Intersectional minority stress, mental health, and HIV treatment and care among MSM living with HIV in Ghana

项目总结/摘要 在加纳，男男性行为者承担着很高的艾滋病毒负担，但只有不到4%的艾滋病毒阳性男男性行为者在接受抗逆转录病毒治疗， 在整个非洲都存在着差异。社会压力因素，如基于性和性别的污名化、刑事定罪， 和暴力，都与不良的心理健康和艾滋病毒的结果，并可能成为障碍， 非洲男男性行为者参与艾滋病毒服务。此K 01应用程序的目标是应用交叉性， 少数民族压力理论，以检查交叉社会压力源对心理健康和艾滋病毒治疗的影响 和照顾艾滋病毒阳性的男子谁发生性关系的男子在加纳，并适应和戏剧测试一个社区- 参与跨部门污名干预，以改善心理健康和艾滋病毒治疗结果。实现 这个目标，这个建议的培训目标是：1）发展内容的专业知识，在交叉社会压力 和少数民族压力理论以及这些理论在理解心理健康方面的交叉点; 2）发展 交叉社会压力源测量的方法学专业知识，包括潜在结构如何 3）获得先进统计方法（结构统计方法）方面的方法专门知识 方程建模，调解和优势分析），以了解可能中断的途径 改善健康;以及4）在社区参与，基于证据的交叉领域获得知识和技能 干预措施设计，以便为最需要的人群实施有效的干预措施。培训的目的 将通过一项研究计划来实现，该计划提出将交叉性和少数民族压力理论相结合 具体研究目标如下：1）探讨社会压力源的交叉性， 心理健康和艾滋病毒治疗经验的艾滋病毒阳性男男性接触者，以适应，概念上的定义， 在加纳使用的综合交叉少数民族压力模型中实施结构; 2）确定 交叉社会压力源，心理健康，保护因素， 和艾滋病毒治疗结果（治疗和护理中的联系和保留）;以及3）适应和剧场测试， 综合交叉心理健康和艾滋病毒治疗干预，以帮助男男性行为者科普艾滋病的影响。 社会压力因素对艾滋病毒治疗结果的影响。

PROJECT SUMMARY/ABSTRACT In Ghana, MSM bear a high HIV burden, yet less than 4% of HIV-positive MSM are on antiretroviral therapy—a disparity found throughout Africa. Social stressors, such as sexuality- and gender-based stigma, criminalization, and violence, have been linked to both poor mental health and HIV outcomes and may be barriers to optimal HIV service engagement among African MSM. The goal of this K01 application is to apply intersectionality and minority stress theory to examine the impact of intersectional social stressors on mental health and HIV treatment and care of HIV-positive men who have sex with men in Ghana and to adapt and theater test a community- engaged intersectional stigma intervention to improve mental health and HIV treatment outcomes. To achieve this goal, the training aims of this proposal are: 1) to develop content expertise in intersectional social stressors and minority stress theory and the intersection of these theories in understanding mental health; 2) to develop methodological expertise in intersectional social stressor measurement, including how latent constructs are operationalized and measured; 3) to gain methodological expertise in advanced statistical methods (structural equation modeling, mediation, and dominance analysis) towards understanding pathways that can be interrupted to improve health; and 4) to obtain knowledge & skills in community engaged, evidence-based intersectional intervention design in order to conduct impactful interventions for the populations most in need. The training aims will be achieved through a research plan that proposes to integrate intersectionality and minority stress theory and operationalize measures to study the following specific aims: 1) to explore the intersectional social stressor, mental health, and HIV treatment experiences of HIV-positive MSM in order to adapt, conceptually define, and operationalize constructs in the integrated intersectional minority stress model for use in Ghana; 2) to identify intervenable factors in the relationship between intersectional social stressors, mental health, protective factors, and HIV treatment outcomes (linkage and retention in treatment and care); and 3) to adapt and theater test an integrated intersectional mental health and HIV treatment intervention to help MSM cope with the impact of intersectional social stressors on HIV treatment outcomes.