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）。如果妇女感染艾滋病毒，她们的诊断最有可能发生在30至40岁之间（疾病预防控制中心，2001年a）。鉴于艾滋病的潜伏期估计为10至11年，接触艾滋病毒的年龄可能在18至30岁之间。这项拟议的研究旨在通过评估300名酒吧年轻女性（18-30岁）饮酒与行为之间的关系，扩大我们对女性艾滋病毒传播风险的认识。女性报告称，在酒吧社交是寻找伴侣的一种方式（如Parks等人，1998年）。对于酒吧女性饮酒者来说，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（即冒险行为）或非自愿（即受害）的高风险接触造成艾滋病毒传播的重大风险。这些关系得到的研究关注有限。我们提出了一个远端（例如，受害历史）和近端（例如，当前饮酒）因素之间关系的概念模型，作为与酒吧环境相关的双方同意和非双方同意的高风险遭遇的先决条件。拟议研究的目的是：1)探索概念模型中概述的关系，2)评估酒吧饮酒与高风险相遇之间的时间关联，以及3)比较在酒吧饮酒日、不在酒吧饮酒日和不饮酒日高风险相遇的近端因素。本研究采用了一种创新的设计，结合了对先前风险因素的初步全球评估，随后进行了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酒精使用和危险行为。假设将使用结构方程和分层数据建模技术进行测试。这项研究填补了关于酒吧知识的重大空白，因为酒吧增加了女性接触艾滋病毒风险增加的可能性。它也有可能提供信息，可用于制定有效的预防方案，以减少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.