Surveying Men About Abuse, Risk Taking: Phone Assessment

描述（由申请人提供）：六分之一到十四分之一的男性报告儿童性虐待史（CSA）。来自艾滋病毒高危行为群体的男性的CSA发病率更高。然而，对男性CSA病史与艾滋病毒风险行为之间关系的研究受到使用不同的、通常是临床样本的阻碍，这些样本在采样方式、采样时间（即在艾滋病毒风险行为变化趋势期间的不同时间）和采样地点等方面存在差异。不同的调查人员授权的CSA定义也造成了解释困难。因此，利用这些来源的数据，挑战了创造干预措施以降低既往CSA男性艾滋病毒风险的努力。随机数字拨号（RDD）方法提供了一种研究男性非临床样本CSA史的方法，同时提供了不同HIV风险亚人群的相对快照，从而限制了风险行为的时间趋势混淆。此外，没有CSA病史的男性的比较亚组可以从相同的潜在人群中招募。因此，CSA史对HIV风险行为活动的独立贡献可以以更可靠的方式进行研究，允许在不同风险群体之间进行比较，同时探索其他影响，如滥用自我定义差异如何影响研究结果。一些人担心在城市部门使用RDD的可行性，那里有大量个人从事艾滋病毒高风险行为，没有进行具体的RDD评估。我们提出了一个可行性方案：研究一是一项横断面研究，从费城（PA）艾滋病高发地区招募成年男性；研究二是对研究一中的男性进行一系列后续的面对面访谈。在研究一中，将通过RDD招募200名男性。将获得研究参与率，以确定是否可以在未来的大规模研究中使用类似的方法。将获得注射药物使用（IDU）率，以确定有注射药物使用史的男性的参与率是否允许对这种危险行为进行研究。性危险行为率也将被估计，以及CSA病史和性危险行为之间的关联。在研究二中，将分别招募20名和10名有和没有CSA病史的男性。面对面访谈将着重于定性探索男性如何将他们的性历史与CSA历史的研究报告联系起来，以及他们如何识别CSA的显著性是他们存在或不存在风险行为的一个因素。

DESCRIPTION (provided by applicant): Between 1-in-6 and 1-in-14 men report histories of child sexual abuse (CSA). CSA rates in men from high HIV risk behavior groups are higher. Studies of the relationship between CSA histories and HIV risk behavior in men, however, are hampered by use of disparate, usually-clinical samples, divergent in the way they were sampled, when they were sampled (i.e., at different times during the shifting trends of HIV risk behavior), and from where they were sampled. Differing investigator-mandated CSA definitions also create interpretation difficulties. Using data from these sources, then, challenge efforts to create interventions to reduce HIV risk in men with past CSA. Random digit dialing (RDD) methodology offers an approach to studying CSA histories in a non-clinical sample of men, providing a relative snapshot of different HIV risk subpopulations simultaneously, thereby limiting the confounding of temporal trends in risk behavior. In addition, comparison subgroups of men without CSA histories can be recruited from the same underlying population. Thus, the independent contribution of a CSA history to HIV risk behavior activity can be studied in a more robust manner, allowing comparisons across different risk groups, while concomitantly exploring other effects such as how abuse self-definition differences affect findings. Some are concerned about feasibility of RDD use in urban sectors with large numbers of individuals engaged in high HIV risk behavior, where no specific RDD evaluation has been done. We propose a feasibility protocol: study one is a cross-sectional study of adult men recruited from high AIDS incidence areas in Philadelphia (PA); study two is a series of follow-up, in-person interviews with men from study one. In study one, 200 men will be recruited via RDD. Study participation rates will be obtained to determine whether similar methods can be used in future, large-scale studies. Injection drug use (IDU) rates will be obtained to determine whether participation rates by men with IDU histories allow study of this risk behavior. Sexual risk behavior rates also will be estimated, as will estimates of the association between CSA histories and sexual risk behavior. In study two, twenty and ten men with and without CSA histories, respectively, will be recruited. In-person interviews will focus on qualitative explorations of how men link an enumeration of their sexual histories with study one reports about CSA histories, as well as how they identify the salience of CSA as a factor in the presence or absence of their risk behavior.