Understanding Intersectional Discrimination and Adversities among Black Queer Women Living with HIV

背景：黑人妇女是美国迈阿密最大的艾滋病毒携带者群体，无论是在全国还是在当地。 艾滋病毒的中心；40%的人没有受到病毒抑制。此外，他们生活在多个边缘化身份的交汇点 在每天都要付出代价的社会结构中。微攻击是每天都有的，通过评论、笑话和微妙的侮辱， 以及贬低边缘群体(例如黑人个人、妇女、艾滋病毒携带者、 LGBTQ+)。尽管它们的频率和潜在的重要性，微侵袭在很大程度上被忽视在科学 关于感染艾滋病毒的黑人妇女的文献(BWLWH)。此外，几乎没有做过什么研究来理解 感染艾滋病毒的黑人顺性同性恋女性的经历。Logie等人。在一个种族中发现了，并且 加拿大艾滋病毒携带者的性别多样化妇女群体，系统性的多层次歧视，如艾滋病毒- 相关的污名、性别歧视、种族主义和同性恋恐惧症与艾滋病毒相关的护理、福祉和 制定应对策略。在感染艾滋病毒的黑人同性恋妇女中，Logie等人。研究发现，增加体内的 生活质量与控制他们的艾滋病毒护理和拥有一个支持的医疗团队有关 专业人士。然而，研究仅限于携带艾滋病毒的黑人同性恋女性，并且没有先前的研究检查 微侵害性、歧视、反复发生的暴力、心理健康和HIV结局之间的关系 特别是在美国震中(佛罗里达州迈阿密)感染艾滋病毒的黑人同性恋女性中。家长助学金：MMAGIC (监测微侵略性和负性以产生改变的干预措施)重点关注微侵害性和 由心理健康症状介导的艾滋病毒病毒抑制(主要结果)的其他负面预测因素 以及黑人妇女的健康行为(对艺术的坚持和对护理的投入)。它正在纵向研究这两个问题 个人(例如，自我效能感)、人际(例如，社会)弹性因素的潜在直接影响和调节 支持)和社区级别(例如，社区卫生中心)。补充研究计划：本项目将(A) 检查MMAGIC中同性恋女性(与非同性恋女性相比)在微攻击性方面的定量数据 (LGBTQ、种族、性别和艾滋病毒相关)、宏观歧视(LGBTQ、种族、性别和艾滋病毒相关)、 创伤/暴力、精神健康和艾滋病毒结果，并观察这些变量如何随时间和(B)相关和变化 对20-30名妇女进行深入的定性访谈，了解她们遭受跨部门歧视的经历和 微攻击性以及他们如何驾驭这些经验(例如，有益的应对和资源)。培训计划： 这一补充将为Mya Wright提供一个无与伦比的培训机会，她是一名非裔美国酷儿博士 迈阿密大学临床健康心理学专业的学生。她将得到著名学者(戴尔博士， 鲍列格、洛吉和铁森)在艾滋病毒和交叉性方面(B)获得定性方法方面的专业知识和高级 评估感染艾滋病毒的黑人同性恋妇女的跨部门逆境的量化技能，(C)加强和 发展技能，利用研究成果，为制定具有文化能力的种族和文化干预措施提供信息 (D)加强其在手稿准备、出版和赠款写作方面的技能。

Background: Black women represent the largest group of women with HIV, both nationally, and locally in Miami, a U.S. HIV epicenter; and 40% are not virally suppressed. Further, they live at the intersection of multiple marginalized identities and within social structures that take a daily toll. Microaggressions are every day and subtle insults via comments, jokes, and behaviors that are demeaning to a marginalized group (e.g. Black individuals, women, people living with HIV, LGBTQ+). Despite their frequency and potential importance, microaggressions have largely been ignored in the scientific literature on Black women living with HIV (BWLWH). Further, little research has been done to understand the experiences of Black cisgender queer women who are living with HIV. Logie et al. found that amongst an ethnically, and sexually diverse group of women living with HIV in Canada, systemic multilevel forms of discrimination such as HIV- related stigma, sexism, racism, and homophobia were interconnected with barriers to HIV-related care, well-being, and development of coping strategies. Among Black queer women living with HIV Logie et al. found that increased levels of quality of life are associated with having control over their HIV care and having a supportive team of healthcare professionals. However, studies are limited among Black queer women living with HIV and no prior studies examining the relationships among microaggressions, discrimination, reoccurring violence, mental health, and HIV outcomes specifically among Black queer women living with HIV in a U.S. epicenter (Miami, FL). Parent Grant: MMAGIC (Monitoring Microaggressions and Adversities to Generate Interventions for Change) focuses on microaggressions and other adversities as negative predictors of HIV viral suppression (main outcome) mediated by mental health symptoms and health behaviors (ART adherence and engagement in care) among Black women. It is longitudinally examining both potential direct effects and moderation by resilience factors at the individual (e.g., self-efficacy), interpersonal (e.g., social support), and neighborhood level (e.g., community health centers). Supplement Research Plan: This project will (a) examine the quantitative data for the queer women in MMAGIC (compared to non-queer women) on microaggressions (LGBTQ-, race-, gender- and HIV-related), macro discrimination (LGBTQ-, race-, gender- and HIV-related), trauma/violence, mental health, and HIV outcomes and observe how the variables relate and change over time and (b) conduct in-depth qualitative interviews with 20-30 of the women on their experiences of intersectional discrimination and microaggressions and how they are navigating these experiences (e.g., helpful coping and resources). Training Plan: This supplement would provide an unmatched training opportunity for Mya Wright, an African American queer PhD student in Clinical Health Psychology at the University of Miami. She will be (a) mentored by renown scholars (Drs. Dale, Bowleg, Logie, and Ironson) in HIV and intersectionality (b) obtain expertise in qualitative methods and advanced quantitative skills for assessing intersectional adversities among Black queer women living with HIV, (c) enhance and develop skills to utilize research findings to inform the development of culturally competent interventions for racial and sexually minoritized women, and (d) strengthen her skills in manuscript preparation, publication, and grant writing.