High Risk Men: Identity, Health Risks, and Stigma

描述（由申请人提供）：本研究是一项关于俄罗斯莫斯科同性恋、双性恋和男男性行为者（GB和MSM）的身份、健康风险和耻辱的流行病学调查。研究的目标是探索这些男性的新身份；优化流行病学方法，研究其健康风险和求医行为；优化难以到达的人群的招募方法，使他们接受艾滋病毒/性传播感染咨询和检测；了解自我，经历和感知到的耻辱在他们的生活中所扮演的角色。一个社会生态框架将用于一个描述性目标和两个方法论目标。目标1是描述性的，将探索莫斯科的GB和MSM社区。形成性质的研究将调查抽样和招募的方法，并探索这些男性经常光顾的实体和互联网场所，并将为调查工具的发展提供信息，包括文化上适当的性别认同测量和在线招募方法。目标2是评估莫斯科获得GB&MSM的最佳招募方法，以及这些招募方法使GB&MSM男性接受艾滋病毒/性传播感染咨询和检测的相对效率。将评估基于人口统计学特征、性认同和性取向、艾滋病毒检测史和未确诊的艾滋病毒/性传播感染流行情况的增强RDS和基于互联网的抽样（IBS）的招募效率和能力。我们还将评估在肠易激综合症招募的男性中进行艾滋病毒检测和保健服务的效率。目的3将调查莫斯科同性恋和非同性恋男性自我、感知和经历的耻辱的流行病学，测量这些群体中耻辱的流行程度，并通过招募法分层调查耻辱在性认同与行为风险、艾滋病毒/性传播感染和应对人权废除之间的关联中的调节作用。为了实现这些具体目标，形成性研究将包括大约120个关键信息者访谈和另外120个参与者的焦点小组，以进行调查工具认知测试和规模验证。随后将在莫斯科的1140名GB和MSM中加强RDS招募，并在网上招募的1140名男性中同时进行IBS。污名和人权评估将包括一个调整和完善污名量表的形成阶段，然后将该量表纳入改进的RDS和IBS招聘中。

DESCRIPTION (provided by applicant): This study is an epidemiologic investigation of identity, health risks, and stigma among gay, bisexual, and men who have sex with men (GB & MSM) in Moscow, Russia. The study goals are to explore the emerging identities among these men; optimize epidemiologic approaches to researching their health risks and health seeking behaviors; optimize recruitment methods for hard to reach subsets so as to bring them in for HIV/STI counseling and testing; and to understand the role that self, experienced and perceived stigma play in their lives. A social ecological framework will be used for the one descriptive and two methodologic aims. Aim 1 is descriptive and will explore the GB & MSM communities in Moscow. Formative qualitative research will investigate approaches to sampling and recruitment, and explore the physical and internet venues frequented by these men, and will inform the development of survey instruments, including a culturally- appropriate sexual identity measure, and online recruitment methods. Aim 2 is an assessment of optimal recruitment methods to access GB&MSM in Moscow and the relative efficiency of these recruitment methods to bring GB&MSM men in for HIV/STI counseling and testing. The recruitment efficiency and the ability of enhanced RDS and internet-based sampling (IBS) to access to GB&MSM subsets based on demographic characteristics, and sexual identity and orientation, history of HIV testing, and prevalence of undiagnosed HIV/STI will be assessed. We will also evaluate the efficiency of accrual into HIV testing and health care services among IBS recruited men. Aim 3 will investigate the epidemiology of self, perceived, and experienced stigma among gay identified and non-gay identified men in Moscow, measure the prevalence of stigma in these groups, and investigate the modifying role of stigma in the associations of sexual identity with behavioral risk, HIV/STI infection, and coping with human rights abrogations , stratifying by recruitment method. To accomplish these specific aims, formative research will include some 120 key informant interviews and focus groups with an additional 120 participants for survey instrument cognitive testing and scale validation. These will be followed by an enhanced RDS recruitment among 1140 GB & MSM in Moscow, and an IBS conducted concurrently among 1140 men recruited online. The stigma and human rights assessment will include a formative phase to adapt and refine the stigma scale, followed by integration of the scale into both the enhanced RDS and IBS recruitments.