Gendered Risks, Substance Use, and HIV Outcomes among Urban Women

城市女性的性别风险、药物使用和艾滋病毒结果

• 批准号: 8541303
• 负责人: Michele R. Decker
• 金额: $ 16.2万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-15 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8541303
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Affect; African American; Alcohol or Other Drugs use; Behavior; Behavior Therapy; Behavioral; Caring; Child Sexual Abuse; Cohort Studies; Comorbidity; Complex; Data; Data Analyses; Development; Dimensions; Drug usage; Economics; Enrollment; Epidemic; Exposure to; Gender; Goals; Grouping; HIV; HIV Infections; HIV risk; Health; Heterosexuals; Home environment; Individual; Infection; Intervention; Life; Link; Nature; Outcome; Participant; Pharmaceutical Preparations; Plant Roots; Play; Population; Prevalence; Provider; Recruitment Activity; Research; Research Personnel; Risk; Risk Behaviors; Role; Running; Services; Shapes; Substance abuse problem; Time; Training; Treatment outcome; United States National Institutes of Health; Unsafe Sex; Violence; Viral; Viral Load result; Woman; Work; base; cohort; condoms; coping; cost; drug abuser; experience; hazard; high risk; improved; insight; intimate partner violence; meetings; prevent; public health relevance; reduced substance use; sex; sexual assault; social; stem; stressor; success; therapy development; transmission process; trend; uptake; urban area

DESCRIPTION (provided by applicant): In the US and globally, marginalized, urban women are disproportionately affected by the mutually reinforcing epidemics known as the "Substance Abuse, Violence and HIV/AIDS (SAVA) Syndemic". Gendered risk in the forms of intimate partner violence (IPV), sexual assault (SA), sexual exploitation that begins early in childhood sexual abuse (CSA), and later in transactional sex or sex work (SW) can accumulate and interact over time. Yet little research has characterized the most common, and the most hazardous, of these gendered risk constellations with respect to substance use trajectories, and behavioral and biologic HIV outcomes. The proposed secondary analysis seeks to 1) identify meaningful constellations of gendered risk (e.g., exposure to both IPV and SA) and their prevalence and stability over time, 2) evaluate the influence of gendered risk constellations on substance use behavior and trends over time, and 3) prospectively evaluate the influence of gendered risk constellations on HIV behavioral (unprotected sex) and treatment (viral suppression) outcomes in a large cohort of marginalized urban women at risk for and actively using drugs. To achieve these goals, the proposed secondary analysis leverages the ongoing, longitudinal Women's Interagency HIV Study (WIHS), the largest and longest-running HIV cohort study of women in the US. The investigative team brings long- standing expertise in substance use and HIV research and interventions with high-risk populations to support the transition of a junior investigator into substance use-related HIV research. Findings will inform a greater understanding of the lived realities of urban women, the intersections among gendered risk, substance use and primary and secondary HIV prevention outcomes, and refined intervention approaches to reduce the interwoven burdens of substance use and HIV among the most marginalized women.

描述（由申请人提供）：在美国和全球范围内，被边缘化的城市妇女不成比例地受到被称为“药物滥用、暴力和艾滋病毒/艾滋病（SAVA）综合征”的相互加强的流行病的影响。亲密伴侣暴力（IPV），性侵犯（SA），儿童性虐待（CSA）早期开始的性剥削，以及后来的性交易或性工作（SW）形式的性别风险可以随着时间的推移而积累和相互作用。然而，关于药物使用轨迹以及行为和生物艾滋病毒结果的这些性别风险星座中最常见和最危险的研究很少。拟议的二次分析旨在1）识别有意义的性别风险星座（例如，暴露于IPV和SA）及其随时间推移的患病率和稳定性，2）评估性别风险星座对药物使用行为和随时间推移的趋势的影响，3）前瞻性评估性别风险星座对艾滋病毒行为（无保护性行为）和治疗（病毒抑制）结果的影响，在一个大型的边缘化城市女性队列中，有吸毒风险和积极使用毒品。为了实现这些目标，拟议的二次分析利用了正在进行的纵向妇女机构间艾滋病毒研究（WIHS），这是美国规模最大、持续时间最长的妇女艾滋病毒队列研究。调查小组带来了在药物使用和艾滋病毒研究以及对高风险人群的干预方面的长期专业知识，以支持初级调查员过渡到与药物使用有关的艾滋病毒研究。调查结果将告知 更好地了解城市妇女的生活现实、性别风险、药物使用以及艾滋病毒初级和二级预防成果之间的交叉点，并改进干预方法，以减少最边缘化妇女的药物使用和艾滋病毒相互交织的负担。