Impact of Violence and Power on a HIV Behavioral Intervention for Female MA Users

暴力和权力对女性 MA 用户 HIV 行为干预的影响

• 批准号: 8233406
• 负责人: Jamila Kinshasa Stockman
• 金额: $ 17.93万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8233406
• 关键词: AIDS prevention; Address; Affect; Barrier Contraception; Behavior; Behavior Therapy; Behavioral; California; Cognitive; Cognitive Therapy; Complex; Conflict (Psychology); Data; Decision Making; Development; Drug usage; Educational workshop; Enrollment; Epidemiologist; Equation; Evaluation; Expectancy; Female; Gender; Goals; HIV; HIV Infections; HIV/STD; Heterosexuals; High Risk Woman; Incidence; Influentials; Instruction; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Knowledge; Mediating; Mediation; Mediator of activation protein; Mental disorders; Mentors; Mentorship; Methamphetamine; Methodology; Methods; Modeling; Multiple Partners; Outcome; Pharmaceutical Preparations; Population; Population Study; Populations at Risk; Positioning Attribute; Prevention; Preventive Intervention; Public Health; Reading; Recording of previous events; Reporting; Research; Research Design; Research Infrastructure; Research Methodology; Research Personnel; Research Training; Risk; Risk Factors; Role; Safe Sex; Sampling; Scientist; Self Efficacy; Sexual Partners; Substance abuse problem; Testing; Training; Training Activity; Underserved Population; United States National Institutes of Health; Universities; Unsafe Sex; Vagina; Violence; Woman; arm; base; career; condoms; depressive symptoms; design; empowerment; ethnic minority population; experience; group intervention; high risk; intimate partner violence; men; post intervention; public health relevance; relationship violence; responsible research conduct; safer sex; sex; sex risk; sexual relationship; sexual violence; skills; social; statistics; substance abuse epidemiology; success; therapy development; transmission process; vaginal microbicide

DESCRIPTION (provided by applicant): The purpose of the proposed Mentored Scientist Career Development Award (K01) is to provide the candidate with mentoring and research experiences that will promote her development as an independent researcher, with particular emphasis in the field of mixed methods HIV intervention research in drug-using populations. Objectives of the training are to develop knowledge and skills in: 1) substance abuse epidemiology, assessment and prevention, to understand how intimate partner violence (IPV) affects drug-using populations and the subsequent risk for HIV/STIs; 2) theoretically-driven behavioral HIV prevention interventions; 3) mixed methods research, specifically related to HIV interventions; and 4) advanced statistics such as structural equation modeling. Training activities will include didactic coursework and specific workshops, directed readings and one-on-one tutorials with mentors, and instruction in the responsible conduct of research. The candidate will receive mentorship from a Training Committee comprised of nationally renowned experts in the fields of substance abuse, behavioral interventions, and mixed methodology research at the University of California, San Diego. The specific aims of the proposed research are to: 1) assess the effect of recent IPV and sexual relationship power differentials on the sexual risk behaviors of HIV-negative heterosexual methamphetamine (MA)-using women enrolled in the intervention arm of an HIV behavioral intervention; 2) examine whether cognitive mediators (e.g., condom use self-efficacy and outcome expectancies) mediate the relationship between recent IPV and sexual relationship power and sexual risk behaviors; and 3) qualitatively characterize how the context of IPV and sexual relationship power differentials affect the implementation of safer sex behaviors during and after participation in the HIV behavioral intervention. The research aims will be accomplished by conducting a mixed methods HIV intervention study. Quantitative data will come from an ethnically diverse sample of 100 MA-using women enrolled in the intervention group of an HIV prevention intervention study designed to reduce sexual risk behaviors, MA use, and depressive symptoms (FASTLANE2, PI: Patterson). Qualitative data will come from in-depth interviews of a subsample of 30 MA-using women enrolled in the FASTLANE2 study, reporting IPV and varying sexual relationship power differentials. Findings from the proposed research will position the candidate to propose an R34 or R01 proposal to pilot test a theoretically-driven, mixed methods behavioral HIV prevention intervention that addresses the multiplicity of risks among drug-using women in the context of female-controlled barrier methods and empowerment. Moreover, the candidate's ethnic minority background combined with the proposed training and research will support a career trajectory focused on vulnerable, underserved populations at risk for HIV while becoming an influential mentor to underrepresented women. PUBLIC HEALTH RELEVANCE: Female methamphetamine users often experience a multiplicity of risks including, intimate partner violence, relationship power differentials, conflict between sex partners over sharing of drugs, and mental illness; yet, there is no best practice evidence on interventions that concurrently address gender-based issues, HIV and drug use. Findings from the proposed research will be critical to the development, implementation, and evaluation of theoretically-driven, mixed methods HIV behavioral interventions that address the multiplicity of risks faced by drug-using women, in the context of female empowerment. Further, developing skills in mixed methods HIV intervention research will uniquely position the candidate as one of only a handful of epidemiologists in gender-based violence research with expertise in applying mixed methodology to HIV interventions focused on drug-using populations.

