NEXUS: A novel social network approach to study the effects of intersectional stigma on HIV prevention among Latino MSM

NEXUS：一种新颖的社交网络方法，用于研究拉丁裔 MSM 中交叉耻辱对艾滋病毒预防的影响

• 批准号: 10617641
• 负责人: Laramie Rae Smith
• 金额: $ 68.55万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10617641
• 关键词: AIDS prevention; Accounting; Acculturation; Adherence; Adult; Affect; Age; California; Characteristics; Communities; County; Data; Environment; Epidemic; Equipment and supply inventories; Ethnic Origin; Exposure to; Family; Family member; Fostering; Friends; Fright; Future; Gender; Gender Identity; HIV; HIV Infections; HIV Seronegativity; HIV diagnosis; HIV disparities; HIV risk; Health; Homophobia; Human immunodeficiency virus test; Incidence; Individual; Intervention; Latino; Masculine; Measures; Mediating; Medical Records; Methods; Newly Diagnosed; Outcome; Pathway Analysis; Persons; Population; Prevention; Prevention strategy; Process; Provider; Public Health; Puerto Rico; Research; Sexual Partners; Sexuality; Site; Social Environment; Social Network; Social support; Source; Stigmatization; US State; United States National Institutes of Health; Work; community organizations; density; ethnic identity; experience; health disparity; improved; innovation; member; men who have sex with men; novel; poor health outcome; pre-exposure prophylaxis; prevent; primary outcome; prospective; racism; recruit; resilience; response; sexual identity; social; social relationships; social stigma; uptake

220.7 PROJECT SUMMARY/ABSTRACT Stigma is a pervasive barrier to HIV testing and PrEP use among US Latino men who have sex with men (LMSM). Routine HIV testing and large scale PrEP coverage are essential HIV prevention strategies for ending the HIV epidemic. LMSM further contend with intersectional stigma, meaning they experience or fear unjust treatment from others due to their ethnic, sexual, and masculine identities (i.e. adherence to masculinity norms). Specific to intersectional stigma, emerging quantitative research suggests exposure to stigma towards >1 intersectional identity is associated with worse health outcomes than exposure to stigma towards a single intersectional identity. While research on intersectional stigma has been largely qualitative, advanced quantitative methods offer an opportunity to identify novel actionable intervention mechanisms and targets; improving our public health response to ending the US HIV epidemic. Social network analysis is a robust method for examining how LMSM interact with and are affected by others in their social network. Social networks are important intervention targets, since network members are capable of (1) stigmatizing LMSM (i.e. stigma sources) and (2) fostering resilience and social support to reduce the negative impact of intersectional stigma on LMSM’s HIV testing and PrEP use. The current study will prospectively assess how anticipated and enacted intersectional stigma are experienced by LMSM in their social networks at baseline to effect HIV testing and PrEP use 12-months post-baseline. We will recruit 500 HIV-negative adult LMSM from MSM and Latino community organizations. Study measures, including an egocentric social network inventory, will be collected at Months 0, 6, and 12. Our primary outcomes, HIV testing and PrEP use, will be abstracted from medical records at Month 12. We will use social network analysis to: (1) Identify how LMSM experience intersectional stigma in their social networks across diverse social context (i.e. types of social relationships [e.g. family, friends, sex partners, providers], expression of intersectional identities [e.g. acculturation, outness, masculinity]) (AIM 1, primary). (2) Prospectively evaluate the effect of social network exposure to intersectional stigma on HIV testing and PrEP use (AIM 2, primary). (3) Identify novel points of intervention to reduce the harmful effects of intersectional stigma on HIV testing and PrEP use (AIMS 3-4, exploratory) and develop data–and–community-informed intervention strategies for future piloting. As the first study to use social networks to evaluate the effects of intersectional stigma on health outcomes, NEXUS is significant because new HIV diagnoses among US LMSM are increasing–due to low rates of HIV testing (undiagnosed HIV) and PrEP use–while new diagnoses among non-LMSM have stabilized or decreased. A SN approach to studying intersectional stigma is highly innovative because it reflects a substantial departure from how intersectional stigma has been studied, opening new opportunities to end the HIV epidemic. Without such efforts, intersectional stigma will persist in producing and maintaining HIV disparities among LMSM.

