Gender Differences in Healthcare and Drug Treatment Utilization among Drug Users

吸毒者在医疗保健和药物治疗利用方面的性别差异

• 批准号: 7336643
• 负责人: SUNG-YEON KANG
• 金额: $ 7.31万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-30 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7336643
• 关键词: AIDS/HIV diagnosis; AIDS/HIV problem; Accounting; Acculturation; Acquired Immunodeficiency Syndrome; Address; Adherence; Admission activity; Adolescence; Affect; African American; Behavior; Case Study; Centers for Disease Control and Prevention (U.S.); Characteristics; Childhood; Communities; Community Services; Condition; Counseling; Crack Cocaine; Data; Data Set; Drug Addiction; Drug usage; Drug user; Education; Enrollment; Environment; Epidemic; Ethnic group; Gender; HIV; HIV Infections; HIV Seropositivity; HIV Seroprevalence; Health Resources; Health Services; Healthcare; Heterosexuals; Highly Active Antiretroviral Therapy; Hispanics; Hour; Individual; Injecting drug user; Injection of therapeutic agent; Intervention; Knowledge; Lead; Length; Length of Stay; Life; Linear Models; Literature; Living Arrangement; Logistic Regressions; Marital Status; Measures; Mediating; Medical; Mental Health; Mental Health Services; Methadone; Minority; Needle-Exchange Programs; New York; New York City; Operative Surgical Procedures; Pharmaceutical Preparations; Policies; Population; Prevention program; Public Health; Puerto Rican; Puerto Rico; Range; Rate; Recommendation; Recording of previous events; Reporting; Research; Resources; Risk; Risk Behaviors; Risk Reduction; Self Efficacy; Services; Severities; Sex Characteristics; Sexual Partners; Site; Smoker; Social support; Substance abuse problem; Symptoms; Testing; Time; Treatment Protocols; Woman; base; ethnic minority population; experience; health care service utilization; improved; men; mortality; pediatric trauma; social; transmission process; trend

DESCRIPTION (provided by applicant): Over the course of the HIV/AIDS epidemic, women (particularly African-American and Hispanic women) have been increasingly affected. Women now account for 1 in every 3 newly reported cases of HIV infection in the U.S., with two major modes of transmission: heterosexual contact and injection drug use. Research has documented a gender disparity in health care and drug treatment utilization. For example, compared with men, drug-using women receive less medical and psychiatric services, although they have poorer physical and mental health. Drug-using women also have lower retention and treatment completion rates than men in substance abuse treatment. In addition, drug-using women with HIV are less likely than men to receive HIV medication and to adhere to HAART. The factors contributing to these gender differences in minority communities are not fully understood and deserve elucidation through research. The proposed study, using existing dual-site longitudinal data, will examine factors related to gender differences in health care and drug use treatment utilization among Puerto Rican IDUs and crack smokers, a group at high risk for HIV. The two sites studied (New York and Puerto Rico) will provide a comparison of gender disparities in health care, for the same ethnic group in two communities with different resource contexts. The specific aims of the proposed study are: 1) To examine, by gender, factors associated with health care utilization among Puerto Rican drug users in NY and PR; 2) to identify (a) factors mediating the relationship between gender and health care utilization, and (b) interaction effects with gender in the relationships with health care utilization; 3) to examine, by gender, factors associated with drug treatment utilization; 4) to identify (a) factors mediating the relationship between gender and drug treatment utilization, and (b) interaction effects with gender in the relationships with drug treatment utilization; and 5) to assess how the relationships above (#1 - #4) vary between two different health resource environments. In addition, the study will assess whether predictors of HIV medication use differ between women and men over time. The major statistical analyses used will be: multiple logistic regression and hierarchical linear modeling (for longitudinal analysis). Findings will be useful in developing gender-specific interventions to improve health care and drug treatment utilization in women. Gender disparities in health care (including drug treatment) utilization are important public health issues. In particular, among minority drug-using populations, women, as compared to men, receive less medical and psychiatric services, although they experience poorer physical and mental health. However, the factors contributing to these gender differences in minority communities remain under-studied. The proposed study will contribute to an understanding of gender-differentiated healthcare behaviors, and further lead to recommendations to narrow the gender gap.

说明（由申请人提供）：在艾滋病毒/艾滋病流行的过程中，妇女（特别是非洲裔美国人和西班牙裔妇女）受到的影响越来越大。在美国，每3例新报告的HIV感染病例中就有1例是女性，主要有两种传播方式：异性性接触和注射毒品。研究证明，在保健和药物治疗利用方面存在性别差异。例如，与男子相比，吸毒妇女得到的医疗和精神服务较少，尽管她们的身心健康状况较差。吸毒妇女在药物滥用治疗中的保留率和治疗完成率也低于男性。此外，与男性相比，感染艾滋病毒的吸毒妇女接受艾滋病毒药物治疗和坚持HAART治疗的可能性较小。造成少数民族社区中这些性别差异的因素尚未完全了解，值得通过研究加以阐明。拟议的研究将利用现有的两地纵向数据，审查波多黎各注射吸毒者和速效吸烟者（感染艾滋病毒的高风险群体）在保健和药物使用治疗利用方面的性别差异相关因素。所研究的两个地点（纽约和波多黎各）将比较两个拥有不同资源背景的社区中同一族裔群体在保健方面的性别差异。拟议研究的具体目的是：1)按性别审查与纽约州和波多黎各吸毒者利用医疗保健有关的因素；2)确定(a)性别与卫生保健利用关系的中介因素，以及(b)性别在卫生保健利用关系中的交互作用；3)按性别调查与药物治疗利用相关的因素；4)确定(a)性别与药物治疗利用关系的中介因素，(b)性别在药物治疗利用关系中的交互作用；5)评估上述关系（#1 - #4）在两种不同的卫生资源环境中如何变化。此外，该研究将评估HIV药物使用的预测因素在女性和男性之间是否随时间而有所不同。使用的主要统计分析将是：多元逻辑回归和层次线性模型（纵向分析）。研究结果将有助于制定针对性别的干预措施，以改善妇女的保健和药物治疗利用情况。保健（包括药物治疗）利用方面的性别差异是重要的公共卫生问题。特别是在使用毒品的少数群体中，与男子相比，妇女获得的医疗和精神服务较少，尽管她们的身心健康状况较差。然而，在少数民族社区造成这些性别差异的因素仍未得到充分研究。本研究将有助于了解性别差异的医疗保健行为，并进一步提出缩小性别差距的建议。