描述（由申请人提供）：拟议的导师科学家职业发展奖（K01）的目的是为候选人提供指导和研究经验，以促进她作为独立研究人员的发展，特别强调吸毒人群混合方法艾滋病毒干预研究领域。培训的目标是培养以下方面的知识和技能： 1) 药物滥用流行病学、评估和预防，了解亲密伴侣暴力 (IPV) 如何影响吸毒人群以及随后的艾滋病毒/性传播感染风险； 2）理论驱动的艾滋病毒行为预防干预措施； 3）混合方法研究，特别是与艾滋病毒干预相关的研究； 4）高级统计，例如结构方程建模。培训活动将包括教学课程和具体研讨会、定向阅读和导师一对一辅导，以及负责任的研究行为指导。候选人将获得由加州大学圣地亚哥分校药物滥用、行为干预和混合方法研究领域的全国知名专家组成的培训委员会的指导。拟议研究的具体目的是： 1) 评估近期 IPV 和性关系权力差异对参加 HIV 行为干预干预组的 HIV 阴性异性恋甲基苯丙胺 (MA) 使用女性的性危险行为的影响； 2) 检查认知中介因素（例如安全套使用自我效能和结果预期）是否介导近期 IPV 与性关系权力和性危险行为之间的关系； 3) 定性描述 IPV 背景和性关系权力差异如何影响参与 HIV 行为干预期间和之后实施安全性行为。该研究目标将通过进行混合方法的艾滋病毒干预研究来实现。定量数据将来自 100 名使用 MA 的女性组成的不同种族样本，这些女性参加了一项 HIV 预防干预研究的干预组，该研究旨在减少性危险行为、MA 使用和抑郁症状（FASTLANE2，PI：Patterson）。定性数据将来自对参加 FASTLANE2 研究的 30 名使用 MA 的女性子样本的深入访谈，报告 IPV 和不同的性关系权力差异。拟议研究的结果将使候选人能够提出 R34 或 R01 提案，以试点测试一种理论驱动的混合方法艾滋病毒行为预防干预措施，该干预措施在女性控制的屏障方法和赋权的背景下解决吸毒妇女面临的多重风险。此外，候选人的少数民族背景与拟议的培训和研究相结合，将支持其职业轨迹侧重于易受感染、服务不足的艾滋病毒高危人群，同时成为代表性不足的女性的有影响力的导师。 公共卫生相关性：女性甲基苯丙胺使用者经常经历多种风险，包括亲密伴侣暴力、关系权力差异、性伴侣之间因共用毒品而发生冲突以及精神疾病；然而，尚无关于同时解决性别问题、艾滋病毒和吸毒问题的干预措施的最佳实践证据。拟议研究的结果对于理论驱动的混合方法艾滋病毒行为干预措施的开发、实施和评估至关重要，这些干预措施可以在女性赋权的背景下解决吸毒妇女面临的多重风险。此外，培养混合方法艾滋病毒干预研究的技能将使候选人成为性别暴力研究中少数几位流行病学家之一，他们拥有将混合方法应用于针对吸毒人群的艾滋病毒干预的专业知识。