HIV-Related Behavior among Rural African American, Young Adult Men

描述（由申请人提供）：在全国范围内，农村和城市地区与女性发生性关系的非洲裔美国男性（MSW）的艾滋病毒感染率几乎是高加索MSW报告的10倍，自2004年以来每年都在增加。这种增长在南方的小城镇和农村社区尤为明显。高中毕业后的几年是一个关键时期，农村非洲裔美国城市固体废物特别容易从事增加其感染艾滋病毒和其他性传播感染风险的行为。很少有人上大学，在南方农村，能找到稳定职业的工作机会也很稀少。在传统的教育或职业体系中没有任何利害关系，向劳动力的过渡可能会令人沮丧和旷日持久。有些人看不到足够的生存或实现个人目标的途径，可能会经历愤怒和其他负面情绪的增加，这些情绪会鼓励物质使用;破坏稳定的一夫一妻制关系;并损害保护性的性行为。根据医学研究所（IOM）的预防科学处方，制定有效的预防计划需要病因模型，将背景因素与近端风险和保护机制联系起来，预测特定目标人群中与艾滋病毒相关的风险行为。目前，这方面的信息不存在一般的非裔美国人的城市固体废物或农村城市固体废物特别。尽管项目开发人员可以在没有必要的科学数据的情况下为非洲裔美国人的农村城市固体废物创建或调整项目，但实施不基于合理病因模型的项目将破坏其公共卫生影响。与国际移民组织的建议相一致，拟议的研究将提供必要的下一步发展有效的艾滋病毒预防干预措施，为农村非洲裔美国人MSW在年轻的成年。 我们建议抽样500名农村非洲裔美国人男子年龄18-21谁住在中部地区的典型地区的格鲁吉亚南部农村地区的非洲裔美国人居民的比例很大。该地区的男子将每隔12个月提供3次调查数据。指导研究的概念模型包括以下过程：（a）背景风险因素，包括经济机会和压力源、种族歧视和促进风险的同伴关系和规范;（B）近端风险机制，包括负面情绪、促进风险的男性意识形态和性关系动态;（c）保护性因素，包括种族自豪感、自我调节能力以及与父母和非正式导师人物的风险威慑关系，以及（d）与艾滋病毒有关的行为，包括药物使用、无保护性交，以及多重性伴侣

DESCRIPTION (provided by applicant): Nationally, rates of HIV among African American men who have sex with women (MSW) in both rural and urban areas are nearly 10 times as high as those reported for Caucasian MSW and have increased annually since 2004. This increase is particularly evident in small towns and rural communities in the South. The years following high school are a critical period when rural African American MSW are particularly vulnerable to engaging in behaviors that increase their risk for HIV and other STIs. Few attend college and, in the rural South, job opportunities that lead to stable occupations are scarce. With no stake in conventional educational or occupational systems, the transition to the workforce can be demoralizing and protracted. Some who see no pathway to adequate subsistence or attainment of personal goals may experience increases in anger and other negative emotions that encourage substance use; undermine stable, monogamous relationships; and compromise protective sexual behavior. Based on the Institute of Medicine's (IOM) prescription for prevention science, the development of effective prevention programs requires etiological models that link contextual factors with proximal risk and protective mechanisms that forecast HIV-related risk behavior in a specified target population. Currently, this information does not exist for African American MSW in general or rural MSW in particular. Although program developers may create or adapt programs for rural African American MSW without the necessary scientific data, implementing programs that are not based on sound etiological models will undermine their public health impact. Consistent with IOM recommendations, the proposed research will provide the necessary next step for the development of efficacious HIV prevention interventions for rural African American MSW during young adulthood. We propose to sample 500 rural African American men age 18-21 who live in a region of central Georgia typical of areas in the rural South with large proportions of African American residents. Men from this region will provide survey data 3 times at 12-month intervals. The conceptual model that guides the study incorporates the following processes: (a) contextual risk factors including economic opportunities and stressors, racial discrimination, and risk-promoting peer affiliations and norms; (b) proximal risk mechanisms including negative emotionality, risk-promoting masculine ideology, and sexual relationship dynamics; (c) protective factors including racial pride, self-regulatory competence, and risk-deterring relationships with parents and informal mentor figures, and (d) HIV-related behaviors including substance use, unprotected intercourse, and multiple and concurrent sexual partnerships.