Developing and Validating New Measures of Multilevel Intersectional Stigma to Improve the HIV Prevention Continuum for Young Black Gay Bisexual and Other Men who Have Sex with Men in the South

项目摘要/摘要 艾滋病毒/艾滋病在美国黑人同性恋、双性恋和其他男性中的不成比例的影响 与男性发生性行为(GBMSM)令人震惊，特别是在居住在南方的年轻黑人GBMSM中。 年龄在13岁到34岁之间的黑人和居住在南方的人分别占艾滋病毒的75%和63% 2016年分别在黑色GBMSM中进行了诊断。大多数交叉柱头的概念化有 几乎完全是个人主义的。因此，在多层次的交叉方面存在很大差距 耻辱--个人(例如，内在化的艾滋病毒耻辱、人际歧视)、社区(例如，反同性恋 教会的耻辱)和社会结构(例如，刑事艾滋病毒暴露法)--阻碍艾滋病毒检测的相互联系 和PrEP用于南方年轻的黑人GBMSM。也缺乏经过验证的多层次衡量标准。 艾滋病毒预防研究的跨部门污名。为了解决这些关键的经验差距，纵向 提出了探索性-序贯混合方法研究(QUALQUANT)的提炼和验证方法 在亲本研究第一阶段对年轻黑人进行的多水平交叉柱头测量 在两个艾滋病毒高发的南部城市：华盛顿特区和杰克逊的GBMSM，有目的的抽样将 用于招募150名艾滋病毒阴性的年轻黑人GBMSM，年龄在15岁至34岁之间。第一阶段，在 母公司研究的原始资助期限，涉及：(1)文献和政策审查，以确定现有的 跨部门污名和与污名相关的法律和政策的措施；(2)60次深入的个人访谈 (30/城市)，以获得对多层次交叉污名的丰富和有背景依据的理解；以及(3) 专家评委(n=5至7)和社区对自我报告量表的内容效度评估 咨询委员会(CAB)成员(n=24；每个城市2个出租车)。拟议补编中的第二阶段和第三阶段继续 与父研究相同。第二阶段包括：(1)对20名参与者(10个/城市)进行认知访谈，以 完善自我报告措施；以及(2)对130名参与者(65个/城市)进行基线和3个月的跟踪调查 心理测量学分析。第三阶段涉及定性和定量结果和有效性的综合。 与每个城市的CAB成员一起对综合结果进行评估。家长研究的意义 在于制定新的多层次交叉污名措施，拟议的补充将 促进按计划完成心理测量评估和措施验证，尽管 该项目遭遇了与新冠肺炎相关的延误。这项研究进行了创新的多层次范式转变 从现状及其理论和方法的忠诚度到交叉性的核心原则。这个 预期成果是多层次的新的自我报告和客观/非自我报告措施的发展 交错的污名，反映了年轻的黑人GBMSM生活在 两个截然不同的南方城市。这些措施将为未来的艾滋病毒预防研究和干预措施提供信息 改善南部年轻黑人GBMSM的艾滋病毒预防连续不断。

PROJECT SUMMARY/ABSTRACT The disproportionate impact of the HIV/AIDS epidemic among U.S. Black gay, bisexual, and other men who have sex with men (GBMSM) is staggering, especially among young Black GBMSM who live in the South. Black GBMSM between ages 13 to 34 and those who live in the South accounted for 75% and 63% of HIV diagnoses among Black GBMSM in 2016, respectively. Most conceptualizations of intersectional stigma have been almost exclusively individualistic. Consequently, substantial gaps exist about how multilevel intersectional stigma — individual (e.g., internalized HIV stigma, interpersonal discrimination), community (e.g., anti-gay stigma at church) and social-structural (e.g., criminal HIV exposure laws) — interconnects to hinder HIV testing and PrEP use for young Black GBMSM in the South. There is also a dearth of validated measures of multilevel intersectional stigma for HIV prevention research. To address these critical empirical gaps, a longitudinal exploratory-sequential mixed methods study (QUAL  QUANT) is proposed to refine and validate the Multilevel Intersectional Stigma Measure developed during Phase I of the parent study for young Black GBMSM in two high HIV incidence southern cities: Washington, DC and Jackson, MS. Purposive sampling will be used to recruit 150 HIV-negative young Black GBMSM, ages 15 to 34. Phase I, completed during the original funding period of the parent study, involved: (1) literature and policy reviews to identify existing measures of intersectional stigma and stigma-related laws and policies; (2) 60 in-depth individual interviews (30/city) to gain a rich and contextually-grounded understanding of multilevel intersectional stigma; and (3) content validity assessments of the self-report measures by expert judges (n = 5 to 7) and Community Advisory Board (CAB) members (n = 24; 2 CABs/city). Phase II and III in the proposed supplement remain unchanged from the parent study. Phase II involves: (1) cognitive interviews with 20 participants (10/city) to refine the self-report measures; and (2) baseline and 3-month follow-up surveys of 130 participants (65/city) for psychometric analyses. Phase III involves the synthesis of the qualitative and quantitative results and validity assessments of the synthesized results with CAB members in each city. The significance of the parent study lies in the development of new Multilevel Intersectional Stigma measures and the proposed supplement will facilitate the completion of the psychometric assessment and validation of the measures as planned despite the project experiencing COVID-19 related delays. The study makes an innovative multilevel paradigmatic shift from the status quo with its theoretical and methodological fidelity to intersectionality’s core tenets. The expected outcome is the development of new self-report and objective/non-self-report measures of multilevel intersectional stigma that reflect the “specific and particular” experiences of young Black GBMSM who live in two distinct southern cities. These measures will inform future HIV prevention research and interventions to improve the HIV prevention continuum for young Black GBMSM in the South.