Drugs, sexual impulsivity, HIV: Psychosocial and cognitive risk factors of YMSM

描述（由申请人提供）：男性之间无保护的性交占所有报告的艾滋病病例的58%，占艾滋病毒病例的80%。15至24奥尔兹的艾滋病毒感染率继续上升，男男性接触行为仍然是青少年男性感染艾滋病毒的主要原因1，2。超过90%的YMSM报告在过去6个月内有一个以上的性伴侣，33%至49%的YMSM在同一时间内有过无保护的肛交。研究表明，使用兴奋剂，特别是甲基苯丙胺，可能会影响危险的性行为，并促成最近的艾滋病毒和其他性传播感染浪潮4-6。理论的系统发展已被确定为有效的干预发展的关键一步，但以前的概念模型集中在一个相对有限的解释结构。然而，社会行动理论（SAT）7提供了一个很有前途的模型来研究YMSM的风险行为，因为它包括个人以及社会和背景的决定因素。SAT在艾滋病毒领域和YMSM中的使用仍有待测试，因为这种模式最初被认为是成年人的一般健康促进模式。使用来自Kipke博士的NIDA资助的“健康年轻男性研究”（HYM）的数据，本研究将进行多变量分析，以测试该模型用于YMSM人群。本研究的具体目的是：1）实证验证社会行动理论中描述的关系链，以确定该理论是否解决了与YMSM相关的性行为和药物风险行为的个体，背景和社会相关因素的相互作用;和2）为了进一步验证SAT，通过测试和合并其他行为理论模型中描述的竞争理论关系，以开发一个全面的在青年男男性行为者中，毒品使用、性冲动和艾滋病毒的社会、心理和认知风险因素理论，以指导预防干预工作。.这项研究将有助于艾滋病科学跟踪奖的研究过渡的目标，1）支持一个新的研究人员; 2）解决艾滋病毒，药物滥用，冲动和应对策略的风险，代表性不足的人口领域的NIDA的研究目标; 3）通过完善综合理论模型，我们将提供一个平台，以制定干预措施，解决与YMSM中艾滋病毒传播相关的风险行为。公共卫生相关性：这项研究将有助于有效的艾滋病毒干预措施的风险青年，通过开发一个模型，以了解环境的风险因素，冲动，和应对策略收敛到药物滥用和性冒险。

DESCRIPTION (provided by applicant): Unprotected sexual intercourse between men constitutes 58% of all reported cases of AIDS and 80% of HIV cases 1,2. Rates of HIV infection among 15 to 24 year olds continue to increase with MSM behavior remaining the leading cause of HIV infection among adolescent males 1,2. Over 90% of YMSM have reported having more than one sexual partner in the past 6 months and between 33% and 49% have had unprotected anal intercourse during the same time3. Studies show that use of stimulants, particularly methamphetamine, may influence risky sexual practices and contribute to the most recent wave of HIV and other sexually transmitted infections (STIs)4-6. Systematic development of theory has been identified as a crucial step in efficacious intervention development, but previous conceptual models have focused on a relatively limited array of explanatory constructs. However, Social Action Theory (SAT)7 provides a promising model for examining the risk behavior of YMSM, because it includes individual as well as social and contextual determinants. SAT remains to be tested for use in the field of HIV and with YMSM, because this model was originally conceived as a general health promotion model for the adult population. Using data from the Dr. Kipke's NIDA funded "Healthy Young Men Study" (HYM), this study will conduct multivariate analysis to test this model for use with the YMSM population. The specific aims of this study are to: 1) To empirically validate the chain of relationships depicted in Social Action Theory to determine if the theory addresses the interaction of individual, contextual, and social correlates of sexual and drug risk taking behaviors as they relate to YMSM; and 2) To further validate SAT by testing and incorporating competing theoretical relationships depicted in other behavioral theory models to develop a comprehensive theory of the social, psychosocial and cognitive risk factors for drug use, sexual impulsivity, and HIV among YMSM to guide prevention intervention efforts. . This study will contribute to the objectives of the AIDS-Science Track Award for Research Transition by 1) supporting a New Researcher; 2) addressing the NIDA research objective in the area of HIV, drug abuse, impulsivity, and coping strategies of an at-risk, under represented population; and 3) through refinement of a comprehensive theoretical model, we will provide a platform for developing interventions that address risk behavior related to HIV transmission among YMSM. PUBLIC HEALTH RELEVANCE: This study will contribute to effective HIV interventions for at-risk youth by developing a model to understand how environmental risk factors, impulsivity, and coping strategies converge into drug abuse and sexual risk taking.