Sex-drugs and HIV: How substances became associated with sex among African Americ

描述（由申请人提供）：非裔美国人和拉丁裔男男性行为者（YMSM）感染艾滋病毒的风险特别高。药物使用与无保护的性行为和其他可能导致艾滋病毒感染的性行为高度相关。虽然在一些男同性恋者人群中已经广泛研究了与这些“性药物”联系相关的风险，但在非裔美国人和拉丁裔男同性恋者中，特别是通过深入的定性调查，这些风险在很大程度上还没有被探索过。拟议的研究将探索非裔美国人和拉丁裔YMSM如何讨论“性药物”——他们报告在过去30天内与性有关的物质——以及这些物质如何与性行为和性风险联系在一起。风险的社会文化理论、生态理论和性剧本理论为我们的研究提供了框架。这些分析将以这些理论为基础，并进一步以我们对这些人群的药物使用和艾滋病毒风险的初步研究为指导。接地理论的方法也将用于提供新的见解如何物质成为与性在非裔美国人和拉丁裔YMSM。本研究旨在：1)确定非裔美国人和拉丁裔YMSM如何以及在何处使用性药物；2)通过调查YMSM使用的性药物脚本来探索性药物的结构；3)研究这些性药物脚本与非洲裔美国人和拉丁裔YMSM中HIV风险行为之间的关系。为了实现这些目标，我们提出了一个两阶段，多方法的研究。在第一阶段，一名定性健康研究人员将在大约12个目标人群经常光顾的公共场所收集重点关注性药物使用中心结构的实地记录。人种学家还将训练五名非裔美国人和拉丁裔YMSM，让他们根据自己对同龄人关于性、毒品和性药的讨论的参与观察，保持“会话日记”。在第二阶段，我们将有针对性地招募40名（20名非裔美国人和20名拉丁裔）年龄在21至24岁的YMSM，他们报告在过去30天内与男性发生性关系时使用酒精，水晶和/或大麻，进行深入的个人访谈和简短的补充定量调查。我们将分析这些实地记录、访谈和调查数据，以确定影响非裔美国人和拉丁裔YMSM使用性药物脚本的重要生态因素。这项研究还将通过展示检验性药物处方的新方法，为更广泛的药物滥用和艾滋病研究领域做出贡献。我们预计，由YMSM使用和修订的特定性药物脚本将影响他们的药物使用和性危险行为。研究数据可用于为针对这些特定人群的艾滋病毒和药物滥用预防干预提供信息，最终有助于减少非洲裔美国人和拉丁裔YMSM中的艾滋病毒感染。公共卫生相关性：与男性发生性行为的非裔美国人和拉丁裔年轻男子感染艾滋病毒的风险特别高。尽管在一些男男性接触者人群中已经广泛研究了与这些“性药物”联系相关的风险，但在非裔美国人和拉丁裔男男性接触者中，这些风险在很大程度上尚未被探索。研究数据可用于为针对这些特定人群的艾滋病毒和药物滥用预防干预提供信息，最终有助于减少非洲裔美国人和拉丁裔YMSM中的艾滋病毒感染。

DESCRIPTION (provided by applicant): African American and Latino young men who have sex with men (YMSM) are at particularly high risk of HIV infection. Substance use is highly correlated with unprotected sex and other sexual behaviors that may lead to HIV infection. Though the risks associated with these 'sex-drug' connections have been extensively studied in some MSM populations, they have been largely unexplored among African American and Latino YMSM, particularly through in-depth, qualitative investigations. The proposed study will explore how African American and Latino YMSM discuss 'sex-drugs' - substances that they report using in association with sex in the past 30 days - and how these substances become associated with sexual behaviors and sexual risk. Socio-cultural theories of risk, ecological theories, and sexual scripts theory provide the framework for our investigation. The analyses will be situated in these theories and further guided by our preliminary research on substance use and HIV risk with these populations. Grounded theory methodologies will also be used to provide new insights into how substances become associated with sex among African American and Latino YMSM. The proposed study aims to: 1) to identify how and where African American and Latino YMSM use sex-drugs, 2) to explore the construct of sex-drugs by investigating sex-drug scripts used by YMSM, and 3) to examine relationships between these sex-drug scripts and HIV risk behaviors among African American and Latino YMSM. To accomplish these aims, we propose a two phase, multi-method study. In phase 1, a qualitative health researcher will collect field notes focusing on the central construct of sex-drug use at approximately 12 public venues frequented by members of the target population. The ethnographer will also train five African American and Latino YMSM to keep 'conversational diaries' based on their own participant observations of their peers' discussions of sex, drugs, and sex-drugs. In phase 2, we will purposefully recruit 40 (20 African American and 20 Latino) YMSM, aged 21 to 24, who report using alcohol, crystal, and/or marijuana during sex with men in the last 30 days for in-depth individual interviews and a brief complementary quantitative survey. We will analyze these field notes, interviews, and survey data to identify important ecological factors that influence sex-drug scripts used by African American and Latino YMSM. The study will also contribute to the larger fields of substance abuse and HIV research by demonstrating novel ways to examine sex-drug scripts. We expect that specific sex-drug scripts that are employed and revised by YMSM will influence their substance use and sexual risk behaviors. The study data can be used to inform HIV and substance abuse prevention interventions targeting these specific populations, ultimately, helping to reduce HIV infections among African American and Latino YMSM. PUBLIC HEALTH RELEVANCE: African American and Latino young men who have sex with men (YMSM) are at particularly high risk of HIV infection. Though the risks associated with these 'sex-drug' connections have been extensively studied in some MSM populations, they have been largely unexplored among African American and Latino YMSM. The study data can be used to inform HIV and substance abuse prevention interventions targeting these specific populations, ultimately, helping to reduce HIV infections among African American and Latino YMSM.