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: 7477952
• 负责人: SUNG-YEON KANG
• 金额: $ 7.16万
• 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 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7477952
• 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（特别是非洲裔美国人和西班牙裔妇女）受到越来越多的影响。在美国，每3例新报告的艾滋病毒感染病例中就有1例是女性，有两种主要的传播方式：异性接触和注射毒品。研究表明，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，吸毒妇女获得的医疗和精神病服务较少，尽管她们的身心健康较差。在药物滥用治疗方面，吸毒妇女的保留率和治疗完成率也低于男子。此外，感染艾滋病毒的吸毒妇女接受艾滋病毒药物治疗和坚持高效抗逆转录病毒疗法的可能性低于男子。造成少数民族社区中这些性别差异的因素尚未得到充分了解，需要通过研究加以阐明。拟议的研究将利用现有的两地纵向数据，审查与波多黎各注射吸毒者和快克吸烟者（艾滋病毒高危群体）在保健和吸毒治疗利用方面的性别差异有关的因素。所研究的两个地点（纽约和波多黎各）将比较两个社区同一族裔群体在保健方面的性别差距，但资源情况不同。拟议研究的具体目的是：1）按性别检查纽约和波多黎各的波多黎各吸毒者中与医疗保健利用相关的因素; 2）确定（a）介导性别和医疗保健利用之间关系的因素，以及（B）在与医疗保健利用的关系中与性别的交互作用;（3）按性别检查与药物治疗利用相关的因素;（4）确定（a）介导性别与药物治疗利用之间关系的因素，以及（B）在与药物治疗利用的关系中与性别的相互作用效应;以及5）评估上述关系（#1 - #4）在两种不同的卫生资源环境之间如何变化。此外，该研究还将评估随着时间的推移，艾滋病毒药物使用的预测因素是否在女性和男性之间存在差异。使用的主要统计分析将是：多元逻辑回归和分层线性模型（用于纵向分析）。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率。在利用保健（包括药物治疗）方面的性别差异是重要的公共卫生问题。特别是，在少数吸毒人群中，与男子相比，妇女获得的医疗和精神病服务较少，尽管她们的身心健康状况较差。然而，造成少数民族社区性别差异的因素仍然没有得到充分研究。拟议的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。