HIV Disparities among Drug Users: Neighborhoods, Neurocognition and Sex Behavior

吸毒者之间的艾滋病毒差异：社区、神经认知和性行为

• 批准号: 7603041
• 负责人: Leah j Floyd
• 金额: $ 12.3万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-05 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7603041
• 关键词: AIDS prevention; AIDS/HIV diagnosis; AIDS/HIV problem; Accounting; Acquired Immunodeficiency Syndrome; Address; Affect; African American; Alcohol or Other Drugs use; Award; Behavior; Cessation of life; Characteristics; Communicable Diseases; Complex; Contracts; Crime; Data; Data Analyses; Data Set; Decision Making; Disease; Doctor of Philosophy; Drug usage; Drug user; Economic Factors; Economics; Epidemiologic Studies; Fellowship; Female; Funding; Gender; HIV; Imprisonment; Incidence; Individual; Injecting drug user; Injection of therapeutic agent; Intervention; Investigation; Knowledge; Literature; Measures; Mediating; Minority; Modeling; Modification; Multiple Partners; National Institute of Drug Abuse; Neighborhoods; Neurocognition; Neurocognitive; Outcome; Paper; Parents; Pathway interactions; Pattern; Peripheral; Persons; Pharmaceutical Preparations; Postdoctoral Fellow; Poverty; Prevalence; Prevention; Preventive Intervention; Problem Solving; Process; Protocols documentation; Publishing; Race; Research; Research Design; Risk; Risk-Taking; Sampling; Sampling Studies; Science; Series; Sex Behavior; Sex Functioning; Socioeconomic Status; Specific qualifier value; Specificity; Statistical Models; Study models; Time; To specify; Unsafe Sex; Woman; Work; base; design; drug market; executive function; health disparity; high risk; improved; innovation; member; person centered; prevent; public health relevance; response; segregation; social; sound; success; symposium

DESCRIPTION (provided by applicant): This R03 application proposes to conduct secondary data analysis to develop statistical models that explain disparities in HIV/AIDS found among African American and white substance users. In the proposed study, we will employ advance statistical analyses (latent variable mixture models) to consider the separate and synergistic influence of neighborhood factors (drug arrest rates and poverty), substance use patterns and neurocognitive functioning on sexual risk partnerships and, in turn, HIV/AIDS. First, we will evaluate the possible specificity in relationships between distinct neighborhood level factors (segregation, drug markets, poverty) and sexual partnerships and HIV/AIDS. Aim 2 of the study is to model the influence of neighborhood characteristics, substance use patterns, incarceration and neurocognitve functioning on sexual risk partnerships and estimate prevalence and incidence over an18-month period. The third aim is to estimate the magnitude of the association between sexual partnerships and being HIV-infected. The possibility of effect modification is considered with a focus on race and gender. If successful, this project should improve prevention science by: (1) increasing understanding of sexual risk partnerships among drug users and how they vary across race and gender; (2) providing support for considering factors beyond traditional SES indicators when attempting to understand racial disparities in HIV by highlighting the importance of contextual influences of drugs (e.g., rate of drug arrests) on sexual partnerships; and (3) specifying potential neurocognitive processes that might mediate/moderate the relationship between neighborhood, substance use and sexual risk partnerships. This study is the first in a series of innovative studies designed to explain racial disparities and prevent HIV/AIDS among African Americans. PUBLIC HEALTH RELEVANCE: The intersection between substance use and HIV is a major concern as core and peripheral members of drug networks represent a significant portion of HIV/AIDS cases. Although all persons involved in drug networks are at increased risk for HIV, African Americans tend to be disproportionately affected. Because interventions focused solely on the individual have had limited success in slowing the spread of HIV among African Americans, it is important to elucidate the influence and model the pathways through which social and interpersonal factors influence HIV acquisition.

描述（由申请人提供）：此 R03 申请建议进行二次数据分析，以开发统计模型，解释非洲裔美国人和白人物质使用者中发现的艾滋病毒/艾滋病差异。在拟议的研究中，我们将采用先进的统计分析（潜变量混合模型）来考虑邻里因素（毒品逮捕率和贫困）、物质使用模式和神经认知功能对性风险伙伴关系以及艾滋病毒/艾滋病的单独和协同影响。首先，我们将评估不同社区层面因素（种族隔离、毒品市场、贫困）与性伙伴关系和艾滋病毒/艾滋病之间关系的可能特殊性。该研究的目标 2 是模拟社区特征、物质使用模式、监禁和神经认知功能对性风险伙伴关系的影响，并估计 18 个月内的患病率和发生率。第三个目标是估计性伴侣与艾滋病毒感染之间关联的程度。考虑影响修改的可能性，重点关注种族和性别。如果成功，该项目应通过以下方式改进预防科学：(1) 增进对吸毒者之间性风险伙伴关系及其在种族和性别之间的差异的了解； (2) 在试图了解艾滋病毒的种族差异时，通过强调毒品背景影响（例如毒品逮捕率）对性伙伴关系的重要性，为考虑传统社会经济地位指标之外的因素提供支持； (3) 明确可能介导/调节邻里、物质使用和性风险伙伴关系之间关系的潜在神经认知过程。这项研究是旨在解释非洲裔美国人中的种族差异和预防艾滋病毒/艾滋病的一系列创新研究中的第一项。 公共卫生相关性：药物滥用和艾滋病毒之间的交叉是一个主要问题，因为毒品网络的核心和外围成员占艾滋病毒/艾滋病病例的很大一部分。尽管参与毒品网络的所有人员感染艾滋病毒的风险都增加，但非洲裔美国人往往受到的影响尤其严重。由于仅针对个人的干预措施在减缓艾滋病毒在非裔美国人中的传播方面收效有限，因此阐明社会和人际因素影响艾滋病毒感染的影响并模拟其途径非常重要。