The Influence of Developmental Assets on Intersectional Stigma and HIV Prevention Behaviors in Black MSM

摘要 在美国，与男性发生性行为的年轻黑人男性(YBMSM)感染艾滋病毒的比例不成比例， 然而，研究只集中在识别和减少艾滋病毒相关的风险因素上，而没有扩展到 同时确定并增加他们生活中存在的有益资产。这项研究将调查如何 以强度为基础的方法可以优化艾滋病毒的结果，促进青壮年男童子军的健康和福祉。这个 发展资产框架侧重于确定四个领域的外部资产(即，支持、 赋权、边界/期望和建设性地利用时间)和四个领域的内部资产 (即积极的身份、积极的价值观、社会能力和对学习的承诺)。该模型包括一个 这些领域中共有40项资产，并假设资产数量的增加与 尽管遇到不良事件，但个体表现出积极结果的可能性增加。这个 资产建设框架的目标是确定尽可能多的资产。目前可用的证据 表明LGBT青年拥有的资产比非LGBT青年少；然而，这些资产的流行 具体而言，YBMSM之间的合作尚未建立。在科学知识方面的差距与 必须填补外部和内部资产对青年男性接触者艾滋病预防结果的影响，以便 可以制定适当的干预策略，以减少不成比例的艾滋病毒发病率。在目标1中，我们 将确定发展资产及其与艾滋病毒预防行为(艾滋病毒检测和预防预防)的关联 使用)。在第一阶段，我们将进行一项基于互联网的横断面调查，以非概率艾滋病毒样本- YBMSM阴性(N=500)，年龄14-25岁，来自美国中西部两个城市。我们将使用潜在的个人资料 分析(LPA)以确定YBMSM可能拥有的内部和外部资产的模式，并探索这些 资产的模式与PrEP的使用和最近的艾滋病毒检测有关。在AIM 1a中，我们将研究 跨部门污名缓和内部和外部资产与艾滋病毒之间的关联的影响 预防行为。在目标2中，我们将研究发展资产如何影响艾滋病毒的看法 使用内容分析的预防行为(艾滋病毒检测和PrEP使用)。我们将进行半深入的 有目的的亚样本(n=40)的结构化访谈，按年龄组和 14-17岁的YBMSM和18-25岁的年轻人的发展资产-高(n=10)和低(n=10) HIV预防行为(n=20)。年轻人将被问及他们对交叉耻辱和 它如何有助于他们参与艾滋病毒预防行为。

ABSTRACT Young Black men who have sex with men (YBMSM) are disproportionately affected by HIV in the United States, yet research has focused only on identifying and reducing HIV-associated risk factors and has not extended to simultaneously ascertain and increase beneficial assets present in their lives. This study will investigate how strength-based approaches can optimize HIV outcomes and promote the health and well-being of YBMSM. The developmental assets framework focuses on identifying external assets in four domains (i.e., support, empowerment, boundaries/expectations, and constructive use of time) and internal assets in four domains (i.e., positive identity, positive values, social competencies, and commitment to learning). The model includes a total of 40 assets within these domains and posits that an increase in the number of assets is associated with an increase in the likelihood of an individual to show positive outcomes despite encountering adverse events. The goal of the asset-building framework is to identify as many assets as possible. The currently available evidence indicates that LGBT youth have fewer assets than non-LGBT youth; however, the prevalence of these assets specifically among YBMSM has not yet been established. Gaps in the scientific knowledge pertaining to the influence of external and internal assets on HIV prevention outcomes among YBMSM must be filled so that proper intervention strategies can be developed to reduce the disproportionate HIV incidence. In Aim 1, we will identify developmental assets and their associations with HIV prevention behaviors (HIV Testing and PrEP Use). In Phase 1, we will conduct a cross-sectional internet-based survey with a non-probability sample of HIV- negative YBMSM (N=500), ages 14–25 years old from two Midwestern US cities. We will use a latent profile analysis (LPA) to identify patterns of internal and external assets YBMSM may have and explore how these patterns of assets are associated with PrEP use and recent HIV testing. In AIM 1a we will examine whether intersectional stigma moderates the effects of associations between the internal and external assets and HIV prevention behaviors. In Aim 2, we will examine perceptions of how developmental assets influence HIV prevention behaviors (HIV Testing and PrEP Use) using content analysis. We will conduct in-depth semi- structured interviews with a purposive sub-sample (n=40) stratified by age groups and the number of developmental assets—high (n=10) versus low (n=10)—for YBMSM ages 14–17 and young adults ages 18–25 on HIV prevention behaviors (n=20). Youth will be queried about their knowledge on intersectional stigma and how it contributes to their engagement in HIV prevention behaviors.