African American Young Mens Study

描述（由申请人提供）：此修订后的申请是为了响应美国国立卫生研究院题为“艾滋病毒/艾滋病的健康差异：关注非裔美国人”（PA-06-069，重新印发为PA-07-116），该法案承认“非裔美国人[代表]这个群体经历了异常高的新艾滋病毒感染率和比这个国家其他种族/种族群体更差的生存率。“可以肯定的是，由于我们现在处于艾滋病毒流行的第三个十年，与男性发生性关系的非洲裔美国男子仍然不成比例地受到美国艾滋病毒/艾滋病流行的影响。也许这一人群中最隐蔽的部分是与男性发生性关系的非洲裔美国年轻男子，他们现在是与男性发生性关系的男子中新感染者的最大比例。虽然利用酒吧环境或社区组织针对同性恋社区开展的艾滋病毒预防工作取得了成功，但研究表明，许多有风险的AAYMSM并不经常光顾这些场所。相反，大量的AAYMSM可以通过球和房子社区接触。Ball社区围绕着被称为“房屋”的集体，这些房屋是种族、民族和性少数群体定义的社区，其特征是由年轻男子组成的群体，他们创建了一个家庭结构，有一个指定的“母亲”、“父亲”和其他成员，称为“孩子”。“这些房子为成员提供了一个朋友网络和一个寻求支持、积极肯定规范、集体认同和AAYMSM之间联系的地方。年轻男子往往在被自己的家庭拒绝后加入一个议院。球，这是一个月举行几次，是奢侈的庆祝活动/比赛，作为一个社会活动的有色男同性恋者，特别是AAYMSM。我们自己的研究表明，球和房子社区可能是理想的设置，在其中进行艾滋病毒预防研究与AAYMSM。因此，我们建议进行民族志和调查研究，以更好地了解和检查：1）球和房子社区的结构，社会和文化特征; 2）球和房子成员使用非法药物和参与艾滋病毒的风险和保护行为，以及他们的社会和性网络;以及3）排斥、歧视和内化的同性恋恐惧症在鼓励吸毒和艾滋病毒风险方面所起的作用。公共卫生相关性：由于我们现在处于艾滋病毒流行的第三个十年，与男性发生性关系的非洲裔美国男子仍然不成比例地受到美国艾滋病毒/艾滋病流行的影响。也许这一人群中最隐蔽的部分是与男性发生性关系的非洲裔美国青年男子，他们现在在与男性发生性关系的男子中占新感染者的最大比例。我们自己的研究表明，球和房子社区可能是理想的设置，在其中提供针对AAYMSM艾滋病毒预防干预措施。因此，我们建议进行人种学和调查研究，以确定这些社区成员的危险行为特征，并确定预防艾滋病毒的机会。

DESCRIPTION (provided by applicant): This revised application is being resubmitted in response to the National Institutes of Health's Program Announcement entitled, "Health Disparities in HIV/AIDS: Focus on African Americans" (PA-06-069, reissued as PA-07-116), which recognizes that "African Americans [represent] a group that has experienced exceptionally high rates of new HIV infections and worse survival rates than other ethnic/racial groups in this country." To be sure, as we are now in the third decade of the HIV epidemic, African American men who have sex with men remain disproportionately affected by the HIV/AIDS epidemic in the US. Perhaps the most hidden segment of this population are African American young men who have sex with men (AAYMSM), who now represent the largest proportion of new infections among men who have sex with men (MSM). Though HIV prevention efforts using bar settings or community-based organizations targeting the gay community have been met with success, research indicates that many at-risk AAYMSM do not frequent these venues. Instead, large numbers of AAYMSM can be reached through the Ball and House communities. The Ball community revolves around collectives called "Houses," which are racial, ethnic, and sexual minority defined communities that are characterized by groups of young men who create a family structure with an appointed "mother," "father" and other members called "the children." The Houses offer members a network of friends and a place to turn to for support, positive affirming norms, collective identity, and connectedness among AAYMSM. Often young men join a House after having been rejected by their own family. The Balls, which are held several times a month, are lavish celebrations/competitions that serve as a social event for MSM of color, particularly AAYMSM. Our own research suggests that the Ball and House communities could be ideal settings in which to conduct HIV prevention research with AAYMSM. We are therefore proposing to conduct ethnographic and survey research to better understand and examine: 1) the structural, social, and cultural characteristics of the Ball and House communities; 2) Ball and House members' use of illicit drugs and involvement in HIV risk and protective behaviors, and their social and sexual networks; and 3) the role that rejection, discrimination, and internalized homophobia play with respect to encouraging drug use and HIV risk. PUBLIC HEALTH RELEVANCE: As we are now in the third decade of the HIV epidemic, African American men who have sex with men remain disproportionately affected by the HIV/AIDS epidemic in the US. Perhaps the most hidden segment of this population are African American young men who have sex with men (AAYMSM), who now represent the largest proportion of new infections among men who have sex with men. Our own research suggests that the Ball and House communities could be ideal settings in which to deliver HIV prevention interventions targeted to AAYMSM. We are therefore proposing to conduct ethnographic and survey research designed to characterize the risk behaviors of members of these communities, as well as identify opportunities for HIV prevention.