Social Networks and HIV-infected Former Prison Inmates

描述(由申请人提供)：项目摘要/摘要释放监狱是一个严重混乱的时期，对感染艾滋病毒的前囚犯以及他们的社会网络和他们返回的社区的福祉构成严重挑战。S不仅必须解决衣食住行等紧迫问题，还必须重新融入家庭和社会网络。对于感染艾滋病毒的前囚犯来说，这些挑战尤其严峻，他们除了满足上述需求外，还必须与定期医疗保健来源建立关系，并找到支付昂贵药物的方法。尽管这些人的吸毒和性风险对公共健康产生了影响，但很少有人对感染艾滋病毒的获释人员的危险行为进行全面评估。我们的初步数据表明，感染艾滋病毒的前囚犯经常有多个性伴侣，避孕套使用率较低。大量研究已经确立了社会网络在界定艾滋病毒危险行为方面的核心作用。对艾滋病毒感染者的基于社会网络的研究主要依赖于受访者驱动的抽样/招募(RDS)。RDS策略在映射联系方面一直很有帮助；然而，依赖自我报告来定性被污名化和非法的行为的策略面临着重大限制。在描述伙伴关系可能是匿名的网络时，这些方法尤其有问题。鉴于网络成员之间的互动在影响艾滋病毒流行传播方面发挥的关键作用，以及对自我报告行为的有效性的关切，需要新的和强有力的方法来更全面地了解这些社会结构。在R21的应用中，我们建议对艾滋病毒感染的前囚犯参与社会网络的生物标记物的效用进行初步评估；具体地说，我们将描述金黄色葡萄球菌鼻腔定植的分子流行病学特征。我们的目标是确定鼻腔携带沙门氏菌是否既可用于验证流行病学联系，也可用于识别以前未知的人之间的联系。在这一系列先导研究中，我们将：1)在北卡罗来纳州惩教署(NCDOC)监禁的250名感染艾滋病毒的囚犯中，描述SA鼻腔定居的特征。2)探讨SA感染的前囚犯中SA基因分型与社会网络特征的关系。项目说明尽管监狱获释人员吸毒和性行为风险对公共健康有影响，但对感染艾滋病毒的获释人员的危险行为进行全面评估的情况很少。依靠自我报告来定性被污名化和非法的行为的策略面临着重大限制；因此，我们建议对感染艾滋病毒的前囚犯参与社会网络的生物标记物的效用进行初步评估。

DESCRIPTION (provided by applicant): Project Summary/Abstract Release from prison is a time of serious dislocation and significant challenges to the well being of the HIV-infected former inmate as well as to their social networks and the communities to which they return. Not only must the pressing exigent questions of food, clothing and shelter be addressed, s/he must also re- integrate into family and social networks. These challenges are particularly acute for the HIV-infected former inmate who, in addition to meeting the needs described above, must also establish a relationship with a regular source of medical care and find a way to pay for expensive medications. Despite the public health implications of the drug and sexual risk taking of these individuals, there have been few comprehensive assessments of the risk behaviors of HIV-infected releasees. Our preliminary data indicate that HIV-infected former inmates frequently have multiple sexual partners and low rates of condom usage. A large number of studies have established a central role for social networks in defining HIV risk behaviors. Social network-based studies of HIV-infected individuals have relied largely on respondent- driven sampling/recruiting (RDS). RDS strategies have been helpful in mapping connections; however, strategies that rely on self-report to characterize behavior that is stigmatized and illegal face significant limitations. These approaches are particularly problematic in characterizing networks in which partnerships may be anonymous. Given the critical role that interactions between network members play in influencing the spread of the HIV epidemic and the concerns regarding the validity of self-reported behavior, novel and robust approaches are required to provide a more complete understanding of these social structures. In this R21 application, we propose to conduct a preliminary assessment of the utility of a biomarker for social network involvement by HIV-infected former inmates; specifically, we will characterize the molecular epidemiology of nasal colonization with Staphylococcus aureus (SA). Our goal is to determine whether nasal carriage with SA can be used both to verify an epidemiologic connection as well as to identify connections among people that were previously unknown. In this series of pilot studies, we will: 1) Characterize SA nasal colonization among 250 HIV-infected inmates incarcerated in the North Carolina Department of Corrections (NCDOC). 2) Characterize the relationship between SA genotypes and social network characteristics among HIV- infected former inmates who are colonized with SA. Project Narrative Despite the public health implications of the drug and sexual risk taking of prison releasees, there have been few comprehensive assessments of the risk behaviors of HIV-infected releasees. Strategies that rely on self-report to characterize behavior that is stigmatized and illegal face significant limitations; therefore, we propose to conduct a preliminary assessment of the utility of a biomarker for social network involvement by HIV-infected former inmates.