Aging, Stress & Health among Gay-Identified Men: Linking Past and Present

衰老、压力

• 批准号: 8285978
• 负责人: RICHARD G WIGHT
• 金额: $ 22.46万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8285978
• 关键词: AIDS/HIV problem; Accounting; Acquired Immunodeficiency Syndrome; Adult; Age; Age Reporting; Aging; Aging-Related Process; Alcohol consumption; Baltimore; Biography; Cardiovascular Diseases; Case Fatality Rates; Chicago; Chronic; Cognition; Cohort Studies; Data; Data Collection; Data Set; Databases; Discrimination; Elderly; Epidemic; Exposure to; Foundations; Future; Gays; Generations; HIV; Health; Health Benefit; Health Resources; Health Status; Hybrids; Individual; Infection; Inflammation; Legal; Life; Life Cycle Stages; Link; Longitudinal Studies; Los Angeles; Marriage; Measures; Mediating; Mediator of activation protein; Mental Health; Methods; Minority; Modeling; Natural History; Outcome; Personal Satisfaction; Population; Population Study; Process; Property; Psychometrics; Psychosocial Stress; Recording of previous events; Reporting; Research; Resources; Risk; Role; Route; Running; Sampling; Sex Behavior; Shapes; Site; Social Environment; Social Identification; Social status; Social support; Stigmata; Stigmatization; Stress; Surveys; Testing; Theoretical model; Time; TimeLine; Typology; age related; biopsychosocial; cardiovascular risk factor; cohort; depressive symptoms; design; early experience; experience; health disparity; interest; longitudinal design; men; middle age; novel; prototype; psychosocial; sex; sexual minority; social; social stigma; social stress; stressor; transmission process

DESCRIPTION (provided by applicant): The AIDS epidemic and the growing social enfranchisement of sexual minorities over the past three to four decades has had a profound impact on the lives of the current cohort of midlife and older gay-identified men (hereinafter, gay men), yet little is known about how the general health status of these men has developed over this time. The proposed exploratory study (a) will analyze 27 years of health and psychosocial data from an existing sample of HIV- and HIV+ midlife and older gay men (b) in conjunction with new data from this sample to be collected with the "Aging, Stress, and Health among Gay Men" (ASH-GM) survey. The sample is the original cohort of the Los Angeles (LA) site of the Multicenter AIDS Cohort Study (MACS, current N = 400; mean age=57, range=43-79). Begun in 1984, the MACS are one of the longest running natural history studies of HIV/AIDS. These data are especially valuable because multiple biopsychosocial domains have been measured biannually since the study's inception, providing a unique data repository that serves as the foundation for innovatively studying aging processes among gay men from a life course perspective. We propose to further develop and test a novel "life course and sexual minority aging stress model", integrating (I) the life course perspective (e.g., trajectories, transition, turning points); (ii) the general stress process model (e.g., financial strain, psychosocial resources); (iii) the minority stress model (e.g., stigmatization); and (iv) aging-related stressor (e.g., independence concerns). A key feature of this conceptual model is the intersection of history with individual biography. The life course concept of trajectories will be operationalized as a latent class mixture model to create clusters of similar trajectories with the 27 years of longitudinal data for two prototypes: health (depressive symptoms, cardiovascular disease) and psychosocial resources (having a confidant). The test of the theoretical model first examines the impact of the types of stressors listed above with current health status, along with the mediating and moderating role of psychosocial resources. This conventional approach is then innovatively elaborated by examining the main and interactive effects of the trajectories to test whether the impact of current conditions on health is conditional upon the past. Due to the dearth of longitudinal data on sexual minorities, research using a life course perspective to study aging among this population will necessarily rely on retrospective data. We will innovatively evaluate such retrospective reports by exploiting the longitudinal design of the MACS to compare reports made at the time to new retrospective reports of the same constructs collected with the ASH-GM. Our specific aims are to: (1) design and implement the ASH-GM; (2) analyze 27-year trajectories with existing MACS-LA data; (3) test the novel theoretical model using both sets of data; and 4) evaluate the use of retrospective reports to study the life course of midlife and olde gay men. Findings will be informative to emergent research on aging among these men, and will provide preliminary data for an RO1 application that will longitudinally expand this exploratory study to all four MACS sites. PUBLIC HEALTH RELEVANCE: The population of midlife and older gay men is increasing exponentially as the baby boomer generation comes of age. The AIDS epidemic and growing social enfranchisement of sexual minorities have transitioned over the past three decades, but little is known about how the general health status of gay men has developed over this unprecedented historical period. The proposed study explores 27 years of health and psychosocial data from an existing sample of midlife and older gay men and concatenates these longitudinal data with new data regarding contemporary stress and aging processes to investigate ways of characterizing and explaining health disparities among these men.

