Sunday, October 1, 2023
10/1/2023
Project Summary/Abstract Persistent HIV health disparities impacts African Americans and are a public health priority. Despite declining HIV rates nationally, African American communities continue to experience disproportionate HIV burden and increasingly account for the largest share of HIV-related morbidity and mortality in the United States. These concerning disparities necessitate research to inform robust responses that target priority subgroups within this population. High rates of incarceration in many African American communities contribute to high HIV risk environments, where the risks persist after release from the criminal justice system. Formerly incarcerated African American youth (FIAAY, ages 18-24 years) in particular are at heightened risk in terms of sexual behavior, illicit drug use, and challenged rates of HIV testing behavior after release. A prominent barrier to HIV testing and timely diagnosis in this and other vulnerable populations is HIV-related stigma. Thus, more research needs to not only examine stigma-related factors that reduce HIV testing behavior, but also create a basis for interventions that can reduce stigma and increase HIV testing and HIV preventive behaviors in priority populations, such as FIAAY. Towards these goals, my proposed study focusing on FIAAY in Louisville Kentucky will allow me to: 1) develop a risk profile of HIV-negative or HIV status unknown FIAAY at greater likelihood of having stigmatizing beliefs related to HIV infection and longitudinally examine the likelihood of HIV testing based on this profile and 2) delineate mediating and moderating mechanisms by which stigma reduces HIV testing in this population. These actions will help generate knowledge for the development of a multilevel intervention targeting individual and structural factors to reduce HIV-related stigma and increase HIV testing and prevention among this population of vulnerable youth. This Career Development Award will provide the necessary knowledge and skills to conduct this and future research with criminal justice-involved populations. This entails enhancing my skills in advanced statistical methods such as survival analysis and structural equation modeling. In addition it will foster content expertise in decision science and the criminal justice system, which will help inform intervention development. Study methods will include longitudinal survey data collection (baseline, 12-months, 24-months) from 274 FIAAY in Louisville, KY. This research will inform the development of stigma-related HIV-risk profiles for FIAAY who are less likely to test and delineate mediators and moderators of the stigma-HIV testing relationship. If a relationship between stigma and testing is not detected, other psychosocial factors will be examined to determine mediators and moderators of HIV testing. This study has important downstream benefits for HIV prevention and treatment in this highly vulnerable population.
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