Women Bar Drinkers: Exploring Risks for HIV

描述（由申请人提供）：本申请响应 NIAAA 的 RFA AA-03-004“女性酒精相关艾滋病毒/艾滋病研究”。从 1985 年到 1998 年，美国女性艾滋病病例的比例增加了三倍（CDC，2002）。如果女性感染艾滋病毒，她们的诊断最有可能发生在 30 岁至 40 岁之间（CDC，2001a）。鉴于艾滋病的潜伏期估计为 10 至 11 年，因此接触艾滋病毒的年龄很可能发生在 18 至 30 岁之间。这项拟议的研究旨在通过评估 300 名年轻（​​18-30 岁）女性酒吧饮酒者的饮酒与行为之间的关系，来扩大我们对女性艾滋病毒传播风险的了解。女性称，在酒吧进行社交活动是寻找友谊的一种方式（例如，Parks 等，1998）。对于女性酒吧饮酒者来说，大量饮酒和酒吧环境中的期望的综合影响可能会通过自愿（即危险行为）或非自愿（即受害）的高风险遭遇而造成艾滋病毒传播的重大风险。这些关系受到的研究关注有限。我们提出了一个远端因素（例如受害史）和近端因素（例如当前饮酒）之间关系的概念模型，作为与酒吧环境相关的自愿和非自愿高风险遭遇的前提。拟议研究的目标是：1）探索概念模型中概述的关系，2）评估酒吧饮酒与高风险遭遇之间的时间关联，3）比较在酒吧饮酒天数、不在酒吧饮酒天数和不饮酒天数的高风险遭遇的近端因素。这项研究采用创新设计，其中包括对先前风险因素的初步全球评估，以及随后 12 周的前瞻性数据收集。每日报告（交互式语音应答）和基于事件的访谈将用于评估饮酒和危险行为。将使用结构方程和分层数据建模技术来测试假设。这项研究填补了人们对酒吧的认知空白，因为酒吧增加了女性遭遇艾滋病毒高风险的可能性。它还可能提供可用于制定有效预防计划的信息，以降低妇女感染艾滋病毒的风险。

DESCRIPTION (provided by applicant): This application responds to NIAAA's RFA AA-03-004, Research on Alcohol-related HIV/AIDS in Women. The proportion of AIDS cases occurring among women in the U.S. increased three-fold from 1985 to 1998 (CDC, 2002). If women contract HIV, their diagnosis is most likely to occur between the ages of 30 and 40 years (CDC, 2001a). Given that the incubation period for AIDS is estimated at 10-11 years, exposure to HIV is likely to occur between the ages of 18 and 30 years. The proposed research seeks to expand our knowledge of risks for HIV transmission among women by assessing the relationships among alcohol use and behavior in a sample of 300 young (18-30 years) women bar drinkers. Women report socializing in bars as a vehicle for finding companionship (e.g., Parks et al., 1998). For women bar drinkers, the combined influences of heavy alcohol use and expectations within the bar context may pose a substantial risk for HIV transmission through high-risk encounters that are either consensual (i.e., risky behavior) or nonconsensual (i.e., victimization). These relationships have received limited research attention. We propose a conceptual model of relationships among distal (e.g., history of victimization) and proximal (e.g., current alcohol use) factors as antecedents to consensual and nonconsensual high-risk encounters related to the bar context. The objectives of the proposed research are to: 1) explore the relationships outlined in the conceptual model, 2) assess the temporal association between alcohol use in bars and high-risk encounters, and 3) compare proximal factors for high-risk encounters on days of alcohol use in bars, days of alcohol use not in bars, and days of no alcohol use. This research uses an innovative design that incorporates an initial global assessment of the antecedent risk factors, followed by 12 weeks of prospective data collection. Daily reports (Interactive Voice Response) and event-based interviews will be used to assess alcohol use and risky behavior. Hypotheses will be tested using structural equation and hierarchical data modeling techniques. This research fills a significant gap in knowledge about bars as a context for increasing the likelihood that women will experience encounters that put them at elevated risk for HIV. It also has the potential to provide information that can be used to develop effective prevention programs to reduce women's risk for HIV.