The objective of this Ruth L. Kirschstein National Research Service Award for Individual Predoctoral Fellows in Nursing Research is to provide Aubrey Florom-Smith, a second year BSN to PhD doctoral student, with a rich and varied training experience during her dissertation period. Two years of funding are requested affording the applicant, through the proposed training plan, a hands-on experience conducting a quantitative study and increased mentorship and guidance from talented sponsors and co-mentors experienced in every facet of the proposed study. Field experiences with nationally recognized research teams and health care providers experienced in HIV/AIDS and health care issues affecting men who have sex with men living with HIV/AIDS (MLWHA) will enhance the applicant's experience. Additional graduate level coursework will further augment her knowledge of HIV/AIDS as a social, cultural, political and behavioral health issue. Further, she will enhance her career development by acquiring valuable contacts for future endeavors and disseminating her findings through peer-reviewed publications and presentations at local, national and international conferences. The proposed cross-sectional, observational study, testing alternate stress process models predicting depression and sexual risk among MLWHA, is predicated upon the concept that stressors, in the form of gay- related or HIV-related discrimination, may impact health-related behaviors and mental health, depression and high risk sexual behavior, and that the effect of stressors can be influenced by intervening chronic strains, such as internalized homophobia and internalized HIV-related stigma. Alternate models will examine whether the intervening variables are statistical moderators or mediators. Because the chronic strains (internalized homophobia and internalized HIV-related stigma) are conceptualized as emerging from the stressors (discrimination), negative life events and social support will be explored to place these stressors within the context of the individual's stress process. Demographic variables will be examined as control variables to ensure they do not mask the effects of interest. An investigation of the pathways linking these factors may result in increased opportunities for more efficacious HIV prevention intervention development with this population. The University of Miami School of Nursing and Health Studies, which contains the NCMHD-funded Center of Excellence for Health Disparities Research: El Centro, and which has close ties to outstanding scholars and both physical and community resources, provides an ideal setting for the proposed training plan. An NRSA would provide a solid foundation upon which the applicant could base her future efforts as a nurse scientist, educator and advocate to help reduce new HIV infections and enhance the mental and physical wellbeing of MLWHA.

Public Health Relevance

Gay and bisexual men compose the group of individuals at greatest risk of acquiring HIV, as members of the at-risk group that has experienced increases in HIV infections steadily over the past several decades (CDC, 2010b). Because gay and bisexual men living with HIV or AIDS remain subject to ongoing discrimination due to HIV infection and sexual minority status, and because these factors may be related to depression and high risk sexual behavior, a better understanding of the important links between discrimination, depression and high risk sexual behavior is needed. The knowledge gained from the proposed study may be used to develop programs delivered within community or health organizations to reduce the negative effects of discrimination, and ultimately reduce the number of new HIV infections among this group of highly at-risk men.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Predoctoral Individual National Research Service Award (F31)
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National Institute of Nursing Research Initial Review Group (NRRC)
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Banks, David
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University of Miami Coral Gables
Schools of Nursing
Coral Gables
United States
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De Santis, Joseph P; Florom-Smith, Aubrey; Vermeesch, Amber et al. (2013) Motivation, management, and mastery: a theory of resilience in the context of HIV infection. J Am Psychiatr Nurses Assoc 19:36-46
Gonzalez-Guarda, Rosa M; Vermeesch, Amber L; Florom-Smith, Aubrey L et al. (2013) Birthplace, culture, self-esteem, and intimate partner violence among community-dwelling Hispanic women. Violence Against Women 19:6-23
Mitrani, Victoria B; McCabe, Brian E; Gonzalez-Guarda, Rosa M et al. (2013) Participation in SEPA, a sexual and relational health intervention for Hispanic women. West J Nurs Res 35:849-66
Florom-Smith, Aubrey L; De Santis, Joseph P (2012) Exploring the concept of HIV-related stigma. Nurs Forum 47:153-65