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

摘要

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.