的总体目标是利用现有和正在进行的数据， 性行为耻辱对获得艾滋病毒医疗保健以及性和心理健康结果的影响 男男性接触者（MSM）全球范围内的男男性行为者是一个关键的人群，承担着不成比例的负担 艾滋病毒感染率和发病率高，但他们接受和/或获得治疗的机会少， 预防与NIH艾滋病毒/艾滋病研究优先事项一致，拟议项目旨在减少健康 艾滋病毒感染和治疗结果的差距，解决在艾滋病毒/艾滋病背景下对男男性行为者的污名化问题， 交叉的柱头和潜在的可改变的介质（例如，抑郁症）。特别是，有效措施 性行为污名化需要有效地衡量污名化相关的干预措施， 了解耻辱感如何在这一关键人群中增加艾滋病毒风险的机制。我们建议 利用从7个不同的撒哈拉以南非洲国家的15，000多名男男性接触者收集的现有数据， 美国男性互联网调查（AMIS）、加州大学洛杉矶分校mSTUDY和艾滋病预防试验网络（HPTN） 078研究加强招聘，联系到护理和治疗艾滋病毒感染的男男性行为者在美国。的 本研究的具体目标是：目标1）开发有效的测量方法，用于评估性行为污名 男男性行为者的性别差异。这将最终确定污名指标 并对MSM污名项目的整合提出建议，可用于未来的研究。目标2）识别 使用结构方程模型，具体介导的耻辱和艾滋病毒相关的结果之间的关联。 此外，测试多种形式的成见的交叉性（例如，性别、艾滋病毒状况、种族/民族）， 一种类别间和类别内的方法。交付的成果将包括量化的性关系， 行为污名与艾滋病毒相关的结果，可用于告知艾滋病毒干预计划， 减轻污名干预措施的可行目标。目标3）将最终验证的耻辱指标纳入 新一轮的非盟特派团和生物验证污名指标。生物验证将包括测试关联 性传播感染（衣原体和淋病）检测呈阳性的性行为耻辱， 以及用端粒DNA长度测量的慢性压力。参与者将自行收集尿液、直肠和 唾液标本使用家庭为基础的性病测试试剂盒。总的来说，拟议的研究将导致一个彻底的 评估男男性接触者的性行为耻辱量表，以及它与其他类型的 耻辱经过验证的耻辱指标将为未来的研究提供建议， 在这一关键人群中的耻辱感及其与艾滋病毒的关系。

项目成果

HIV prevalence and behavioral and psychosocial factors among transgender women and cisgender men who have sex with men in 8 African countries: A cross-sectional analysis.

• DOI: 10.1371/journal.pmed.1002422
• 发表时间: 2017-11
• 期刊: PLoS medicine
• 影响因子: 15.8
• 作者: Poteat T;Ackerman B;Diouf D;Ceesay N;Mothopeng T;Odette KZ;Kouanda S;Ouedraogo HG;Simplice A;Kouame A;Mnisi Z;Trapence G;van der Merwe LLA;Jumbe V;Baral S
• 通讯作者: Baral S

Physical Violence and Psychological Distress Among Asian and Pacific Islander Sexual Minority Men in the United States Before and During the COVID-19 Pandemic.

COVID-19 大流行之前和期间美国亚裔和太平洋岛民性少数男性的身体暴力和心理困扰。

• DOI: 10.1089/lgbt.2021.0418
• 发表时间: 2022
• 期刊: LGBT health
• 影响因子: 4.8
• 作者: Lee,JaneJ;Katz,DavidA;Kerani,RoxanneP;Lerner,JustinE;Baral,StefanD;Sanchez,TravisH
• 通讯作者: Sanchez,TravisH

The feasibility of modified HIV and antiretroviral drug testing using self-collected dried blood spots from men who have sex with men.

• DOI: 10.1186/s12879-021-06110-x
• 发表时间: 2021-05-05
• 期刊: BMC infectious diseases
• 影响因子: 3.7
• 作者: Luo W;Sullivan V;Chavez PR;Wiatrek SE;Zlotorzynska M;Martin A;Rossetti R;Sanchez T;Sullivan P;MacGowan RJ;Owen SM;Masciotra S
• 通讯作者: Masciotra S

Exploring the Potential of Participatory Theatre to Reduce Stigma and Promote Health Equity for Lesbian, Gay, Bisexual, and Transgender (LGBT) People in Swaziland and Lesotho.

• DOI: 10.1177/1090198118760682
• 发表时间: 2019-03
• 期刊: Health education & behavior : the official publication of the Society for Public Health Education
• 作者: Logie CH;Dias LV;Jenkinson J;Newman PA;MacKenzie RK;Mothopeng T;Madau V;Ranotsi A;Nhlengethwa W;Baral SD
• 通讯作者: Baral SD

Disclosure of Same-Sex Sexual Practices to Family and Healthcare Providers by Men Who Have Sex with Men and Transgender Women in Nigeria.

• DOI: 10.1007/s10508-020-01644-8
• 发表时间: 2021-05
• 期刊: Archives of sexual behavior
• 影响因子: 3.8
• 作者: Kokogho A;Amusu S;Baral SD;Charurat ME;Adebajo S;Makanjuola O;Tonwe V;Storme C;Michael NL;Robb ML;Ake JA;Nowak RG;Crowell TA;TRUST/RV368 Study Group
• 通讯作者: TRUST/RV368 Study Group