220.7 项目概要/摘要 在美国拉丁裔男男性行为者 (LMSM) 中，耻辱是艾滋病毒检测和 PrEP 使用的普遍障碍。 常规 HIV 检测和大规模 PrEP 覆盖是结束 HIV 的重要 HIV 预防策略 流行性。 LMSM 进一步应对交叉耻辱，这意味着他们经历或害怕不公正的待遇 由于种族、性别和男性身份（即遵守男性气质规范）而受到其他人的影响。具体的 对于交叉耻辱，新兴的定量研究表明，> 1 交叉耻辱暴露于耻辱 与暴露于单一交叉点的耻辱相比，身份与更糟糕的健康结果相关 身份。虽然对交叉污名的研究主要是定性的，但先进的定量方法 提供确定新的可行干预机制和目标的机会；改善我们的公共卫生 结束美国艾滋病毒流行的反应。社交网络分析是检查 LMSM 如何实现的可靠方法 与社交网络中的其他人互动并受其影响。社交网络是重要的干预目标， 因为网络成员有能力 (1) 羞辱 LMSM（即耻辱源）和 (2) 培养复原力 和社会支持，以减少交叉耻辱对 LMSM 的 HIV 检测和 PrEP 使用的负面影响。 当前的研究将前瞻性地评估预期和实施的交叉耻辱是如何经历的 由 LMSM 在基线时在其社交网络中进行，以在基线后 12 个月内进行 HIV 检测和 PrEP 使用。我们 将从 MSM 和拉丁裔社区组织招募 500 名 HIV 阴性成人 LMSM。研究措施， 包括以自我为中心的社交网络库存，将在第 0、6 和 12 个月收集。我们的主要成果， HIV 检测和 PrEP 使用将从第 12 个月的医疗记录中提取。我们将使用社交网络 分析目的：(1) 确定 LMSM 如何在跨不同社会的社交网络中经历交叉耻辱 背景（即社会关系的类型[例如家人、朋友、性伴侣、提供者]、交叉关系的表达 身份[例如文化适应、外在、男性气质]）（AIM 1，主要）。 (2) 前瞻性评估效果 社交网络在 HIV 检测和 PrEP 使用方面面临交叉耻辱（AIM 2，主要）。 (3) 识别小说 减少交叉耻辱对 HIV 检测和 PrEP 使用的有害影响的干预点（AIMS 3-4，探索性）并为未来的试点制定数据和社区知情的干预策略。 作为第一项使用社交网络来评估交叉耻辱对健康结果影响的研究， NEXUS 意义重大，因为美国 LMSM 中新的艾滋病毒诊断正在增加——由于艾滋病毒感染率较低 检测（未确诊的 HIV）和 PrEP 使用——而非 LMSM 中的新诊断已稳定或减少。 研究交叉耻辱的 SN 方法具有高度创新性，因为它反映了重大背离 交叉污名的研究为结束艾滋病毒流行提供了新的机会。没有 通过这些努力，交叉耻辱将持续产生和维持 LMSM 之间的艾滋病毒差异。

项目成果

The moderating role of resilience in the relationship between experiences of COVID-19 response-related discrimination and disinformation among people who inject drugs.

• DOI: 10.1016/j.drugalcdep.2023.109831
• 发表时间: 2023-05-01
• 期刊: Drug and alcohol dependence
• 影响因子: 4.2
• 作者: Algarin AB;Yeager S;Patterson TL;Strathdee SA;Harvey-Vera A;Vera CF;Stamos-Buesig T;Artamanova I;Abramovitz D;Smith LR
• 通讯作者: Smith LR

Examining HIV Stigma, Depression, Stress, and Recent Stimulant Use in a Sample of Sexual Minority Men Living with HIV: An Application of the Stigma and Substance Use Process Model.

检查HIV污名，抑郁，压力和最近在患有艾滋病毒的性少数族裔男性样本中使用：污名和药物使用过程模型的应用。

• DOI: 10.1007/s10461-021-03517-0
• 发表时间: 2022-01
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Meyers-Pantele SA;Lammert S;Rendina HJ;Shalhav O;Talan AJ;Smith LR;Pitpitan EV;Horvath KJ
• 通讯作者: Horvath KJ

Association of alcohol and other substance-related diagnoses with severe maternal morbidity.

酒精和其他与物质有关的诊断与严重的母体发病率的关联。

• DOI: 10.1111/acer.14671
• 发表时间: 2021-09
• 期刊: Alcoholism, clinical and experimental research
• 作者: Courchesne NS;Smith LR;Zúñiga ML;Chambers CD;Reed MB;Ballas J;Marienfeld CB
• 通讯作者: Marienfeld CB

Binge drinking disparities by gender identity, race, and ethnicity in California secondary schools.

加州中学因性别认同、种族和民族而存在的酗酒差异。

• DOI: 10.1080/19361653.2022.2113198
• 发表时间: 2023
• 期刊: Journal of LGBT youth
• 影响因子: 2.4
• 作者: Andrzejewski,Jack;Calzo,JerelP;Smith,LaramieR;Corliss,HeatherL;Felner,JenniferK
• 通讯作者: Felner,JenniferK