# Developing and Validating New Measures of Multilevel Intersectional Stigma to Improve the HIV Prevention Continuum for Young Black Gay Bisexual and Other Men who Have Sex with Men in the South

> **NIH NIH R21** · GEORGE WASHINGTON UNIVERSITY · 2022 · $218,058

## Abstract

PROJECT SUMMARY/ABSTRACT
The disproportionate impact of the HIV/AIDS epidemic among U.S. Black gay, bisexual, and other men who
have sex with men (GBMSM) is staggering, especially among young Black GBMSM who live in the South.
Black GBMSM between ages 13 to 34 and those who live in the South accounted for 75% and 63% of HIV
diagnoses among Black GBMSM in 2016, respectively. Most conceptualizations of intersectional stigma have
been almost exclusively individualistic. Consequently, substantial gaps exist about how multilevel intersectional
stigma — individual (e.g., internalized HIV stigma, interpersonal discrimination), community (e.g., anti-gay
stigma at church) and social-structural (e.g., criminal HIV exposure laws) — interconnects to hinder HIV testing
and PrEP use for young Black GBMSM in the South. There is also a dearth of validated measures of multilevel
intersectional stigma for HIV prevention research. To address these critical empirical gaps, a longitudinal
exploratory-sequential mixed methods study (QUAL  QUANT) is proposed to refine and validate the
Multilevel Intersectional Stigma Measure developed during Phase I of the parent study for young Black
GBMSM in two high HIV incidence southern cities: Washington, DC and Jackson, MS. Purposive sampling will
be used to recruit 150 HIV-negative young Black GBMSM, ages 15 to 34. Phase I, completed during the
original funding period of the parent study, involved: (1) literature and policy reviews to identify existing
measures of intersectional stigma and stigma-related laws and policies; (2) 60 in-depth individual interviews
(30/city) to gain a rich and contextually-grounded understanding of multilevel intersectional stigma; and (3)
content validity assessments of the self-report measures by expert judges (n = 5 to 7) and Community
Advisory Board (CAB) members (n = 24; 2 CABs/city). Phase II and III in the proposed supplement remain
unchanged from the parent study. Phase II involves: (1) cognitive interviews with 20 participants (10/city) to
refine the self-report measures; and (2) baseline and 3-month follow-up surveys of 130 participants (65/city) for
psychometric analyses. Phase III involves the synthesis of the qualitative and quantitative results and validity
assessments of the synthesized results with CAB members in each city. The significance of the parent study
lies in the development of new Multilevel Intersectional Stigma measures and the proposed supplement will
facilitate the completion of the psychometric assessment and validation of the measures as planned despite
the project experiencing COVID-19 related delays. The study makes an innovative multilevel paradigmatic shift
from the status quo with its theoretical and methodological fidelity to intersectionality’s core tenets. The
expected outcome is the development of new self-report and objective/non-self-report measures of multilevel
intersectional stigma that reflect the “specific and particular” experiences of young Black GB...

## Key facts

- **NIH application ID:** 10599709
- **Project number:** 3R21MH121313-02S1
- **Recipient organization:** GEORGE WASHINGTON UNIVERSITY
- **Principal Investigator:** Ingrid Alisa Bowleg
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $218,058
- **Award type:** 3
- **Project period:** 2019-08-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10599709

## Citation

> US National Institutes of Health, RePORTER application 10599709, Developing and Validating New Measures of Multilevel Intersectional Stigma to Improve the HIV Prevention Continuum for Young Black Gay Bisexual and Other Men who Have Sex with Men in the South (3R21MH121313-02S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10599709. Licensed CC0.

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