Situational Adaptations to Katrina and HIV Risk

描述（由申请人提供）：虽然卡特里娜飓风造成的物质破坏可能是广泛的，但可以预见的是，对行为健康的长期影响可能不会在社区中均匀分布。有滥用药物风险的个人可能受到的影响尤其严重，而且可能仍然特别脆弱。我们与该地区的主要学术机构（杜兰大学和路易斯安那州立大学）合作，提出了一项R21形成性研究，其总体目标是了解这种自然灾害对吸毒者情境适应的影响。拟议研究的设计和方法借鉴了人类学民族志的理论和方法——“民族流行病学”，这是一种我们已经成功地应用于许多先前针对未接受治疗人群和环境的公共卫生研究的方法。该研究位于新奥尔良，将从社区评估过程（CAP）开始，该过程将用于描述卡特里娜飓风后新奥尔良街头毒品使用的地理、时间和社会分布，特别是与海洛因、可卡因和速效可卡因的使用有关。在这一初步形成性评估之后，我们将招募一个规模适中的街头吸毒者样本，并对他们进行为期一年的跟踪调查，每月进行一次访谈，以评估卡特里娜飓风后与药物滥用和艾滋病毒风险相关的适应情况。评估工具将包括正在进行的民族志观察以及详细的民族志访谈，其中将包括一系列旨在阐明情境决策的面向事件的模块。研究结果将直接分发给当地的治疗和服务专业人员，通过与当地大学合作发展的技术能力将提高当地的研究能力，将这些研究方法应用于未接受治疗的人群和环境。

DESCRIPTION (provided by applicant): While the physical destruction wrought by hurricane Katrina may have been widespread, it may be anticipated that the long term impact on behavioral health may not be equally distributed in the community. Individuals at risk for drug abuse may have been especially affected and may remain especially vulnerable. In collaboration with both the major academic institutions in the area (Tulane University and Louisiana State University), we propose an R21 formative study with the overall goal of understanding the impact of this kind of natural disaster on situational adaptation among drug users. The design and methods of the proposed study are informed by theory and methods from Anthropological Ethnography---"Ethno-Epidemiology", an approach we have successfully applied in a number of prior public health studies in out-of-treatment populations and settings. Situated in New Orleans, the study will begin with a Community Assessment Process (CAP) which will be used to describe the geographic, temporal, and social distribution of street drug use in post-Katrina New Orleans, particularly in relation to use of heroin, cocaine, and crack-cocaine. Following this initial formative assessment, we will recruit a modest size sample of active street drug users and follow them for one year, conducting monthly interviews with the general goal of assessing post Katrina adaptations related to drug abuse and HIV risk. Assessment tools will include ongoing ethnographic observation as well as detailed ethnographic interviews which will include a series of event-oriented modules that are aimed at illuminating situational-decision making. Findings will be disseminated directly to local treatment and service professionals, and the technical capacity developed through the collaboration with local universities will enhance the local research capacity to apply these research methods to out-of-treatment populations and settings.