RISK TAKING AND ADJUSTMENT IN WOMEN AFFECTED BY HIV

女性，特别是有色人种女性，构成了增长最快的 艾滋病病例的类别。然而，人们对这些因素知之甚少。 影响艾滋病毒携带者的性决策和药物使用 感染，他们遇到的压力源的性质，包括影响 艾滋病毒对他们与男性伴侣的关系，他们的应对反应， 心理调适、健康行为、病程。在此之前 可以为感染艾滋病毒的妇女制定有效的干预措施，这是 了解影响他们生活的性别因素很重要， 种族和文化上的特殊性。这将确保更多 迅速规划的干预措施将纳入妇女的冒险行为 以及对艾滋病毒的适应。拟议的纵向研究将审查 适应、高危行为和病程超过24个月的 400名非裔美国人、拉丁裔和白人异性恋者的多种族样本 育龄妇女(18至45岁)。样本将包括200个 艾滋病不同阶段的HIV血清阳性者是从一个 为健康服务的各种医院、诊所和社区机构 以及洛杉矶县妇女的社会经济需求。此外，a 与200名血清阴性妇女配对的邻里对照样本 种族，年龄，婚姻状况，是否有孩子，以及 居住地和200名(100人/组)艾滋病毒男性伴侣的样本 HIV阳性和HIV阴性的妇女将被招募。所有参与者将 由训练有素的多种族、多文化的女性团队进行评估 面试者使用了一系列综合的心理社会访谈， 行为、健康和神经精神测量。女性将接受评估 以基线计算的4小时及为期2年的每6个月收费，每小时50元 会议。男性在入场时和12岁和24岁时将接受2小时的评估 2个月，每次25美元。评估的频率将 对于在生命周期内血清转换的参与者，增加 学习。所有措施都将经过预先测试和修订，以确保其 适合与多民族样品一起使用。 艾滋病妇女(AWWH)适应的概念模型已经被提出 制定来回答两个主要的研究问题：1)什么角色 社会文化和个人因素在影响性决策中的作用 和高危行为？2)生活压力源有什么影响， 应对策略和其他风险和资源对健康的影响， 心理健康和艾滋病毒病程？次要目标将是 探索与重要男性伴侣的关系会产生什么影响 对女性心理健康、健康行为和健康的影响 状态。横截面(即，多元)和纵向(即， 生存分析、结构方程建模)分析 以检查高危行为的预测因素，心理和 HIV感染者的身体健康状况和病程。这个 这项前瞻性研究的结果将为未来的干预提供信息 预防艾滋病毒异性传播的研究和改善 艾滋病毒感染妇女的生活质量。

Women, particularly women of color, constitute the fastest-growing category of AIDS cases. However, little is known about factors that influence sexual decision-making and drug use in women who are HIV infected, the nature of the stressors they encounter, including the impact of HIV on relationships with their male partners, their coping responses, psychological adjustment, health behaviors, and disease course. Before effective interventions can be developed for women affected by HIV, it is important to understand factors affecting their lives that are gender, ethnically and culturally specific. This will ensure that more expeditiously planned interventions will incorporate women's risk taking and adjustment to HIV. The proposed longitudinal study will examine adjustment, high risk behavior and disease course over 24 months in a multi-ethnic sample of 400 African America, Latina and White heterosexual women of child bearing age (18 to 45 years). The sample will include 200 HIV seropositives at different stages of AIDS who are recruited from a variety of hospitals, clinics and community agencies that serve the health and socio-economic needs of women in Los Angeles County. In addition, a neighborhood control sample of 200 seronegative women matched on ethnicity, age, marital status, presence of children, and neighborhood of residence and a sample of 200 (100/group) male partners of the HIV positive and HIV negative women will be recruited. All participants will be assessed by a trained multi-ethnic, multicultural team of female interviewers using a comprehensive interview battery of psychosocial, behavioral, health, and neuropsychiatric measures. Women will be assessed for four hours at baseline and every 6 months for 2 years at $50.00 per session. Men will be assessed for 2 hours at entry and at 12, and 24 months for 2 years at $25 per session. The frequency of assessments will be increased for participants who seroconvert during the life of the study. All measures will be pretested and revised to insure their appropriateness for use with a multi-ethnic samples. A conceptual model of The Adjustment in Women with HIV (AWWH) has been formulated to answer two primary research questions: 1) What role do socio-cultural and personal factors play in influencing sexual decision making and high risk behaviors? and 2) What effects do life stressors, coping strategies and other risks and resources have on health, psychological well-being and HIV-disease course? A secondary goal will be to explore what effects the relationship with the significant male partner have on women's psychological well being, health behaviors and health status. Both cross-sectional (i.e., multivariate) and longitudinal (i.e., survival analysis, structural equation modeling) analyses will be conducted to examine predictors of high risk behaviors, psychological and physical health status and disease course in women affected by HIV. The results from this prospective study will inform future intervention studies to prevent the heterosexual spread of HIV and to improve the quality of life of HIV-infected women.