Understanding and reducing HIV risk behavior and substance use among self-identified bisexual adolescent men

项目摘要： 年轻的男同性恋、双性恋和其他男男性行为者（MSM）受艾滋病毒影响的比例不成比例。 尽管有这样的负担，大多数艾滋病毒预防干预措施都针对成年男男性行为者（其中大多数人是同性恋）， 同性恋和双性恋青少年的问题，迫切需要对同性恋和双性恋青少年进行干预。此外，自- 已确定的双性恋男子，特别是青少年，在研究中被忽视。这是一个关键问题 因为：（1）双性恋青少年男性的数量与同性恋青少年男性的数量一样多，如果不是更多的话;（2）双性恋青少年男性的数量与同性恋青少年男性的数量一样多，如果不是更多的话。 男性青少年比同性恋青少年更多地从事几种HIV危险行为;（3）双性恋男性青少年 物质使用的风险增加-这是艾滋病毒的一个强有力的风险因素;（4）双性恋男性面临独特的艾滋病毒 预防问题。鉴于双性恋男性很少被纳入研究， 关注“行为双性恋”的成年男性，对推动风险行为的因素知之甚少 双性恋的青少年中。关注双性恋身份对于减少艾滋病毒和 物质使用，因为双性恋是高度污名化和污名相关的压力源（例如，担心 披露自己的双性恋身份）会影响性行为、物质使用和医疗保健利用。 干预措施在适合人群时也更有效，强调需要采取干预措施， 自认为是双性恋的青少年男性本研究的目的是：（1）探讨影响教师敬业度的因素 在艾滋病毒的危险行为和物质使用自我认定的双性恋青少年男子;和（2）开发和试点 测试针对这一人群的艾滋病毒和药物使用预防干预措施。在第一阶段，面试将 对60名不同的自我认同的双性恋青少年男性进行了调查，年龄在14-17岁之间，重点关注性身份，性取向， 决策、药物使用动机和干预偏好/障碍。在第二阶段， 将使用第1阶段的结果制定干预措施。在第三阶段，可行性、可接受性和初步 疗效将在一项试验性随机试验（N = 60）中进行测试，其中有一个等待名单对照和一个月的随访。这 奖学金将为申请人提供青少年健康，定性方法和 西北大学性与性别少数健康研究所的干预发展， 福祉--为培训性和性别少数学者提供资源充足、丰富的智力环境 健康研究。培训和研究活动将有助于申请人过渡到独立的 一个研究项目的调查员，该项目的重点是了解和消除艾滋病毒和药物使用 影响双性恋男性的差异。总而言之，自我认同的双性恋青少年男性感染艾滋病毒的风险增加 和物质使用，但对促使他们参与风险行为的因素知之甚少。通过关注 自我认定的双性恋青少年男性-一个代表性不足，健康差距的人口-这项研究可以确定 预防目标，减少艾滋病毒和药物使用方面的差距。

Project Summary: Young gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. Despite this burden, most HIV prevention interventions target adult MSM (most of whom identify as gay) and heterosexual youth, creating an urgent need for interventions for gay and bisexual adolescents. Further, self- identified bisexual men, especially adolescents, have been neglected in research. This is a critical problem because: (1) there are as many, if not more, bisexual adolescent men than gay adolescent men; (2) bisexual adolescent men engage in several HIV risk behaviors more than their gay peers; (3) bisexual adolescent men are at increased risk for substance use–a robust risk factor for HIV; and (4) bisexual men face unique HIV prevention issues. Given that bisexual men are rarely included in research and most existing research on them focuses on “behaviorally bisexual” adult men, little is known about factors that drive engagement in risk behavior among self-identified bisexual adolescent men. Attending to bisexual identity is critical to reducing HIV and substance use, because bisexuality is highly stigmatized and stigma-related stressors (e.g., concerns about disclosing one’s bisexual identity) impact sexual behavior, substance use, and healthcare utilization. Interventions are also more effective when tailored to populations, underscoring the need for an intervention for self-identified bisexual adolescent men. The goals of this study are to: (1) examine factors that drive engagement in HIV risk behavior and substance use among self-identified bisexual adolescent men; and (2) develop and pilot test a tailored HIV and substance use prevention intervention for this population. In Phase 1, interviews will be conducted with 60 diverse self-identified bisexual adolescent men ages 14-17 focused on sexual identity, sexual decision-making, substance use motivations, and intervention preferences/barriers. In Phase 2, a tailored intervention will be developed using findings from Phase 1. In Phase 3, feasibility, acceptability, and preliminary efficacy will be tested in a pilot randomized trial (N = 60) with a waitlist control and one-month follow-up. This award will provide the applicant with career development training in adolescent health, qualitative methods, and intervention development at Northwestern University’s Institute for Sexual and Gender Minority Health and Wellbeing–a well-resourced, rich intellectual environment for training scholars in sexual and gender minority health research. The training and research activities will facilitate the applicant’s transition to an independent investigator with a program of research focused on understanding and eliminating HIV and substance use disparities affecting bisexual men. In sum, self-identified bisexual adolescent men are at increased risk for HIV and substance use, but little is known about factors that drive their engagement in risk behavior. By focusing on self-identified bisexual adolescent men–an underrepresented, health disparity population–this study can identify prevention targets and reduce disparities in HIV and substance use.