THE ROLE OF TRAUMA EXPOSURE IN DRUG USE AND HIV RISK

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DESCRIPTION (provided by applicant): The proposed three-year study requests funds to investigate the role of trauma exposure in HIV risk behavior. While the link between the drug use and HIV/AIDS epidemics is well known, there is an emerging body of evidence suggesting that violence and other types of trauma exposure are integrally connected to these two public health problems. The central purpose of the proposed study is to document these associations and to investigate the role that traumatization plays. A clearer understanding of the associations among the three epidemics is a key to crafting an effective public health response. Such knowledge may allow us to improve the treatment of victimized or traumatized individuals, to design more effective HIV risk prevention programs, to better target drug prevention programs, and to guide the development of more effective drug treatment programs. In addition, understanding the interrelations among these public health problems may point us toward policies and programs that can break the cycle of violence, drug use and disease in those disadvantaged communities that have been most affected by all three epidemics. This proposed research would be conducted on 600 persons comprised of approximately equal numbers of intravenous drug users (IDUs), non-intravenous drug users (NIUs), and non-users of illicit drugs (NUs) drawn from communities in Harlem and the Bronx that are known from our prior research to experience high levels of drug use and HIV risk behavior. A street-based targeted sampling methodology, employed in our previous research, will be used for recruitment. Based on our prior research, we expect to recruit a heterogeneous mix of African-American and Latino participants, with significant numbers of females. Study participants will complete one assessment session of approximately 75 minutes duration. The instrument will be administered via a combination of fully structured face-to-face interview and computer-assisted self-administered interview (A-CASI). The specific aims of the proposed study are: Aim 1: To describe the types and extent of trauma exposure within the samples of IDUs, NIUs, and NUs in this community. Aim 2: To assess the association between trauma exposure and HIV risk behaviors. Aim 3: To examine the psychological factors that may mediate the relationship between trauma exposure and HIV risk behaviors and that may serve as effective points of intervention.