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

描述（由申请人提供）：非洲裔美国人和拉丁美洲年轻男子谁与男性发生性关系（YMSM）是在特别高的风险艾滋病毒感染。药物使用与可能导致艾滋病毒感染的无保护性行为和其他性行为高度相关。虽然与这些“性-药物”联系相关的风险已经在一些MSM人群中进行了广泛的研究，但在非洲裔美国人和拉丁裔YMSM中，特别是通过深入的定性调查，它们在很大程度上尚未被探索。这项拟议中的研究将探讨非洲裔美国人和拉丁裔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相关。风险的社会文化理论、生态理论和性脚本理论为我们的调查提供了框架。分析将位于这些理论，并进一步指导我们对这些人群的物质使用和艾滋病毒风险的初步研究。扎根理论方法也将被用来提供新的见解如何物质成为与性之间的非洲裔美国人和拉丁美洲YMSM。拟议的研究旨在：1）确定非洲裔美国人和拉丁裔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，以及3）检查这些性药物脚本与非洲裔美国人和拉丁裔YMSM之间的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目标人群经常光顾的大约12个公共场所收集实地记录，重点关注性药物使用的中心结构。人种学家还将培训五名非洲裔美国人和拉丁裔YMSM，根据他们自己对同龄人关于性、毒品和性毒品的讨论的参与观察，记录"对话日记"。在第二阶段，我们将有目的地招募40名（20名非洲裔美国人和20名拉丁裔）YMSM，年龄在21至24岁之间，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。我们将分析这些现场记录，访谈和调查数据，以确定影响非裔美国人和拉丁裔YMSM使用的性药物脚本的重要生态因素。该研究还将通过展示检查性药物脚本的新方法，为药物滥用和艾滋病毒研究的更大领域做出贡献。我们期望YMSM所采用和修改的特定性药物脚本会影响他们的物质使用和性风险行为。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美洲YMSM的艾滋病毒感染。公共卫生相关性：与男性发生性关系的非洲裔美国人和拉丁美洲青年男子（YMSM）感染艾滋病毒的风险特别高。虽然与这些“性-药物”联系相关的风险已经在一些MSM人群中进行了广泛的研究，但在非洲裔美国人和拉丁裔YMSM中，它们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美洲YMSM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.