Assessing the Impact of State-Level Policies on Drug Use and HIV Risk for YMSM

评估州级政策对 YMSM 吸毒和 HIV 风险的影响

• 批准号: 9065237
• 负责人: Morgan Mari Philbin
• 金额: $ 17.85万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-15 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9065237
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adopted; Adoption; Affect; Age; Alcohol or Other Drugs use; Behavior; Case Study; Climate; Data; Data Analyses; Databases; Development; Development Plans; Drug Monitoring; Drug usage; Educational workshop; Elements; Environment; Environmental Policy; Equation; Ethnography; Faculty; Future; Gender; Geographic state; Goals; HIV; HIV Infections; HIV risk; Health; Health Policy; Health Status; Heterosexuals; Human immunodeficiency virus test; Incidence; Individual; Inequality; Intervention; Knowledge; Life; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Minor; Modeling; National Institute of Drug Abuse; Outcome; Parental Notification; Pathway interactions; Police; Policies; Policy Analysis; Population; Positioning Attribute; Poverty; Prevention; Prevention approach; Preventive Intervention; Psyche structure; Public Health; Publishing; Race; Reporting; Research; Research Methodology; Research Personnel; Risk; Risk Behaviors; Science; Sexual Health; Shapes; Suicide; Tobacco use; Training; Universities; Voting; Vulnerable Populations; Work; Youth; career; career development; evidence base; hands-on learning; health inequalities; innovation; longitudinal analysis; male; men who have sex with men; peer; population based; prevent; programs; public health ethics; public health intervention; public health relevance; public health research; sex risk; skills; social exclusion; success; symposium; theories; therapy development; young man; young men who have sex with men

 DESCRIPTION (provided by applicant): The purpose of this Mentored Research Scientist Development Award (K01) is to help me become an independent researcher focused on identifying modifiable structural factors that can explain and address disparities in substance use and sexual risk behaviors, and thus rates of HIV acquisition, among young men who have sex with men (YMSM) in the U.S. The training from this K01 will allow me to 1) apply my qualitative skills to policy case study analysis; 2) learn and apply key quantitative methods (i.e. structural equation modeling and longitudinal data analysis) to analyze population-based data and the impact of structural interventions; 3) understand the multi-level factors that influence substance use and sexual risk for YMSM; and 4) gain skills in public health ethics relevant to substance use, HIV and YMSM. My career development plan includes specific seminars, workshops, coursework, conferences, hands-on practica and tailored mentoring with a mentorship team comprised of experts in structural HIV prevention, HIV risk for YMSM, substance use- and sexual health- focused policies, quantitative methods and public health policy analysis. The focus on YMSM is particularly important as they are at nearly twice the risk of substance use compared to their heterosexual peers. In 2013 YMSM constituted 92% of new HIV infections among young men; indeed, YMSM are the group for whom HIV incidence is increasing most rapidly. The majority of YMSM-focused HIV interventions have targeted individual- level factors; little is known about how structural factors influence HIV risk for YMSM To achieve the combination HIV prevention approach outlined in the US National HIV/AIDS Strategy, and a goal of NIDA, it is important to identify modifiable structural-level factors (e.g. state-level policies) that can be intervened upon to address HIV risk for YMSM on a population level. However, no published studies have examined how the state-level policy climate-i.e., the aggregate impact of public health policies-affects HIV risk for YMSM. To fill this gap, the proposed research will first examine whether the state-level policy climate explains differences in substance use and sexual risk for YMSM across the US. It will then use longitudinal data analysis and policy case study analysis to assess how a state's political context influences the adoption of two specific policies relevant to HIV risk for YMSM-prescription drug monitoring database programs and parental notification of minors' HIV testing. This research will provide critical formative data that will be used to develop a NIDA R01 proposal that will examine the etiologic pathways through which state-level policies affect HIV risk behaviors for YMSM. The new skills acquired through this K01 will help me achieve my career goal to become an independent investigator who conducts innovative, high impact research examining how and why state-level factors affect substance use and sexual risk behaviors for YMSM with a goal of informing structural-level HIV interventions. This training will position me as one of the few mult-methods researchers working in the policy domain of HIV prevention and enable me to uniquely contribute to the Department of Sociomedical Sciences at Columbia University.

 描述(由申请人提供)：这个指导研究科学家发展奖(K01)的目的是帮助我成为一名独立研究员，专注于识别可改变的结构性因素，这些因素可以解释和解决美国男男性行为者(YMSM)在药物使用和性危险行为方面的差异，从而解释和解决艾滋病毒感染的比率。K01的培训将使我能够1)将我的定性技能应用于政策案例研究分析；2)学习和应用关键的定量方法(即 结构方程建模和纵向数据分析)，以分析以人口为基础的数据和结构性干预措施的影响；3)了解影响青少年吸毒和性行为风险的多层次因素；以及4)掌握与吸毒、艾滋病毒和基督教男同性恋有关的公共卫生伦理技能。我的职业发展计划包括具体的研讨会、研讨会、课程、会议、动手实践和量身定制的指导团队，该团队由结构性艾滋病毒预防、YMSM的艾滋病毒风险、以药物使用和性健康为重点的政策、量化方法和公共卫生政策分析方面的专家组成。对YMSM的关注尤其重要，因为与他们的异性恋同龄人相比，他们使用药物的风险几乎是两倍。2013年，青年男性接触者占新增艾滋病毒感染者的92%；实际上，青年男性接触者是艾滋病毒发病率上升最快的群体。大多数以基督教青年会为重点的艾滋病毒干预措施针对的是个人层面的因素；人们对结构性因素如何影响基督教青年会的艾滋病毒风险知之甚少，以实现美国国家艾滋病毒/艾滋病战略中概述的艾滋病毒预防方法和NIDA的目标，重要的是确定可以干预的可改变的结构性因素(例如，州一级的政策)，以在人口层面上解决青年男性同性恋者的艾滋病毒风险。然而，还没有发表的研究考察国家一级的政策环境--即公共卫生政策的总体影响--如何影响YMSM的艾滋病毒风险。为了填补这一空白，这项拟议的研究将首先检查州一级的政策环境是否解释了美国各地YMSM在物质使用和性风险方面的差异。然后，它将使用纵向数据分析和政策案例研究分析，以评估一个州的政治环境如何影响YMSM采用与艾滋病毒风险相关的两项具体政策-处方药监测数据库计划和未成年人艾滋病毒检测的父母通知。这项研究将提供关键的形成数据，这些数据将用于制定NIDA R01提案，该提案将检查州一级政策影响YMSM艾滋病毒危险行为的病因学途径。通过K01获得的新技能将帮助我实现我的职业目标，成为一名独立调查员，进行创新的、高影响力的研究，调查州一级因素如何以及为什么影响YMSM的物质使用和性危险行为，目的是为结构性水平的艾滋病毒干预提供信息。这次培训将使我成为为数不多的在艾滋病毒预防政策领域工作的多方法研究人员之一，并使我能够为哥伦比亚大学社会医学科学系做出独特的贡献。