Examining network dynamics, neighborhood factors and HIV among drug-using MSM

描述(由申请人提供)：男男性行为者(MSM)仍然是美国正在进行的艾滋病毒流行中最大的风险群体，非裔美国MSM受到艾滋病毒的影响不成比例。滥用药物的性少数群体需要得到更多的关注，因为他们更有可能得不到治疗或治疗利用不足，感染艾滋病毒的风险增加，并可能成为艾滋病毒人群与非吸毒者之间的桥梁。MSM物质使用文献中的一个空白是考虑到酒精和药物使用模式的异质性。识别和定义这些模式可以改善风险群体的规范，并更有效地分配治疗和预防资源。潜在类别分析(LCA)是一种被广泛接受的归纳统计方法，它提供了酒精和毒品使用模式的数据派生分类。这项拟议的研究将使用LCA对现有数据集n=368名与男性发生性行为的非裔美国男性(AA MSM)的毒品和酒精使用模式进行经验性定义和表征，并按使用模式检查艾滋病毒风险的差异。生命周期评估还可以提高对药物使用和艾滋病毒风险的社会和环境背景的理解。关于网络动态如何随着药物和酒精使用模式的变化而变化，我们知之甚少。与疾病传播动态直接相关的两个未得到充分研究但至关重要的社会网络特征是多重性(例如性和吸毒网络重叠)以及性和毒品网络的密度。在这项拟议的研究中，我们将检查AA、MSM的物质使用模式和网络动态之间的关联，以扩大对药物使用和HIV风险之间的交叉的理解。最后，这项拟议的研究将通过MSM的酒精和毒品使用模式来检查他们的空间分布，以检查邻里环境如何影响物质使用和HIV风险之间的交叉。这项研究由风险环境框架提供信息，研究结果将为制定有针对性的艾滋病毒和药物使用预防干预措施提供经验基础。此外，这项研究将有助于推进国家艾滋病毒/艾滋病战略的目标，39重点关注艾滋病毒/艾滋病高度集中的社区，特别是男男性接触者、非裔美国人和药物滥用者。

DESCRIPTION (provided by applicant): Men who have sex with men (MSM) continue to represent the largest risk group in the on-going HIV epidemic in the United States and African American MSM are disproportionately affected by HIV. Substance- abusing sexual minorities warrant increased attention as they are more likely to be untreated or under-utilize treatment, at elevated risk for HIV and a potential HIV bridge population to non-drug using populations. A gap in the MSM substance use literature is consideration of the heterogeneity of alcohol and drug use patterns. Identifying and defining these patterns can improve specification of risk groups and more efficient allocation of treatment and prevention resources. Latent class analysis (LCA) is a well-accepted inductive statistical method that provides data derived classifications of patterns of alcohol and drug use. The proposed study will use LCA to empirically define and characterize drug and alcohol use patterns of an existing dataset of n=368 African American men who have sex with men (AA MSM) and to examine differences in HIV risk by pattern of use. LCA also can improve understanding of the social and environmental context to substance use and HIV risk. Less is known about how network dynamics vary by patterns of drug and alcohol use. Two understudied, but critical features of social networks that directly pertain to disease transmission dynamics are multiplexity (e.g. overlap in sexual and drug use networks) and density of sex and drug networks. In the proposed study we will examine associations between substance use patterns of AA MSM and network dynamics to expand understanding of the intersection between drug use and HIV risk. Finally, the proposed study will examine the spatial distribution of MSM by pattern of their alcohol and drug use to examine how neighborhood context influences the intersection between substance use and HIV risk. This research is informed by the risk environment framework and findings will provide an empirical foundation for developing tailored HIV and substance use prevention interventions. Furthermore, this study will contribute to advancing the goals of the National HIV/AIDS Strategy,39 by focusing on communities with heavy concentration of HIV/AIDS, particularly MSM, African Americans and substance abusers.