HIV Disparities among Drug Users: Neighborhoods, Neurocognition and Sex Behavior

吸毒者之间的艾滋病毒差异：社区、神经认知和性行为

• 批准号: 7494882
• 负责人: Leah j Floyd
• 金额: $ 12.3万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-05 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7494882
• 关键词: AIDS prevention; AIDS/HIV diagnosis; AIDS/HIV problem; Accounting; Acquired Immunodeficiency Syndrome; Address; Affect; African American; Alcohol or Other Drugs use; Award; Behavior; Cessation of life; Characteristics; Class; Communicable Diseases; Complex; Contracts; Crime; Data; Data Analyses; Data Set; Decision Making; Disease; Doctor of Philosophy; Drug usage; Drug user; Economic Factors; Economics; Epidemiologic Studies; Fellowship; Female; Funding; Gender; HIV; Imprisonment; Incidence; Individual; Injecting drug user; Injection of therapeutic agent; Intervention; Investigation; Knowledge; Literature; Measures; Mediating; Minority; Modeling; Modification; Multiple Partners; National Institute of Drug Abuse; Neighborhoods; Neurocognition; Neurocognitive; Outcome; Paper; Parents; Pathway interactions; Pattern; Peripheral; Persons; Pharmaceutical Preparations; Postdoctoral Fellow; Poverty; Prevalence; Prevention; Prevention intervention; Problem Solving; Process; Protocols documentation; Public Health; Publishing; Race; Rate; Research; Research Design; Risk; Risk-Taking; Sampling; Sampling Studies; Science; Series; Sex Behavior; Sex Functioning; Socioeconomic Status; Specific qualifier value; Specificity; Statistical Models; Study models; Time; To specify; Unsafe Sex; Woman; Work; base; design; drug market; executive function; health disparity; improved; innovation; member; person centered; prevent; response; segregation; social; sound; success; symposium

DESCRIPTION (provided by applicant): This R03 application proposes to conduct secondary data analysis to develop statistical models that explain disparities in HIV/AIDS found among African American and white substance users. In the proposed study, we will employ advance statistical analyses (latent variable mixture models) to consider the separate and synergistic influence of neighborhood factors (drug arrest rates and poverty), substance use patterns and neurocognitive functioning on sexual risk partnerships and, in turn, HIV/AIDS. First, we will evaluate the possible specificity in relationships between distinct neighborhood level factors (segregation, drug markets, poverty) and sexual partnerships and HIV/AIDS. Aim 2 of the study is to model the influence of neighborhood characteristics, substance use patterns, incarceration and neurocognitve functioning on sexual risk partnerships and estimate prevalence and incidence over an18-month period. The third aim is to estimate the magnitude of the association between sexual partnerships and being HIV-infected. The possibility of effect modification is considered with a focus on race and gender. If successful, this project should improve prevention science by: (1) increasing understanding of sexual risk partnerships among drug users and how they vary across race and gender; (2) providing support for considering factors beyond traditional SES indicators when attempting to understand racial disparities in HIV by highlighting the importance of contextual influences of drugs (e.g., rate of drug arrests) on sexual partnerships; and (3) specifying potential neurocognitive processes that might mediate/moderate the relationship between neighborhood, substance use and sexual risk partnerships. This study is the first in a series of innovative studies designed to explain racial disparities and prevent HIV/AIDS among African Americans. PUBLIC HEALTH RELEVANCE: The intersection between substance use and HIV is a major concern as core and peripheral members of drug networks represent a significant portion of HIV/AIDS cases. Although all persons involved in drug networks are at increased risk for HIV, African Americans tend to be disproportionately affected. Because interventions focused solely on the individual have had limited success in slowing the spread of HIV among African Americans, it is important to elucidate the influence and model the pathways through which social and interpersonal factors influence HIV acquisition.

描述（由申请人提供）：本R 03申请建议进行二次数据分析，以开发统计模型，解释非裔美国人和白色物质使用者之间发现的艾滋病毒/艾滋病差异。在拟议的研究中，我们将采用先进的统计分析（潜在变量混合模型），考虑单独和协同影响的邻里因素（毒品逮捕率和贫困），物质使用模式和神经认知功能的性风险的伙伴关系，反过来，艾滋病毒/艾滋病。首先，我们将评估不同的邻里水平的因素（隔离，毒品市场，贫困）和性伙伴关系和艾滋病毒/艾滋病之间的关系可能的特异性。该研究的目的2是建立社区特征、药物使用模式、监禁和神经认知功能对性风险伴侣关系的影响模型，并估计18个月期间的患病率和发生率。第三个目标是估计性伙伴关系与感染艾滋病毒之间的关联程度。考虑影响修改的可能性，重点关注种族和性别。如果成功，该项目将通过以下方式改善预防科学：（1）增加对吸毒者之间性风险伙伴关系的了解，以及他们在种族和性别之间的差异;（2）在试图了解艾滋病毒的种族差异时，通过强调毒品的背景影响（例如，毒品逮捕率）对性伙伴关系;（3）指定潜在的神经认知过程，可能调解/缓和邻里，物质使用和性风险伙伴关系之间的关系。这项研究是一系列创新研究中的第一项，旨在解释种族差异和预防非裔美国人中的艾滋病毒/艾滋病。 公共卫生相关性：药物使用与艾滋病毒之间的交叉是一个重大关切，因为毒品网络的核心和外围成员在艾滋病毒/艾滋病病例中占很大比例。虽然所有参与毒品网络的人感染艾滋病毒的风险都在增加，但非洲裔美国人往往受到不成比例的影响。由于干预措施只集中在个人有有限的成功，在非洲裔美国人中减缓艾滋病毒的传播，重要的是要阐明的影响和模型的途径，通过社会和人际因素影响艾滋病毒的收购。