Polysubstance use and mental health outcomes after substance abuse treatment among community-based men of color who have sex with men in Los Angeles living with and without HIV

洛杉矶社区有色人种男性与感染艾滋病毒和未感染艾滋病毒的男性发生性行为的多物质使用和药物滥用治疗后的心理健康结果

• 批准号: 10838068
• 负责人: Julia Jan Koerber
• 金额: $ 5.25万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10838068
• 关键词: Aftercare; Alcohol consumption; Alcohols; Anxiety; Black race; Cannabis; Clinic; Cocaine; Communities; Data; Disparity; Equation; Fostering; Frequencies; Funding; Goals; HIV; Health; Housing; Individual; Intervention; Latino; Logistic Regressions; Los Angeles; Measures; Mental Depression; Mental Health; National Institute of Drug Abuse; Outcome; Participant; Patient Self-Report; Persons; Prospective cohort; Quality of life; Recording of previous events; Recovery; Reporting; Research; Social outcome; Social support; Structure; Substance abuse problem; Time; Tobacco; Tobacco use; Treatment outcome; Viral Load result; Visit; Work; anxiety symptoms; career; cocaine use; cohort; data visualization; depressive symptoms; experience; follow-up; housing instability; improved; marijuana use; men; men of color; men who have sex with men; methamphetamine use; polysubstance abuse; polysubstance use; reduced substance use; relapse prediction; sex; social; social factors; sociodemographic factors; statistics; structural determinants; substance abuse treatment; substance use; treatment program

Project Abstract This dissertation aims to better understand what substance use, treatment, and mental health outcomes occur after men of color who have sex with men (MoCSM) who live in Los Angeles, CA exit formal substance abuse treatment (SAT) programs, and if these outcomes vary across people living with HIV (PWH) versus people living without HIV (PWOH). The objective of the research is to identify which social and structural factors impede or foster positive SAT engagement, substance use reduction, depression, and anxiety outcomes in order to promote a higher quality of life for MoCSM in recovery. These goals will be met using data from the NIDA-funded mSTUDY (U01 DA036267) prospective cohort of over 500 MoCSM in Los Angeles, approximately half of whom are PWH, and will be accomplished through the following aims: Aim 1: Using longitudinal data from a cohort of MoCSM (2014-2023), describe engagement in, exits, and re-entry into SAT. Assess how sociodemographic factors, baseline substance use, and HIV status are associated with SAT at baseline and during follow up. Aim 2: Evaluate changes in self-reported frequency of methamphetamine, cocaine, cannabis, tobacco, and alcohol use among mSTUDY participants who have exited substance abuse treatment up to 3 years post-treatment. Among people use methamphetamine, cocaine, cannabis, tobacco, or alcohol at baseline, assess if people with prior SAT use those substances at a lower frequency than people who have never been in treatment, and if use outcomes vary by HIV status. Aim 3: Assess if there are differences in depression or anxiety symptoms (respectively measured by CES-D 13 and GAD-7 14) following SAT among people with and without prior SAT. Evaluate if these associations vary by HIV status. Among people in recovery, assess if higher social support scores (measured by MSPSS 15) are associated with improved depression and anxiety outcomes. Outcomes will be assessed across 4,319 study visits conducted across 129 men with prior SAT at baseline, 91 men who first entered SAT during follow-up, and 358 men who use substances but have never received treatment. Descriptive statistics and data visualization will be performed, and these outcomes will be assessed through multinomial regression, logistic regression, and generalized estimating equations, as appropriate, adjusting for relevant confounding factors. Through assessing the understudied, longer-term mental health, treatment, and substance abuse factors following substance abuse treatment, and analyzing the differences in these outcomes due to structural factors, this dissertation will help understand what supports better recovery outcomes among community-based MoCSM living with and without HIV in Los Angeles.

项目摘要 该论文旨在更好地了解哪种药物使用，治疗和心理健康 结果是在与男人发生性关系（MOCS）的有色人种之后发生的 退出正式药物滥用治疗（SAT）计划，如果这些结果各不相同 与艾滋病毒（PWH）与没有艾滋病毒的人（PWOH）生活。研究的目的是 确定哪些社会和结构性因素阻碍或促进积极的SAT参与， 降低药物的使用，抑郁和焦虑症状，以促进更高的质量 MOCSM恢复的生命。这些目标将使用来自NIDA资助的Mstudy的数据实现 （U01 DA036267）洛杉矶超过500 MOCS的预期队列，约一半 谁是PWH，将通过以下目的完成：目标1：使用纵向 来自MOCSM队列的数据（2014-2023），描述参与，退出并重新进入SAT。 评估社会人口统计学因素，基线药物使用和HIV状况如何 坐在基线和后续过程中。目标2：评估自我报告的频率的变化 MSTUDY参与者中的甲基苯丙胺，可卡因，大麻，烟草和饮酒 他们在治疗后长达3年退出了药物滥用治疗。在人们中使用 基线时甲基苯丙胺，可卡因，大麻，烟草或酒精，评估是否有先验的人 SAT使用这些物质的频率低于从未接受过治疗的人 如果使用结果因艾滋病毒状况而有所不同。目标3：评估抑郁症或 焦虑症状（通过CES-D 13和GAD-7分别测量） 有和没有前SAT的人。评估这些关联是否因艾滋病毒状况而变化。之中 康复的人，评估较高的社会支持分数（通过MSPS 15衡量）是否是 与改善抑郁和焦虑结局有关。结果将进行评估 4,319次研究访问，在129名男子中进行了先前的SAT，在基线上，有91名男子首次进入 在随访期间坐着，有358名使用物质但从未接受过治疗的男性。 将执行描述性统计和数据可视化，这些结果将是 通过多项式回归，逻辑回归和广义估计进行评估 方程式适当地调整了相关的混杂因素。通过评估 研究的，长期的心理健康，治疗和药物滥用因素之后 药物滥用治疗，并分析由于结构性的这些结果的差异 因素，本文将有助于了解哪些支持更好的恢复结果 以社区为基础的MOCSM在洛杉矶生活和没有艾滋病毒。