描述（由申请人提供）：在过去的三到四十年中，艾滋病的流行和性少数群体的社会社会竞争不断增长，对当前中年和年龄较大的同性恋者的生活产生了深远的影响（以下是同性恋，同性恋，同性恋 男人），但对于这些男人的总体健康状况如何发展而言，知之甚少。拟议的探索性研究（A）将分析现有的HIV和HIV+中年样本样本以及年长的同性恋者（B）的27年健康和社会心理数据，并与该样本的新数据一起，将与“同性恋者之间的衰老，压力和健康”（ASH-GM）调查收集。样本是多中心艾滋病队列研究的洛杉矶（LA）地点的原始队列（MAC，当前n = 400；平均年龄= 57，范围= 43-79）。 MAC始于1984年，是艾滋病毒/艾滋病运行时间最长的自然历史研究之一。这些数据尤其有价值，因为自从研究成立以来，已经进行了双单次测量的多个生物心理社会领域，从而提供了一个独特的数据存储库，该数据存储库是从生活课程的角度研究同性恋者在同性恋者中创新的衰老过程的基础。我们建议进一步开发和测试一种新颖的“生命过程和性少数族裔压力模型”，整合（i）生命过程的观点（例如轨迹，过渡，转折点）； （ii）一般压力过程模型（例如财务压力，社会心理资源）； （iii）少数族裔应力模型（例如，污名化）； （iv）与衰老相关的压力源（例如，独立问题）。这种概念模型的关键特征是历史与个人传记的交集。轨迹的生命课程概念将作为一种潜在的类混合模型运行，以创建具有27年的两个原型的纵向数据的类似轨迹的簇：健康（抑郁症状，心血管疾病）和心理社会资源（具有亲密关系）。理论模型的测试首先检查了上面列出的具有当前健康状况的压力源类型的影响，以及社会心理资源的中介和调节作用。然后，通过检查轨迹的主要和互动效应来测试当前状况对健康的影响是否有条件的有条件，从而对这种常规的方法进行了创新的详细说明。由于缺乏关于性少数群体的纵向数据，研究人群中研究衰老的研究必然依靠回顾性数据。我们将通过利用Mac的纵向设计来将当时的报告与与ASH-GM收集的相同结构的新回顾性报告进行比较，从而对此类回顾性报告进行创新评估。我们的具体目的是：（1）设计和实施ASH-GM； （2）使用现有的MACS-LA数据分析27年的轨迹； （3）使用两组数据测试新的理论模型； 4）评估使用回顾性报告来研究中年和奥德同性恋者的生活课程。研究结果将为这些男性的新兴研究提供信息，并将为RO1应用程序提供初步数据，该数据将纵向扩展到所有四个Mac站点。 公共卫生相关性：随着婴儿潮一代的成熟，中年和年长的同性恋者的人口呈指数增长。在过去的三十年中，艾滋病流行和不断增长的性少数群体社会特征已经过渡，但是对于这个前所未有的历史时期，男同性恋者的总体健康状况如何发展。拟议的研究探索了现有的中年和年长同性恋者样本的27年健康和社会心理数据，并将这些纵向数据与有关当代压力和衰老过程的新数据相连，以研究这些男性中的健康方式和解释健康差异的方式。