Barry Megan C, Threats Megan, Blackburn Natalie A, LeGrand Sara, Dong Willa, Pulley Deren V, Sallabank Greg, Harper Gary W, Hightow-Weidman Lisa B, Bauermeister Jose A, Muessig Kathryn E
a Department of Maternal and Child Health, Gillings School of Global Public Health , The University of North Carolina at Chapel Hill , Chapel Hill , USA.
b School of Information and Library Science , The University of North Carolina at Chapel Hill , Chapel Hill , USA.
AIDS Care. 2018 Aug;30(sup5):S27-S38. doi: 10.1080/09540121.2018.1510106. Epub 2019 Jan 11.
Overlapping stigmas related to sexual minority-, race/ethnicity-, and HIV-status pose barriers to HIV prevention and care and the creation of supportive social networks for young, Black, gay, bisexual, and other men who have sex with men (GBMSM). A risk-based approach to addressing the HIV epidemic focuses on what is lacking and reinforces negative stereotypes about already-marginalized populations. In contrast, a strengths-based approach builds on Black GBMSM's existing strengths, recognizing the remarkable ways in which they are overcoming barriers to HIV prevention and care. HealthMpowerment (HMP) is an online, mobile phone optimized intervention that aimed to reduce condomless anal intercourse and foster community among young Black GBMSM (age 18-30). Applying a resilience framework, we analyzed 322 conversations contributed by 48 HMP participants (22/48 living with HIV) on the intervention website. These conversations provided a unique opportunity to observe and analyze dynamic, interpersonal resilience processes shared in response to stigma, discrimination, and life challenges experienced by young Black GBMSM. We utilized an existing framework with four resilience processes and identified new subthemes that were displayed in these online interactions: (1) Exchanging social support occurred through sharing emotional and informational support. (2) Engaging in health-promoting cognitive processes appeared as reframing, self-acceptance, endorsing a positive outlook, and agency and taking responsibility for outcomes. (3) Enacting healthy behavioral practices clustered into modeling sex-positive norms, reducing the risk of acquiring or transmitting HIV, and living well with HIV. (4) Finally, empowering other gay and bisexual youth occurred through role modeling, promoting self-advocacy, and providing encouragement. Future online interventions could advance strengths-based approaches within HIV prevention and care by intentionally building on Black GBMSM's existing resilience processes. The accessibility and anonymity of online spaces may provide a particularly powerful intervention modality for amplifying resilience among young Black GBMSM.
与性少数群体、种族/族裔和艾滋病毒感染状况相关的重叠污名,对艾滋病毒预防和护理以及为年轻的黑人、男同性恋、双性恋和其他男男性行为者(GBMSM)建立支持性社会网络构成了障碍。基于风险的应对艾滋病毒流行的方法侧重于所缺乏的东西,并强化了对已经边缘化群体的负面刻板印象。相比之下,基于优势的方法则建立在黑人GBMSM现有的优势之上,认识到他们克服艾滋病毒预防和护理障碍的非凡方式。健康赋权(HMP)是一种在线的、针对手机优化的干预措施,旨在减少无保护肛交,并在年轻的黑人GBMSM(18至30岁)中促进社区建设。应用复原力框架,我们分析了48名HMP参与者(48人中22人感染艾滋病毒)在干预网站上贡献的322条对话。这些对话提供了一个独特的机会,来观察和分析年轻黑人GBMSM在应对污名、歧视和生活挑战时所分享的动态人际复原力过程。我们利用了一个具有四个复原力过程的现有框架,并确定了在这些在线互动中呈现的新子主题:(1)通过分享情感和信息支持来交换社会支持。(2)参与促进健康的认知过程表现为重新构建、自我接受、认可积极展望、能动性以及对结果负责。(3)实施健康行为习惯集中在塑造性积极规范、降低感染或传播艾滋病毒的风险以及与艾滋病毒共存。(4)最后,通过树立榜样、促进自我倡导和提供鼓励来增强其他男同性恋和双性恋青年的权能。未来的在线干预措施可以通过有意建立在黑人GBMSM现有的复原力过程基础上,在艾滋病毒预防和护理中推进基于优势的方法。在线空间的可及性和匿名性可能为增强年轻黑人GBMSM的复原力提供一种特别有力的干预方式。