Adolescent health at the intersections of sexual, gender, racial/ethnic, immigrant identities and native language: a supplementary study of HIV/AIDS preventive behaviors

项目摘要 包括青少年在内的性和性别少数群体（SGM）面临的风险不成比例 艾滋病毒/艾滋病感染与他们的异性恋，顺性别同龄人相比。然而，SGM青年并不是一个同质的 每个人都有多重社会身份，这影响了他们在世界上的看法，以及他们面临的风险和 他们所经历的保护。交叉性是指权力和特权的结构化方式， 相互关联的社会地位（例如，由于种族/民族，移民身份，母语）以及如何 个人经历反映了赋予特权和劣势的过程。相互构成的形式 社会压迫（例如，同时基于种族/民族、性别和性取向的耻辱）可能 不同的影响艾滋病毒的预防和治疗的SGM人与多重边缘化的社会地位。 生活在这些交叉的社会地位中可能会带来独特的挑战，也会带来优势， 促进健康发展。 2021年美国国家科学院、工程院和医学院共识研究报告强调 需要利用交叉性框架开展以性传播感染和艾滋病毒为重点的性健康研究， 预防和干预工作，包括针对处于社会边缘地位的青年。建立在文学上 揭示了艾滋病毒不平等对青年、SGM和种族/族裔多样性的不利和不成比例影响 社区，建议的补充将扩大我们现有的R 01，以应对以下艾滋病毒/艾滋病- 关于SGM青少年（13-19岁）的具体研究问题：1）艾滋病毒的差异 检测，艾滋病毒状况，PrEP经验和态度，以及不同年龄段青少年的高风险性行为 社会地位（即种族/民族群体、移民经历和母语）？2)差异如何 保护因素和其他特征解释了这些结果在不同年龄组之间的差异。 社会地位？和3）什么积极和消极的经验是特别相关的重叠， SGM身份、种族/民族、移民经历和本地人同时产生的不平等 语言？我们将通过两个研究目标来回答这些问题：第一，对2022年的浪潮进行分析 LGBTQ全国青少年调查（预计N~ 17，000）调查艾滋病毒/艾滋病预防方面的差异 行为，风险和保护因素的青少年与交叉的社会地位。我们将测试 多重假设，使用新的方法设计的研究扎根在一个交叉框架。 第二，对24-32岁的SGM青年进行定性访谈，从不同的社会地位，更深入地 了解量化结果，并提出具体、有效的干预建议。面试将 重点探讨污名化的经历如何影响艾滋病毒预防行为，以及什么支持青年 描述为防止艾滋病毒/艾滋病风险。定性调查结果将提供有关资产的重要信息， 最脆弱的SGM青年，以及如何为其他年轻人提供支持。

Project Summary Sexual and gender minority (SGM) populations, including adolescents, are at disproportionate risk of HIV/AIDS infection compared to their straight, cisgender peers. SGM youth, however, are not a homogenous population; each has multiple social identities that affect how they are viewed in the world and the risk and protection they experience. Intersectionality refers to ways in which power and privilege are structured based on interrelated social positions (e.g. due to race/ethnicity, immigrant status, native language) and how individual experiences reflect processes that confer privilege and disadvantage. Mutually constitutive forms of social oppression (e.g., stigma simultaneously based on race/ethnicity, gender, and sexual orientation) may differentially affect the HIV prevention and treatment of SGM people with multiple marginalized social positions. Living within these intersecting social positions may give rise to unique challenges as well as strengths that promote healthy development. The 2021 National Academies of Sciences, Engineering, and Medicine consensus study report highlights the need for sexual health research focused on STIs and HIV using an intersectionality framework to inform prevention and intervention efforts, including for youth with marginalized social positions. Building on literature revealing HIV disparities adversely and disproportionately affecting youth, SGM and racially/ethnically diverse communities, the proposed supplement will expand our existing R01 to address the following HIV/AIDS- specific research questions regarding SGM adolescents (13-19 years old): 1) What are differences in HIV testing, HIV status, PrEP experience and attitudes, and high-risk sexual behaviors among youth with different social positions (i.e. racial/ethnic groups, immigrant experiences, and native language)? 2) How do differences in protective factors and other characteristics explain differences in these outcomes among youth with different social positions? and 3) What positive and negative experiences are particularly relevant to the overlapping, simultaneous production of inequalities by SGM identity, race/ethnicity, immigration experiences, and native language? We will answer these questions through two study aims: First, conduct analysis of the 2022 wave of the LGBTQ National Teen Survey (expected N~17,000) to investigate disparities in HIV/AIDS-preventive behaviors, risk, and protective factors among adolescents with intersecting social positions. We will test multiple hypotheses using novel methods designed for studies grounded in an intersectional framework. Second, conduct qualitative interviews with 24-32 SGM youth from different social positions to more deeply understand quantitative findings and generate concrete, valid intervention recommendations. Interviews will focus on exploring how experiences of stigma affect HIV preventive behaviors and what supports youth describe as protective against HIV/AIDS risk. Qualitative findings will provide critical information on assets for the most vulnerable SGM youth and how they can be bolstered for other young people.