Race-related Social Contextual Factors, Substance Use, and HIV

 描述（由申请人提供）：与男性发生性关系的黑人男性（MSM），特别是年轻的MSM，比白色MSM更容易感染艾滋病毒。到目前为止，研究还无法解释导致这种种族差异的机制，因为艾滋病毒研究主要针对个人风险因素，但黑人男男性行为者一贯报告的这些行为与其他男男性行为者相当或更少。此外，很少有研究种族差异承认，物质使用和其他艾滋病毒的风险行为是社会和空间依赖性，因此，网络和场地隶属关系的差异可能会塑造不同种族群体的YMSM的风险环境和行为，并可能是理解艾滋病毒差异的关键。新兴的研究与黑人男男性接触者的文件种族差异的网络，地点和邻里关系的YMSM。这些研究结果表明，尽管黑人YMSM的吸毒率和其他艾滋病毒风险行为可能低于其他种族群体，但由于这些年轻人所经历的风险环境的性质，其后果可能有所不同。该项目的总体目标是促进有关结构机制的知识（例如，耻辱和歧视），塑造了这些风险环境，这反过来又塑造了年轻的黑人男男性行为者使用药物和其他艾滋病毒风险行为的后果。然而，适当地解释描述这些社会和文化背景的经验数据（即，社会、性、毒品、场所和邻里关系网络的结构）如果没有参与者的声音、生活经历和知识的结合，我会有问题。因此，该项目提出的创新混合方法将指导对现有NIH资助的YMSM队列中捕获的网络级结构的解释。将出现三个阶段，其中网络和地理数据可视化（第1阶段），并用于指导与YMSM的访谈，导致该人群中的机制和功能的理论（第2阶段），随后将使用多级建模（第3阶段）进行测试。整个项目有两个目标：1）确定网络，场地和社区如何运作的风险环境，塑造不同种族群体的YMSM的物质使用和艾滋病毒风险行为的后果，以及2）确定结构性机制，如耻辱和歧视，如何影响网络，场地出勤率，以及不同种族群体的YMSM的邻里关系。

 DESCRIPTION (provided by applicant): Black men who have sex with men (MSM), especially young MSM, are more likely to contract HIV than White MSM. Research thus far has been unable to account for the mechanisms driving this racial disparity, as HIV research has largely targeted individual risk factors, but Black MSM consistently report comparable or fewer of these behaviors than other MSM. In addition, little research examining racial disparities acknowledges that substance use and other HIV risk behaviors are socially and spatially dependent; thus, differences in network and venue affiliation may shape the risk environments and behaviors of YMSM of different racial groups, and may be key in understanding differences in HIV. Emerging research with Black MSM documents racial differences in the network, venue, and neighborhood affiliations of YMSM. These findings suggest that although rates of drug use and other HIV risk behaviors may be lower among Black YMSM than other racial groups, their consequences may be different due to the nature of the risk environments experienced by these young men. The overall objective of this project is to contribute to knowledge about structural mechanisms (e.g., stigma and discrimination) that shape these risk environments, which in turn shape consequences of substance use and other HIV risk behaviors for young Black MSM. However, appropriately interpreting the empirical data describing these social and cultural contexts (i.e., the structure of social, sex, drug, venue, and neighborhood affiliation networks) i problematic without the incorporation of the voices, lived experiences, and knowledge of participants. Therefore, the innovative mixed methods approach proposed by this project will guide the interpretation of network-level structures captured within an existing NIH-funded cohort of YMSM. Three phases will occur in which network and geographic data is visualized (Phase 1) and used to guide interviews with YMSM, leading to a theory of mechanisms and functions in this population (Phase 2), which will be subsequently tested using multilevel modeling (Phase 3). The overall project has two aims: 1) identify how networks, venues, and neighborhoods operate as risk environments that shape the consequences of substance use and HIV risk behavior for YMSM of different racial groups, and 2) identify how structural mechanisms, such as stigma and discrimination, influence the networks, venue attendance, and neighborhood affiliations of YMSM of different racial groups.