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.

描述（由申请人提供）：在艾滋病毒/艾滋病流行的过程中，妇女（尤其是非裔美国人和西班牙裔妇女）受到了越来越多的影响。现在，妇女在美国每3例新报告的艾滋病毒感染病例中有1个，具有两种主要传播方式：异性恋接触和注射药物使用。研究记录了医疗保健和药物治疗利用方面的性别差异。例如，与男性相比，尽管身体健康和心理健康较差，但吸毒的女性获得的医疗和精神病服务较少。与男性在药物滥用治疗方面的保留率和治疗率还低的保留率和治疗率还低。此外，与男性接受HIV药物并遵守HAART的可能性相比，使用艾滋病毒的妇女的可能性较小。导致少数群体社区中性别差异的因素尚未完全理解，应该通过研究阐明。拟议的研究使用现有的双站点纵向数据，将研究波多黎各Idus和Crack吸烟者中与卫生保健和药物使用治疗利用相关的因素，这是一个高风险HIV的人群。研究的两个地点（纽约和波多黎各）将对在两个具有不同资源环境的社区中的同一族裔群体的性别差异进行比较。拟议的研究的具体目的是：1）通过性别检查与纽约州​​和PR的波多黎各吸毒者中医疗保健利用相关的因素； 2）确定（a）介导性别与医疗保健利用之间关系的因素，以及（b）与性别与医疗保健利用关系中的相互作用效应； 3）通过性别检查与药物治疗使用相关的因素； 4）确定（a）介导性别和药物治疗利用之间关系的因素，以及（b）与性别与药物治疗利用关系中的相互作用效应； 5）评估以上关系（＃1-＃4）在两个不同的健康资源环境之间的变化。此外，该研究将评估男性和男性随着时间的流逝的艾滋病毒药物使用预测因素是否有所不同。所使用的主要统计分析将是：多个逻辑回归和分层线性建模（用于纵向分析）。调查结果将有助于制定特定性别的干预措施，以改善妇女的医疗保健和药物治疗利用。医疗保健中的性别差异（包括药物治疗）是重要的公共卫生问题。特别是，在少数毒品的人群中，与男性相比，女性获得了较少的医疗和精神病服务，尽管她们的身心健康效果较差。但是，导致少数民族社区这些性别差异的因素仍然不足。拟议的研究将有助于理解性别差异的医疗行为，并进一步提出建议缩小性别差距的建议。