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）：拟议的指导科学家职业发展奖（K 01）的目的是为候选人提供指导和研究经验，这将促进她作为一个独立的研究人员的发展，特别强调在吸毒人群中的混合方法艾滋病毒干预研究领域。培训的目标是发展以下方面的知识和技能：⑴药物滥用流行病学、评估和预防，以了解亲密伴侣暴力如何影响吸毒人群以及随后感染艾滋病毒/性传播感染的风险; ⑵理论驱动的艾滋病毒行为预防干预措施; ⑶混合方法研究，特别是与艾滋病毒干预措施有关的方法; 4）高级统计学，如结构方程模型。培训活动将包括教学课程和具体讲习班、指导阅读和与导师一对一辅导，以及指导负责任地开展研究。候选人将接受培训委员会的指导，该委员会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。拟议研究的具体目的是：1）评估最近IPV和性关系权力差异对HIV阴性异性甲基苯丙胺（MA）使用女性的性风险行为的影响; 2）检查认知介导者（例如，避孕套使用自我效能和结果预期）在最近IPV和性关系权力与性风险行为之间起中介作用; 3）定性描述IPV和性关系权力差异的背景如何影响参与HIV行为干预期间和之后的安全性行为的实施。研究目的将通过进行混合方法的艾滋病干预研究来实现。定量数据将来自100名使用MA的女性的种族多样性样本，这些女性参加了一项旨在减少性风险行为、MA使用和抑郁症状的HIV预防干预研究的干预组（FASTLANE 2，PI：Patterson）。定性数据将来自一个子样本的30个MA使用的妇女参加了FASTLANE 2研究，报告IPV和不同的性关系权力差异的深入采访。拟议研究的结果将使候选人提出R34或R 01提案，以试点测试一种理论驱动的混合方法行为艾滋病毒预防干预措施，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中的多重风险。此外，候选人的少数民族背景加上拟议的培训和研究，将有助于其职业轨迹侧重于易感染艾滋病毒、得不到充分服务的高危人群，同时成为代表性不足的妇女的有影响力的导师。 公共卫生关系：女性甲基苯丙胺使用者往往面临多种风险，包括亲密伴侣暴力、关系权力差异、性伴侣之间因分享毒品而发生的冲突以及精神疾病;然而，没有最佳做法证据表明可以同时处理基于性别的问题、艾滋病毒和吸毒问题。从拟议的研究结果将是至关重要的发展，实施和评价的理论驱动，混合方法艾滋病毒行为干预措施，解决吸毒妇女面临的风险的多样性，在妇女赋权的背景下。此外，发展混合方法艾滋病毒干预研究的技能将使候选人成为少数几个在基于性别的暴力研究中具有将混合方法应用于以吸毒人群为重点的艾滋病毒干预措施的专门知识的流行病学家之一。