Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Developing state-level social-structural metrics to examine HIV inequities: Protocol for an interdisciplinary policy working group
ABSTRACT
Background:
Black, Latino/a/e/x, and Multiracial (BLM) sexual and gender minorities who have sex with men (SGMSM) in the US continue to experience a disproportionate burden of HIV, particularly younger BLM SGMSM for whom HIV incidence continues to rise despite advances in HIV prevention. Evidence suggests that social-structural factors, such as state policy and its impacts, create and maintain inequitable risk environments that heighten their risk. However, few protocols exist for comprehensively analyzing policy and social impact indicators.
Objective:
This study aims to develop a protocol to analyze anti-LGBTQ stigma, structural racism, and restrictive HIV care through state-level policies and social impact indicators in all 50 US states, Puerto Rico, and the District of Columbia. These analyses will be compiled into an Intersectional Structural Oppression Index to assess the impact of these social-structural factors on HIV incidence.
Methods:
Researchers compiled state-level policy and social impact indicators related to anti-LGBTQ stigma, structural racism, and restrictive HIV care and developed a coding scale to assess the effects of policies. These indicators included a combination of primary sources (such as state statutes via LexisNexis) and secondary sources (such as scorecards of state policy by the Movement Advancement Project). An interdisciplinary team of research and legal scholars analyzed policies and compiled social impact indicators in accordance with the protocol for all 50 US states, Puerto Rico, and Washington, DC.
Results:
Researchers and legal scholars analyzed 89 policy indicators and 46 social impact indicators across all 50 states, Puerto Rico, and Washington, DC.
Conclusions:
By providing a methodology for evaluating anti-LGBTQ stigma, structural racism, and restrictive HIV care through state-level policy and social impact indicators, this protocol will provide researchers with data to assess the impact of these social-structural indicators on health outcomes and inequities, including within HIV.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.