Gender, Power and Latino Mens HIV Risk

描述（由申请人提供）：十多年来，艾滋病一直是25至44岁拉丁裔男女死亡的主要原因。专门为拉丁裔男性制定的少数艾滋病毒预防和治疗干预措施侧重于注射吸毒者（IDU）或男男性行为者（MSM），但忽视了一个重要的流行病学群体，即男男性行为者和女男性行为者（MSMW）。考虑到他们在性行为活跃的男性人群和异性恋人群之间的性网络联系中所起的作用，这一群体对理解艾滋病毒的传播尤其重要。这项拟议的研究将为行为上双性恋的拉丁裔男性开发一种创新的试点干预措施。我们提出以下具体目标：1)描述劳动和文化背景的背景因素（如就业机会、民族-种族紧张关系、工作相关情况的处理、异性恋和工作场所的性别规范）影响双性恋男性从事危险性行为的可能性的机制；2)探讨家庭和宗教背景的中心地位如何塑造男性的权力观念，以及这些因素如何反过来促进或阻止双性恋拉丁裔男性的性冒险行为；3)描述拉丁裔双性恋男性的艾滋病毒风险意识、艾滋病毒风险的地理背景、双性恋风险行为，以及这些行为与男性生活中的性别和权力动态之间的关系；4)研究艾滋病服务提供组织（ASDOs）成员对拉丁裔男性和双性恋的社会观念如何影响或限制纽约大都会地区拉丁裔双性恋男性获得艾滋病毒预防服务。为了实现这些目标，我们提出了一项为期4年的民族志研究设计，包括数据收集的两个组成部分。第一部分将包括对行为上双性恋的拉丁裔男性（n=160）的深入访谈，这些人来自纽约市大都市区的五个研究地点。研究的前两年将专门用于深度访谈部分。该研究的第二个数据收集部分将是人种志。该部分将持续3年，从第一年和第二年开始进行关键信息提供者访谈（n=25），并在第三年继续进行人种学绘图，并与5个研究地点的艾滋病服务提供机构进行25次小组访谈。项目的最后一年将侧重于使用干预绘图（IM）来分析收集的数据并设计试点干预措施，以降低双性恋拉丁裔男性的艾滋病毒风险。这项被提议的研究将是第一个关注美国拉美裔双性恋和艾滋病风险问题的大规模研究项目之一。

DESCRIPTION (provided by applicant): AIDS has been a leading cause of death among Latino women and men 25 to 44 years of age for more than a decade. The few HIV prevention and treatment interventions developed specifically for Latino men have focused on injecting drug users (IDU) or men who have sex with men (MSM), but have neglected a critical epidemiological group, men who have sex with men and with women (MSMW). This group is particularly relevant in understanding the spread of HIV given the role they play in sexual network connections between the homosexually active male population and heterosexual population. The proposed study will develop an innovative pilot intervention for behaviorally bisexual Latino men. We propose the following specific aims: 1) To describe the mechanisms by which contextual factors of labor and cultural backgrounds (such as access to employment, ethnic-racial tensions, coping with job-related situations, heterosexism and gender norms in the workplace) influence bisexual men's likelihood of engaging in risky sexual practices; 2)To explore how men's notions of power are shaped by the centrality of family and religious background, and how these factors in turn, facilitate or prevent sexual risk taking among bisexual Latino men; 3) To describe bisexual Latino men's ideologies of HIV risk, the geographical context of HIV risk, and how bisexual risk behavior, and how they are related or not to gender and power dynamics in the men's lives; and, 4) To examine how the perceptions of members of AIDS Service Delivery Organizations (ASDOs) of societal notions of Latino masculinity and bisexuality create or limit access to HIV prevention services for bisexual Latino men in the New York Metropolitan Area. To accomplish these aims, we propose a 4-year ethnographic study design with two components of data collection. The first component will consists of in-depth interviews with behaviorally bisexual Latino men (n=160) from five research sites in the New York City metropolitan area. The first two years of the study will be dedicated to the in-depth interviews component. The second data collection component of the study will be an ethnography. This component will last 3 years, beginning in years 1 and 2 with key informant interviews (n=25) and continuing in year 3 with ethnographic mapping and 25 group interviews with AIDS Service Delivery Organizations across the 5 research sites. The last year of the project will focus on using Intervention Mapping (IM) to analyze the data collected and design the pilot intervention to reduce HIV risk among bisexual Latino men. The proposed study will be one of the first large-scale research projects to focus on issues of bisexuality and HIV risk among Latinos in the United States. PUBLIC HEALTH RELEVANCE: 1. Given the raise in HIV cases in the United States, particularly among homosexually and bisexually active men of color, this study takes an innovative approach to the examination of HIV risk among by exploring how broad forms of social inequality and the sexual ecology of bisexual behavior among Latino men constrain the options for a relatively less powerful group of men, and how ideologies of masculinity intersect with structural social inequalities to create HIV risks for bisexual Latino men. 2. This will be one of the first large-scale research projects to focus on issues of bisexuality and HIV risk among Latinos and the first one to examine how the context of labor and sexual markets shape the sexual lives and health risks of bisexual men of color. 3. The proposed study will be one of the few research projects that utilize HIV prevention research to design a multilevel, theory and evidence-based intervention to reduce HIV/STI risk for bisexual Latino men, a consistently overlooked population in public health.