Understanding the effects of substance use on male couples' risk for HIV

了解物质使用对男性夫妇感染艾滋病毒风险的影响

• 批准号: 9439398
• 负责人: Jason W Mitchell
• 金额: $ 54.99万
• 依托单位: UNIVERSITY OF HAWAII AT MANOA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-01 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9439398
• 关键词: AIDS prevention; Address; Adherence; Affect; Agreement; Alcohol or Other Drugs use; Anal Sex; Anti-Retroviral Agents; Attention; Behavior; Behavioral; Centers for Disease Control and Prevention (U.S.); Characteristics; Communities; Couples; Data; Data Collection; Development; Drug usage; Ecological momentary assessment; Eligibility Determination; Ensure; Equilibrium; Event; Florida; Foundations; Future; HIV; HIV Seropositivity; HIV risk; HIV/STD; Hair; Incidence; Individual; Internet; Interview; Investments; Length; Link; Longitudinal Studies; Marijuana; Methamphetamine; Methodology; Methods; Monitor; Participant; Persons; Phonation; Population; Population Intervention; Populations at Risk; Prevention; Preventive Intervention; Public Health; Questionnaires; Recruitment Activity; Reporting; Research; Research Design; Research Personnel; Risk; Sampling; Services; Sex Behavior; Social support; Technology; Telephone; Testing; Text; Time; Trust; Viral Load result; Work; base; binge drinking; contextual factors; experience; innovation; male; men; men who have sex with men; multilevel analysis; novel; pleasure; public health relevance; same-sex partnership; sample collection; sex; theories; time use; transmission process; treatment adherence

 DESCRIPTION (provided by applicant): Despite between one- and two-thirds of US men who have sex with men (MSM) acquire HIV from their primary 4 same-sex relationship partner (i.e., male couples), most HIV prevention efforts have targeted MSM at the 5 individual- and community-levels. Substance use is also an important Public Health issue that affects HIV 6 acquisition and transmission among MSM; substances are often used to enhance pleasure and sustain 7 engagement in sexual behaviors including condomless anal sex (CAS). Findings from the few studies 8 conducted with male couples indicate their use of substances with sex negatively impacts their relationship 9 dynamics and behaviors related to HIV prevention, including CAS with casual MSM partners and poor 10 treatment adherence. Although these findings suggest the need to intervene for prevention, less is known 11 about how primary partners within the male couple influence one another's use of substances, the different 12 context(s) in which they use substances, and how their usage directly affects their risk for HIV and dynamics of 13 the relationship. To that calling, we propose to conduct a 4-year mixed method study that is theoretically 14 grounded to examine how male couples' use of substances affects their relationship and risk for acquisition 15 and/or transmission of HIV. We will use venue-time sampling to recruit 225 substance-using male couples, 16 diverse in terms of HIV status and relationship length, from community and Internet venues in South Florida. 17 We will collect qualitative and quantitative longitudinal dyadic data over a 6-month period to examine the 18 associations between intrapersonal, interpersonal and contextual factors in general and with event level 19 substance use. Participants will complete in-person ACASI at 3 time points (baseline, 3 and 6 months), and 20 daily ecological momentary assessments (EMA) during months 2 and 5. Every third reported substance use 21 event will be supplemented with an in-depth phone interview. All data will be collected independently from each 22 partner of the couple, and couples' substance use and HIV serostatus will be verified at baseline, 3 and 6 23 months. Longitudinal quantitative data obtained from the ACASI and EMA will be analyzed using 24 mixed/multilevel models, including actor-partner effects. Qualitative content analysis, specifically latent and 25 manifest content analysis, will be used to identify and describe the major themes and sub-themes that emerge 26 from the phone interview data. We will use standard mixed methodology to integrate the quantitative and 27 qualitative findings to elucidate how primary partners' influence one another's use of substances and risk for 28 HIV, and how their usage affects dynamics of their relationship. Under the direction of Mitchell, he and his 29 team of senior co-investigators will disseminate these findings, and apply them toward development of a 30 couples-focused HIV and substance use preventive intervention for use in a future project.

 描述（由申请人提供）：尽管有三分之一到三分之二的美国男男性行为者 (MSM) 从他们的 4 个主要同性关系伴侣（即男性伴侣）那里感染艾滋病毒，但大多数艾滋病毒预防工作都针对 5 个个人和社区层面的 MSM。药物使用也是一个重要的公共卫生问题，影响 MSM 中 HIV 6 的感染和传播； 7 物质通常用于增强快感并维持性行为，包括无套肛交 (CAS)。对男性夫妇进行的少数研究 8 的结果表明，他们在性行为中使用物质会对他们的关系 9 与艾滋病毒预防相关的动态和行为产生负面影响，包括与临时 MSM 伴侣的 CAS 和较差的 10 治疗依从性。尽管这些研究结果表明需要进行干预预防，但关于男性夫妇中的主要伴侣如何影响彼此使用药物、他们使用药物的不同背景、以及他们的使用如何直接影响艾滋病毒风险和关系动态 13 ，人们知之甚少 11 。为此，我们建议进行一项为期 4 年的混合方法研究，该研究理论上 14 旨在研究男性夫妇使用物质如何影响他们的关系以及感染艾滋病毒和/或传播艾滋病毒的风险 15 。我们将采用场地时间抽样方法，从南佛罗里达州的社区和互联网场所招募 225 对使用药物的男性夫妇，其中 16 对在艾滋病毒状况和关系长度方面各不相同。 17 我们将在 6 个月的时间内收集定性和定量纵向二元数据，以检查个人内部、人际和背景因素之间的 18 种关联以及与事件级别 19 物质使用之间的关联。参与者将在 3 个时间点（基线、第 3 个月和第 6 个月）完成现场 ACASI，并在第 2 个月和第 5 个月期间完成 20 次每日生态瞬时评估 (EMA)。每 3 个报告的物质使用 21 事件将辅以深入的电话访谈。所有数据都将从这对夫妇的每 22 名伴侣中独立收集，夫妇的药物使用和 HIV 血清状况将在基线、第 3 个月和第 6 个月进行验证。从 ACASI 和 EMA 获得的纵向定量数据将使用 24 个混合/多级模型进行分析，包括行动者-合作伙伴效应。定性内容分析，特别是潜在内容分析和 25 明显内容分析，将用于识别和描述从电话采访数据中出现的主要主题和子主题 26 。我们将使用标准混合方法整合定量和 27 定性研究结果，以阐明主要伴侣如何影响彼此的物质使用和 28 HIV 风险，以及他们的使用如何影响他们关系的动态。在 Mitchell 的指导下，他和他的 29 名高级联合研究人员团队将传播这些发现，并将其应用于开发针对 30 对夫妇的艾滋病毒和药物使用预防干预措施，以便在未来的项目中使用。