Understanding the Role of Power in Drug Use and HIV Risk Behaviors Among Non-Inje

了解权力在非注入者吸毒和艾滋病毒风险行为中的作用

• 批准号: 7670866
• 负责人: ROBERT Edwin BOOTH
• 金额: $ 18.8万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-15 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7670866
• 关键词: AIDS diagnosis; Accident and Emergency department; Accounting; Address; Admission activity; Attention; Behavior; Behavioral; Centers for Disease Control and Prevention (U.S.); Clinic; Clinical Trials; Community Health; Complex; Controlled Clinical Trials; Data; Decision Making; Development; Diagnosis; Drug abuse; Drug usage; Drug user; Educational Background; Empirical Research; Epidemic; Female; Focus Groups; Future; Grant; HIV; Heterosexuals; Illicit Drugs; Individual; Infection; Intervention; Interview; Investigation; Latina; Measures; Methamphetamine; Methods; Mosses; Nature; Phase; Population; Population Attributable Risks; Prevalence; Preventive Intervention; Property; Psychometrics; Public Health; Recording of previous events; Recruitment Activity; Research; Research Personnel; Respondent; Risk; Risk Behaviors; Risk Estimate; Role; Route; Sampling; Sex Behavior; Smoking; Structure; Testing; The Sun; United States; United States Substance Abuse and Mental Health Services Administration; Virus Diseases; Visit; Vulnerable Populations; Woman; base; condoms; consistent condom use; contextual factors; drug of abuse; effective intervention; farmer; high risk; high risk sexual behavior; innovation; instrument; instrumentation; men; men who have sex with men; non-drug; psychosocial; public health relevance; satisfaction; sex risk; sexual relationship; sexual violence; theories; trend

DESCRIPTION (provided by applicant): Infection with the Human Immunodeficiency Virus (HIV) is an increasing public health concern among women. At the beginning of the HIV epidemic relatively few women were infected. However, women currently comprise over a quarter of new diagnoses and the primary mode of infection is heterosexual contact (CDC, 2006). Methamphetamine (MA) is a drug of abuse that has been shown to increase sexual risk behaviors among women (Klee, 1993; Lorvick, Martinez, & Laurne, 2006; Molitor, Truaz, Ruiz, & Sun, 1998; Rawson, Washton, Domier, & Reiber, 2002; Semple, Grant, & Patterson, 2004) and unlike other illicit drugs women appear to be using MA in equal portions to men (Cardona, 2007). Current data indicate that women account for 40% of stimulant related emergency department visits and 45% of MA treatment admissions in the United States (SAMHSA, 2004). Researchers are increasingly recognizing the importance of contextual factors, including power, as essential to understanding HIV risk behaviors among women (Amaro, 1995; Bourgois, 1995; Bourgois, Prince, & Moss, 2004; Epele, 2002; Farmer, Connors, & Simmons, 1996; Gomez & Marin, 1996; Kershaw et al., 2006; Wingood & Di Clemente, 2000; Wingood & DiClemente, 2002). However, few empirical studies have investigated power and its relationship to HIV risk behaviors among drug using women. This study proposes to draw upon structural, psychosocial and behavioral theories to guide the understanding of power among a sample of non-injecting female MA users. The aim of this project is to better understand how power impacts female MA users in relation to drug abuse and HIV-related sex risk behaviors. Through using mixed methods this grant will address the following aims: 1) to understand and describe the multi-level power issues that are salient for MA using women; 2) to modify the SRPS that assesses interpersonal power for this population and to operationalize three additional levels of power (structural, cultural and individual); 3) to assess preliminary psychometric properties of the modified power scale; 4) to explore the prevalence of power issues in this population and their relationship to drug use and HIV-related sex risk behaviors; and 5) to identify intervention strategies that will target the salient levels of power for this population. To date, methodological and empirical research on power is limited and there are no empirical studies of power with MA using women. The preliminary development of an innovative measure to assess power dynamics among MA using women is necessary in order to obtain further empirical information on the relationship between multiple levels of power, drug use and HIV sex risk behaviors. Future research would include validating this scale among other subpopulations and using information from the study to develop an HIV prevention intervention for out-of treatment MA using women that is founded on a multi-level theory of power that could be tested in a larger clinical control trial. PUBLIC HEALTH RELEVANCE: With the increase of HIV infection among women and the prevalence of high risk sex behaviors among methamphetamine (MA) using women, researchers must strive to better understand contextual issues that impact risk behaviors among this population. Through using mixed methods, this study proposes to operationalize and develop a scale to assess power issues for this population on four levels: structural, cultural, interpersonal and individual and to identify relevant intervention strategies to impact the salient levels of power. Future research would include validating this scale among other subpopulations and using information from the study to develop an HIV prevention intervention founded on multi-level theory of power that could be tested in a larger clinical control trial.

