Patterns of Substance Use Among HIV Positive and Negative Aging MSM

描述（由申请人提供）：本研究的目的是研究参与多中心艾滋病队列研究（MACS）的HIV阳性和阴性男男性行为（MSM）的现有队列中的物质使用模式。很少得到研究关注的一个重要健康问题是，男男性行为者的物质使用模式如何从幼年延续到晚年，以及随着男男性行为者年龄的增长，不同的物质使用模式是否与功能下降、健康和社会问题增加有关。虽然对异性恋男性的研究发现，随着年龄的增长，吸毒的情况有所下降或减少，但对男男性接触者的现有研究并没有发现在整个生命过程中吸毒的情况有实质性的下降。本提案寻求资金来进行一项混合方法研究，其中包括：1)对现有MACS数据进行二次定量数据分析的创新方法；2)对选定的MACS参与者进行定性深入访谈。该分析将比较药物使用减少与药物使用增加或持续高水平的轨迹。这些模式比较将有助于确定与减少药物使用以及相关的健康和社会问题有关的复原力特征。研究结果将作为未来R21赠款申请的基础，用于制定和评估一种模式干预措施，以防止艾滋病毒阳性和阴性男男性行为者滥用药物及相关的健康和社会问题。随着时间的推移，导致物质使用减少的因素的定量发现和参与者如何管理其物质使用的定性数据对基于优势的干预措施的发展具有直接意义。分析还将特别寻求从定性和定量数据中提出假设，这些假设可以在其他老年药物使用者群体中进行测试。关于物质使用模式如何随着男男性接触者年龄的增长而改变或保持稳定，以及影响生命过程中物质使用模式变化或稳定的因素，人们知之甚少。这项研究的结果将有助于确定与减少药物使用和相关的健康和社会问题有关的复原力特征，并将作为未来申请拨款的基础，以制定和评估一种模式干预措施，以防止老年艾滋病毒阳性和阴性男男性行为者滥用药物和相关的健康和社会问题。

DESCRIPTION (provided by applicant): The goal of this research is to examine the patterns of substance use over time among an existing cohort of HIV positive and negative men who have sex with men (MSM) participating in the Multicenter AIDS Cohort Study (MACS). An important health issue that has received little research attention is how the patterns of substance use among MSM are carried from early age into later life and whether distinct patterns of substance use are associated with decreased functioning, increased health and social problems as MSM age. While research among heterosexual men has found a fall-off or decrease in drug use with increased age, existing research among MSM has not observed a substantial decline in drug use across the life course. This proposal seeks funding to conduct a mixed method study that includes 1) an innovative approach to secondary quantitative data analysis of existing MACS data and 2) qualitative in-depth interviews with select MACS participants. The analysis will compare trajectories of declining substance use with increasing or consistently high levels of use. These pattern comparisons will allow for the identification of resiliency characteristics associated with decreased substance use and related health and social problems. Results will be used as the basis of a future R21 grant application to develop and evaluate a model intervention to prevent substance abuse and related health and social problems among both HIV positive and negative MSM. Quantitative findings regarding the factors that contributed to decreased substance use over time and qualitative data regarding how the participants manage their substance use over time have direct implications for development of a strengths-based intervention. The analysis will also specifically seek to develop hypotheses from the qualitative and quantitative data that can be tested with other aging populations of substance users. Little is known regarding how substance use patterns change or stay stable as MSM age and the factors influencing patterns of change or stability in substance use across the life course. The results of this research will allow for the identification of resiliency characteristics associated with decreased substance use and related health and social problems and will be used as the basis for a future grant application to develop and evaluate a model intervention to prevent substance abuse and related health and social problems among both older HIV positive and negative MSM.