African American Young Mens Study

描述（由申请人提供）：本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：关注非洲裔美国人”的项目公告（PA-06-069，重新发布为PA-07-116）而重新提交的，该公告承认“非洲裔美国人[代表]一个经历了异常高的新艾滋病毒感染率和比这个国家其他民族/种族群体更差的生存率的群体。”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裔美国男性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行为的非裔美国年轻男性（AAYMSM），他们现在在与男性发生性行为的男性（MSM）中占新感染的比例最大。尽管通过酒吧设置或以社区为基础的组织针对同性恋群体的艾滋病预防工作取得了成功，但研究表明，许多有感染风险的男同性恋者并不经常光顾这些场所。相反，大量的AAYMSM可以通过Ball和House社区接触到。鲍尔社区围绕着被称为“房子”的集体展开，这些集体是由种族、民族和性少数群体定义的社区，其特点是由一群年轻男性组成的家庭结构，其中有指定的“母亲”、“父亲”和其他被称为“孩子”的成员。这些房屋为成员提供了一个朋友网络和一个可以寻求支持、积极肯定规范、集体认同和AAYMSM之间联系的地方。年轻人通常是在被自己的家庭拒绝后加入一个家族的。舞会一个月举行几次，是一场盛大的庆祝活动/比赛，是有色人种男同性恋者（尤其是同性恋男同性恋者）的社交活动。我们自己的研究表明，Ball和House社区可能是开展艾滋病预防研究的理想场所。因此，我们建议进行人种学和调查研究，以更好地理解和检查：1)鲍尔和豪斯社区的结构、社会和文化特征；2)参众两院议员使用违禁药物和参与艾滋病毒风险和保护行为，以及他们的社会和性网络；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，与男性发生性行为的非裔美国人仍然不成比例地受到美国艾滋病毒/艾滋病流行的影响。也许这个人群中最隐蔽的部分是与男性发生性行为的非洲裔美国年轻男性（AAYMSM），他们现在在与男性发生性行为的男性中占新感染的比例最大。我们自己的研究表明，Ball和House社区可能是提供针对AAYMSM的艾滋病毒预防干预措施的理想场所。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.