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

制定和验证多层次交叉耻辱的新措施，以改善南方年轻黑人同性恋双性恋和其他男男性行为者的艾滋病毒预防连续性

• 批准号: 10599709
• 负责人: Ingrid Alisa Bowleg
• 金额: $ 21.81万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10599709
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Age; Award; Bisexual; Black race; COVID-19; COVID-19 pandemic effects; Censuses; Church; Cities; Communities; Data; Development; Discrimination; Ecology; Epidemic; Funding; Future; Gays; Gender; Group Structure; HIV; HIV Seronegativity; HIV diagnosis; HIV risk; Health; Heterosexuals; Human immunodeficiency virus test; Incidence; Individual; Interview; Knowledge; Laws; Literature; Maps; Measures; Methodology; Methods; National Institute of Mental Health; National Institute on Minority Health and Health Disparities; Outcome; Parents; Participant; Patient Self-Report; Phase; Policies; Population; Positioning Attribute; Poverty; Prevention Research; Property; Psychometrics; Race; Religion and Spirituality; Research; Sampling; Self Assessment; Sexual and Gender Minorities; Social Processes; Stigmatization; Surveys; Validation; Visualization; Washington; Woman; base; cognitive interview; data space; design; experience; follow-up; improved; innovation; intersectionality; member; men; men who have sex with men; multidisciplinary; pre-exposure prophylaxis; preventive intervention; programs; recruit; sexual minority; social; social media; social stigma; social structure; sociodemographics

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.

项目总结/摘要 艾滋病毒/艾滋病流行病对美国黑人同性恋、双性恋和其他男性的影响尤为严重。 与男性发生性关系（GBMSM）是惊人的，特别是在年轻的黑人GBMSM谁住在南方。 年龄在13岁至34岁之间的黑人GBMSM和那些居住在南方的人分别占艾滋病毒感染者的75%和63% 在2016年，黑GBMSM的诊断分别。大多数交叉污名的概念化都有 几乎完全是个人主义的。因此，关于多层次交叉的 污名-个体（例如，内化的艾滋病毒耻辱、人际歧视）、社区（例如，反同性 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。也缺乏多层次的有效措施， 艾滋病预防研究的交叉污名。为了解决这些关键的经验差距， 探索性序贯混合方法研究（QUAL QUANT-QUANT）提出了完善和验证 在对年轻黑人的父母研究的第一阶段开发的多水平交叉污名测量 在两个艾滋病毒高发病率的南方城市：华盛顿，DC和杰克逊，MS。 用于招募150名艾滋病毒阴性的年轻黑人GBMSM，年龄在15至34岁之间。第一阶段， 母研究的原始资助期，包括：（1）文献和政策审查，以确定现有的 交叉污名化和污名化相关法律和政策的措施;（2）60次深入的个人访谈 (30/城市），以获得一个丰富的和上下文接地的多层次交叉污名的理解;和（3） 由专家法官（n = 5至7）和社区对自我报告措施进行内容效度评估 咨询委员会（CAB）成员（n = 24; 2个CAB/城市）。拟议补编的第二和第三阶段仍然是 与母研究相同。第二阶段包括：（1）与20名参与者（10名/城市）进行认知访谈， 完善自我报告的措施;（2）基线和3个月的后续调查的130名参与者（65/城市）， 心理分析。第三阶段涉及定性和定量结果的综合和有效性 与每个城市的CAB成员一起评估综合结果。父母研究的意义 在于制定新的多层次交叉污名措施，拟议的补充措施将 促进按计划完成心理测量评估和措施的验证， 该项目经历了与COVID-19相关的延迟。这项研究进行了创新性的多层次范式转变 从现状出发，在理论和方法上忠实于交叉性的核心原则。的 预期的结果是发展新的自我报告和客观/非自我报告的多层次措施 交叉的耻辱，反映了“具体和特殊”的经验，年轻的黑人GBMSM谁住在 两个不同的南方城市。这些措施将为今后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性。