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打破障碍,兄弟相助:为感染艾滋病毒的年轻黑人男同性恋者和双性恋者开展的增强复原力的社会资本干预措施的制定

Brothers Building Brothers by Breaking Barriers: development of a resilience-building social capital intervention for young black gay and bisexual men living with HIV.

作者信息

Hussen Sophia A, Jones Marxavian, Moore Shamia, Hood Jasper, Smith Justin C, Camacho-Gonzalez Andres, Del Rio Carlos, Harper Gary W

机构信息

a Hubert Department of Global Health , Emory University Rollins School of Public Health , Atlanta , GA , USA.

b Department of Behavioral Science and Health Education , Emory University Rollins School of Public Health , Atlanta , GA , USA.

出版信息

AIDS Care. 2018;30(sup4):51-58. doi: 10.1080/09540121.2018.1527007. Epub 2019 Jan 9.

Abstract

Young Black gay/bisexual and other men who have sex with men (YB-GBMSM) are disproportionately impacted by HIV/AIDS. Novel intervention strategies are needed to optimize engagement in HIV care for this population. We sought to develop a group-level intervention to enhance resilience by augmenting social capital (defined as the sum of resources in an individual's social network) among YB-GBMSM living with HIV, with the ultimate goal of improving engagement in HIV care. Our multiphase, community-based participatory research (CBPR) intervention development process included: (1) Development and maintenance of a youth advisory board (YAB) comprised of YB-GBMSM living with HIV; (2) Qualitative in-depth interviews with YB-GBMSM living with HIV; (3) Qualitative in-depth interviews with care and service providers at clinics and community-based organizations; and (4) Collaborative development of intervention modules and activities with our YAB, informed by social capital theory and our formative research results. The result of this process is Brothers Building Brothers By Breaking Barriers, a two-day, 10-module group-level intervention. The intervention does not focus exclusively on HIV, but rather takes a holistic approach to supporting youth and enhancing resilience. Intervention modules aim to develop resilience at the individual level (exploration of black gay identity, development of critical self-reflection and coping skills), social network level (exploring strategies for navigating family and intimate relationships) and community level (developing strategies for navigating clinical spaces and plans for community participation). Most intervention activities are interactive, in order to facilitate new social network connections - and accompanying social capital - within intervention groups. In summary, our intensive CBPR approach resulted in a novel, culturally-specific intervention designed to enhance HIV care engagement by augmenting resilience and social capital among YB-GBMSM living with HIV.

摘要

年轻的黑人男同性恋者/双性恋者以及其他男男性行为者(YB-GBMSM)受艾滋病毒/艾滋病的影响尤为严重。需要新的干预策略来优化这一人群对艾滋病毒护理的参与度。我们试图开发一种团体层面的干预措施,通过增加感染艾滋病毒的YB-GBMSM的社会资本(定义为个人社交网络中的资源总和)来增强复原力,最终目标是提高对艾滋病毒护理的参与度。我们基于社区的多阶段参与式研究(CBPR)干预开发过程包括:(1)组建并维持一个由感染艾滋病毒的YB-GBMSM组成的青年咨询委员会(YAB);(2)对感染艾滋病毒的YB-GBMSM进行定性深入访谈;(3)对诊所和社区组织的护理及服务提供者进行定性深入访谈;以及(4)根据社会资本理论和我们的形成性研究结果,与我们的YAB合作开发干预模块和活动。这一过程的成果是“打破障碍,兄弟相助”,这是一个为期两天、包含10个模块的团体层面干预措施。该干预措施并非仅专注于艾滋病毒,而是采取整体方法来支持年轻人并增强复原力。干预模块旨在在个人层面(探索黑人同性恋身份、培养批判性自我反思和应对技能)、社交网络层面(探索处理家庭和亲密关系的策略)和社区层面(制定在临床场所活动的策略以及社区参与计划)培养复原力。大多数干预活动具有互动性,以便在干预小组内促进新的社交网络联系以及随之而来的社会资本。总之,我们深入的CBPR方法产生了一种新颖的、针对特定文化的干预措施,旨在通过增强感染艾滋病毒的YB-GBMSM的复原力和社会资本来提高对艾滋病毒护理的参与度。

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