Understanding Pathways between Intimate Partner Violence and HIV risk for Men

了解男性亲密伴侣暴力与艾滋病毒风险之间的关系

• 批准号: 10668444
• 负责人: Erin M Kahle
• 金额: $ 65.77万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10668444
• 关键词: AIDS prevention; ATOD; Address; Behavior Control; Behavioral; Behavioral Research; Biological; Biological Markers; Bisexual; Cohort Studies; Communities; Complex; Couples; Data; Epidemic; FOXP3 gene; Female; Foundations; Frequencies; Gays; HIV; HIV Infections; HIV Seronegativity; HIV risk; HLA-DR Antigens; Heterosexuals; IL2RA gene; Immune; Immune System Diseases; Immunologic Markers; Immunologics; Incidence; Interruption; Intervention; Knowledge; Link; Measures; Mediating; Michigan; Monitor; Outcome; Pathway interactions; Phase; Prevalence; Process; Psychosocial Factor; Recommendation; Recording of previous events; Regulatory T-Lymphocyte; Reporting; Research; Research Activity; Research Personnel; Risk; Risk Behaviors; Role; Sampling; Sex Behavior; Shapes; Social support; Stress; Theoretical model; Time; Trauma; United States National Institutes of Health; Victimization; Violence; Woman; alcohol tobacco and other drug use; behavioral response; biological adaptation to stress; cohort; coping; design; emotional abuse; experience; immune function; inattention; innovation; intimate partner violence; male; men; men who have sex with men; minority stress; minority stressor; perpetrators; prospective; psychological distress; recruit; resilience; sexual violence; social factors; social stigma; structural determinants; substance use; synergism; therapy development; violence victimization

PROJECT SUMMARY/ABSTRACT There is increasing evidence that gay, bisexual and other men who have sex with men (GBMSM) experience dual epidemics of HIV and intimate partner violence (IPV), yet understanding of the synergies between these two epidemics is underdeveloped. Estimated prevalence for receipt of IPV among GBMSM range from 12% to 78%. Emergent evidences demonstrates associations between the experience of IPV among GBMSM and participation in risk behaviors that heighten the risk of HIV (i.e. substance use). Beyond the indirect behavioral associations between IPV and HIV, less is known about direct pathways through which IPV may increase HIV acquisition risk among GBGBMSM. According to Schafer’s theoretical model, IPV not only contributes to behavioral risk, but also to immunologic change that impacts HIV risk – but all of this evidence comes from studies of heterosexual women. With the identification of HIV-specific immunologic dysfunction associated with IPV, we are able to further investigate upstream factors, including minority stressors that may contribute to such changes, as well as protective measures such as coping and resiliency processes. We hypothesize that experiences of IPV (including victimization, perpetration, and bi-directional IPV), in the context of minority stress, increases both indirect behavioral (sexual behavior, substance use), and direct biological (STI) and immunologic risks for HIV infection among GBMSM. To fill the critical gap in knowledge, we propose an innovative 24-month cohort study of partnered HIV-negative GBMSM in SE Michigan, to identify the pathways and points of intervention between IPV and HIV risk for GBMSM. Prior research is limited by cross-sectional designs, inconsistent measures of violence, and inattention to important psychosocial and structural factors that co-occur with both IPV and HIV, and may moderate or mediate relationships. We address these limitations by employing a rigorous cohort design, measures of IPV that are specific for GBMSM, considering the role of IPV victimization, perpetration and bi-directional IPV, and consider the multiple minority stressors and stress response behaviors that may shape both IPV and HIV risk behaviors, and measure indicators of HIV-specific immunologic dysfunction, biological risk (STI) and behavioral risk. The proposed research activities include a prospective 24- month cohort of 360 HIV-negative partnered GBMSM (>18 years) recruited in SE Michigan. The overall aim of the proposed activities is to provide new knowledge of how victimization or perpetration of IPV shapes engagement in HIV prevention and risk behaviors.

项目摘要/摘要 越来越多的证据表明，同性恋，双性恋和其他与男性发生性关系的男性（GBMSM）经历双重性行为。 艾滋病毒流行和亲密伴侣暴力（IPV），但了解这两者之间的协同作用 流行病发展不足。GBMSM中接受IPV的估计患病率范围为12%至78%。 新出现的证据表明GBMSM中IPV的经历与参与之间存在关联 增加艾滋病毒风险的危险行为（即物质使用）。除了间接的行为关联 在IPV和HIV之间，关于IPV可能增加HIV感染的直接途径知之甚少 GBGBMSM之间的风险。根据Schafer的理论模型，IPV不仅会导致行为风险， 也与影响艾滋病风险的免疫变化有关--但所有这些证据都来自于以下研究： 异性恋女性随着与IPV相关的HIV特异性免疫功能障碍的鉴定，我们 能够进一步调查上游因素，包括可能导致这种情况的少数压力因素， 变化，以及保护措施，如应对和弹性过程。我们假设经验 IPV（包括受害，犯罪和双向IPV），在少数民族压力的背景下，增加 间接行为（性行为，物质使用），直接生物（STI）和免疫风险， GBMSM中HIV感染情况调查为了填补知识的关键差距，我们提出了一个创新的24个月的队列 对密歇根州东南部HIV阴性GBMSM伴侣的研究，以确定干预途径和点 IPV与GBMSM的HIV风险之间的关系。以前的研究受到横截面设计的限制，不一致 暴力的措施，以及不注意重要的心理和结构因素，同时发生的两个 IPV和HIV，并可能缓和或介导的关系。我们通过采用严格的 队列设计，GBMSM特定的IPV措施，考虑IPV受害的作用， 犯罪和双向IPV，并考虑多种少数民族的压力源和压力反应行为 这可能会影响IPV和HIV的危险行为，并测量HIV特异性免疫指标， 功能障碍，生物风险（STI）和行为风险。拟议的研究活动包括一个前瞻性的24- 在密歇根州东南部招募的360名HIV阴性的GBMSM伴侣（>18岁）的一个月队列。的总体目标 建议的活动是提供关于IPV受害或实施如何形成的新知识 参与艾滋病毒预防和危险行为。