# Developing a novel approach to assessing intersectional stigma to advance HIV prevention research with Black men who sex with men.

> **NIH NIH R21** · UNIVERSITY OF CONNECTICUT STORRS · 2020 · $241,500

## Abstract

HIV incidence among Black men who have sex with men (BMSM) in the southeastern United States is
among the highest in the world. Current trends show that as many as 60% of BMSM will contract HIV by the
age of 40 and nearly half (46%) of BMSM who are living with HIV in the US are undiagnosed. Infrequent HIV
testing and the poor uptake of evidence-based approaches to preventing HIV by BMSM, particularly HIV pre-
exposure prophylaxis (PrEP), constitutes a public health crisis. Among the factors that impede HIV prevention
for BMSM, including HIV testing and linkage to PrEP, are the social stigmas and discrimination based on
race, sexual orientation and HIV-risk. Furthermore, combinations of stigmas, including race, sexual
orientation and HIV-risk intersect to shape unique experiences such that BMSM are stigmatized not just
through racism and homophobia, but by the unique experiences of being a Black man who engages in same-
sex sexual behaviors. Stigmatized characteristics intersect within individuals, a concept known as
intersectional stigma; the juncture of multiple stigmatized characteristics including race, sexual orientation
and HIV-risk. However, there are few measures of intersectional stigma and none are designed for use in HIV
prevention with BMSM. Reliable and valid measures of internalized, anticipated, and enacted stigmas that
encompass the concept of intersectionality are needed to improve HIV prevention intervention research. The
proposed research will meet the need for measures of intersectional stigma by developing and testing a novel
and parsimonious approach to assessing intersectional internalized, anticipated, and enacted stigmas. This
research is grounded in the HIV Stigma Framework and will capitalize on standard computerized interviewing
to administer assessments of internalized, anticipated and enacted stigmas attributed at the item-level to
multiple personal characteristics (race, sexual orientation, and HIV-risk). Two studies will be conducted to test
the reliability and validity of this innovative approach to simultaneously assessing multiple stigma dimensions.
Study 1 will perform rigorous psychometric analyses and confirmatory factor analyses to establish the
reliability and concurrent validity of the intersectional stigma scales in a sample of 500 BMSM who have not
been tested for HIV in the previous 6-months and meet the CDC criteria as a candidate for PrEP but have
never been prescribed PrEP. Study 2 will serve to cross-validate scale reliability and concurrent validity and
determine the time stability (test-retest reliability) and predictive validity of the intersectional stigma scales in
a sample of 300 BMSM meeting the same criteria described above. Participants in Study 2 will be assessed
twice over a 4-month period. Regression models will test the predictive validity of the scales, specifically
predicting HIV testing, PrEP interest and PrEP uptake over 4-months. Findings from the two-years of
research will yield a ...

## Key facts

- **NIH application ID:** 9985201
- **Project number:** 5R21MH121314-02
- **Recipient organization:** UNIVERSITY OF CONNECTICUT STORRS
- **Principal Investigator:** SETH C KALICHMAN
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $241,500
- **Award type:** 5
- **Project period:** 2019-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9985201

## Citation

> US National Institutes of Health, RePORTER application 9985201, Developing a novel approach to assessing intersectional stigma to advance HIV prevention research with Black men who sex with men. (5R21MH121314-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9985201. Licensed CC0.

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