Structural Influences on Methamphetamine Use among Black Gay and Bisexual Men in Atlanta

亚特兰大黑人男同性恋和双性恋男性吸食甲基苯丙胺的结构性影响

• 批准号: 10474862
• 负责人: Sophia A. Hussen
• 金额: $ 72.42万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10474862
• 关键词: Bisexual; Black American; Black Populations; Black race; Censuses; Climate; Communities; Data; Destinations; Development; Discrimination; Ecological momentary assessment; Economics; Educational workshop; Environment; Epidemic; Ethnography; Exposure to; Foundations; Freedom; Gays; General Population; Goals; Harm Reduction; Health; Health Services Accessibility; Healthcare; Homelessness; Housing; Income; Individual; Intervention; Interview; Knowledge; Lead; Lesbian Gay Bisexual Transgender; Link; Location; Longitudinal cohort study; Maps; Measures; Mediating; Mediator of activation protein; Mental Health; Methamphetamine; Methamphetamine prevention; Methamphetamine use disorder; Methods; Participant; Pathway interactions; Personal Satisfaction; Persons; Pharmaceutical Preparations; Population; Prevention; Public Health; Race; Reporting; Research; Risk; Science; Services; Social Work; Social status; Structural Racism; Surveys; System; Technology Assessment; Time; United States; United States National Institutes of Health; Walking; Work; base; behavior change; cohort; community engaged research; comorbidity; design; experience; follow-up; health inequalities; homonegativity; housing instability; improved; innovation; insight; men; men who have sex with men; methamphetamine use; model building; prevent; prospective; recruit; residential segregation; response; segregation; service providers; social; social vulnerability; substance use treatment

PROJECT SUMMARY Emerging data demonstrates a rise in methamphetamine (meth) use among Black gay, bisexual and other men who have sex with men (GBMSM). Meth is associated with myriad physical and social harms, and has the potential to exacerbate existing health inequities impacting Black GBMSM. Existing meth prevention and treatment interventions do not address the unique social position of Black GBMSM or the related health impacts of structural racism and discrimination (SRD). Based on our preliminary studies, we hypothesize that four forms of SRD are likely to influence meth use among Black GBMSM: housing discrimination, gentrification, racial and income segregation, and discriminatory LGBT community climate. Additionally, we posit that these forms of SRD operate through housing instability and inadequate service access to increase risk for meth use among Black GBMSM. The goal of this project is to generate knowledge that will inform the design of multi- level, culturally congruent structural approaches to prevent meth use and associate harms among Black GBMSM. Our study will be based in Atlanta, Georgia – an ideal setting to examine these questions given the cultural significance for Black Americans, large population of Black GBMSM, and recent SRD-related demographic shifts. Drawing on the risk environment framework as its theoretical foundation, this study will pursue three specific aims: (1) to examine the impacts of census-tract level measures of SRD on housing instability, service access and meth use among Black GBMSM in Atlanta; (2) to elicit narratives of meth use, housing instability, service access and SRD among Black GBMSM; and (3) to examine systems of structural influence and develop qualitative causal maps linking various forms of SRD, service access, housing and meth use among Black GBMSM. For the first aim, we will recruit N=300 Black GBMSM into a longitudinal cohort study, and conduct serial surveys every 6 months over a two-year follow-up period. Additional location and meth use data will be obtained monthly using ecological momentary assessment technology. Individual survey responses will be linked to geolocated census-tract level measures of SRD and service access. For the second aim, we will conduct a longitudinal qualitative study including in-depth interviews and walking ethnographies with N=40 cohort participants, to gather insights on their experiences with SRD, housing, service access and meth use. For the third aim, we will use a community-based system dynamics approach to convene a group model building workshop with key stakeholders (N=25), which will lead directly to the development of causal maps that will inform structural interventions. The proposed research is highly significant because of its potential to inform effective structural strategies for preventing meth use and ameliorating meth-related harms among Black GBMSM.

项目摘要 新的数据表明，黑人同性恋，双性恋和其他人使用甲基苯丙胺（冰毒）的增加 与男性发生性关系的男性（GBMSM）冰毒与无数的身体和社会危害有关， 有可能加剧现有的健康不公平现象，影响黑人GBMSM。现有的冰毒预防和 治疗干预措施没有解决黑人GBMSM的独特社会地位或相关的健康问题， 结构性种族主义和歧视的影响。基于我们的初步研究，我们假设 四种形式的SRD可能会影响黑人GBMSM中的冰毒使用：住房歧视，中产阶级化， 种族和收入隔离以及歧视性的LGBT社区氛围。此外，我们认为，这些 各种形式的SRD通过住房不稳定和服务不足来增加使用冰毒的风险 在黑人GBMSM中这个项目的目标是产生知识，将通知多个设计- 水平，文化上一致的结构性方法，以防止甲基使用和黑人之间的相关伤害 GBMSM。我们的研究将设在格鲁吉亚的亚特兰大，这是研究这些问题的理想场所， 对美国黑人的文化意义，大量的黑人GBMSM人口，以及最近的SRD相关 人口变化本文以风险环境框架为理论基础， 追求三个具体目标：（1）研究SRD的普查层面措施对住房的影响 亚特兰大黑人GBMSM中的不稳定性、服务获得和冰毒使用;（2）引出冰毒使用的叙述， 黑人GBMSM中的住房不稳定性、服务获取和SRD;以及（3）检查结构系统 影响和发展定性因果图，将各种形式的SRD、服务获得、住房和医疗保健联系起来， 在黑色GBMSM中使用。对于第一个目标，我们将招募N=300名黑人GBMSM进入纵向队列 研究，并在两年的随访期内每6个月进行一次系列调查。额外的位置和 将使用生态瞬时评估技术每月获得甲安菲他明使用数据。单个的调查 答复将与地理定位的人口普查区一级的SRD和服务获取措施挂钩。第二 目的是，我们将进行一项纵向定性研究，包括深入访谈和步行民族志 与N=40队列参与者，以收集他们的经验与SRD，住房，服务获取和 吸毒对于第三个目标，我们将使用基于社区的系统动力学方法召集一个小组， 与主要利益相关者（N=25）举行模型构建研讨会，这将直接导致因果关系的发展 这些地图将为结构性干预提供信息。这项研究具有重要意义，因为它 为预防甲基苯丙胺使用和改善甲基苯丙胺相关危害提供有效结构性战略信息的潜力 在黑人GBMSM中