描述(由申请人提供)：感染人类免疫缺陷病毒(HIV)是妇女日益关注的公共卫生问题。在艾滋病毒流行之初，受感染的妇女相对较少。然而，妇女目前占新诊断病例的四分之一以上，感染的主要方式是异性接触(CDC，2006年)。甲基苯丙胺(MA)是一种滥用毒品，已被证明会增加女性的性行为风险(Klee，1993；Lorvick，Martinez，&Laurne，2006；Molitor，Truaz，Ruiz，&Sun，1998；Rawson，Washington，Domier，&Reiber，2002；Semple，Grant，&Patterson，2004)，而且与其他非法药物不同，女性使用MA的比例似乎与男性相同(Cardona，2007)。目前的数据表明，在美国，女性占兴奋剂相关急诊科就诊的40%，占MA治疗入院人数的45%(SAMHSA，2004年)。研究人员日益认识到背景因素的重要性，包括权力，对于理解妇女中的艾滋病毒危险行为是必不可少的(Amaro，1995；Bourgois，Bourgois，Prince，&Moss，2004；Epele，2002；Farmer，Connors，&Simmons，1996；Gomez&Marin，1996；Kershaw et al.，2006；WinGood&Di Clemente，2000；WinGood&DiClemente，2002)。然而，很少有实证研究调查吸毒女性的权力及其与艾滋病毒危险行为的关系。本研究建议借鉴结构、心理社会和行为理论来指导非注射女性MA使用者对权力的理解。该项目的目的是更好地了解权力如何在药物滥用和与艾滋病毒相关的性行为方面影响女性吸毒者。通过使用混合方法，这笔赠款将达到以下目标：1)了解和描述使用MA的妇女突出的多层次权力问题；2)修改评估这一人群的人际权力的SRPS，并实施额外的三种权力水平(结构、文化和个人)；3)评估修改后的权力量表的初步心理测量学特性；4)探索这一人群中权力问题的普遍性及其与吸毒和与艾滋病毒相关的性风险行为的关系；以及5)确定针对这一人群显著权力水平的干预策略。到目前为止，关于权力的方法论和实证研究是有限的，还没有关于MA使用女性的权力的实证研究。有必要初步制定一种评估使用妇女的MA中的权力动态的创新措施，以便获得关于多种权力、药物使用和艾滋病毒性行为风险行为之间关系的进一步经验信息。未来的研究将包括在其他亚人群中验证这一量表，并利用研究中的信息开发一种针对女性使用的未接受治疗的MA的艾滋病毒预防干预措施，该干预措施建立在多水平的权力理论基础上，可以在更大的临床对照试验中进行测试。 公共卫生相关性：随着妇女中艾滋病毒感染的增加和使用甲基苯丙胺(MA)的妇女中高危性行为的流行，研究人员必须努力更好地了解影响这一人群危险行为的背景问题。通过使用混合方法，本研究提出了一种量表，以评估这一群体在结构、文化、人际和个人四个层面上的权力问题，并确定相关的干预策略，以影响显著的权力水平。未来的研究将包括在其他亚人群中验证这一量表，并利用研究中的信息开发基于多水平力量理论的艾滋病毒预防干预措施，可以在更大的临床对照试验中进行测试。