# 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 · 2020 · $197,288

## 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. The epidemic is particularly dire for Black GBMSM who are young
and live in the South. Black GBMSM between the 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 available for HIV prevention research. To address
these critical empirical gaps, a longitudinal exploratory-sequential mixed methods study (QUAL à QUANT) is
proposed to: (1) develop and validate self-report measures of individual, community, and social-structural-level
intersectional stigma; (2) develop objective/non-self-report measures of social-structural stigma (e.g., based on
Census data, laws, policies); and (3) produce visualizations of spatial stigma (e.g., living in and/or navigating
impoverished and other stigmatizing places) for young Black GBMSM in two high HIV incidence southern
cities: Washington, DC and Jackson, MS. Purposive sampling will be used to recruit 210 HIV-negative young
Black GBMSM, ages 15 to 34. Phase I involves: (a) literature and policy reviews to identify existing measures
of intersectional stigma and stigma-related laws and policies; (b) 60 in-depth individual interviews (30/city) to
gain a rich and contextually-grounded understanding of multilevel intersectional stigma, and the use of maps to
collect social and health activity space data relevant to spatial stigma; and (c) 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 involves: (a) cognitive interviews with 20 participants (10/city) to refine the self-report
measures; and (b) baseline and 6-month follow-up surveys of 130 participants (65/city) for psychometric
analyses. Phase III involves the synthesis of the qualitative, spatial, and quantitative results and validity
assessments of the synthesized results with CAB members in each city. The significance of the proposed
research lies in the development of new multilevel intersectional stigma measures. The proposed research
makes an innovative 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...

## Key facts

- **NIH application ID:** 9981031
- **Project number:** 5R21MH121313-02
- **Recipient organization:** GEORGE WASHINGTON UNIVERSITY
- **Principal Investigator:** Ingrid Alisa Bowleg
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $197,288
- **Award type:** 5
- **Project period:** 2019-08-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9981031

## Citation

> US National Institutes of Health, RePORTER application 9981031, 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 (5R21MH121313-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9981031. Licensed CC0.

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