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: 7841908
• 负责人: ROBERT Edwin BOOTH
• 金额: $ 15.65万
• 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 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7841908
• 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）：人类免疫缺陷病毒（HIV）感染是女性日益关注的公共卫生问题。在艾滋病毒流行之初，感染的女性相对较少。然而，目前女性占新诊断病例的四分之一以上，主要感染方式是异性接触（CDC，2006）。甲基苯丙胺 (MA) 是一种滥用药物，已被证明会增加女性的性危险行为（Klee, 1993; Lorvick, Martinez, & Laurne, 2006; Molitor, Truaz, Ruiz, & Sun, 1998; Rawson, Washton, Domier, & Reiber, 2002; Semple, Grant, & Patterson, 2004），与其他非法药物不同女性使用 MA 的比例似乎与男性相同 （卡多纳，2007）。目前的数据表明，在美国，女性在与兴奋剂相关的急诊就诊中占 40%，在 MA 治疗入院中女性占 45%（SAMHSA，2004 年）。研究人员越来越认识到包括权力在内的环境因素的重要性，对于理解女性艾滋病毒危险行为至关重要（Amaro，1995；Bourgois，1995；Bourgois，Prince，& Moss，2004；Epele，2002；Farmer，Connors，& Simmons，1996；Gomez & Marin，1996；Kershaw 等，2006；温古德和迪克莱门特，2000； 迪克莱门特，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。本研究建议利用结构、心理社会和行为理论来指导非注射女性 MA 使用者样本中对权力的理解。该项目的目的是更好地了解权力如何影响女性 MA 使用者在药物滥用和艾滋病毒相关性风险行为方面的影响。通过使用混合方法，这笔赠款将实现以下目标：1）理解和描述使用女性的 MA 中突出的多层次权力问题； 2) 修改评估该人群人际权力的 SRPS，并实施三个额外级别的权力（结构、文化和个人）； 3) 评估修改后的功率量表的初步心理测量特性； 4) 探讨该人群中权力问题的普遍程度及其与吸毒和艾滋病毒相关性危险行为的关系； 5) 确定针对该人群显着权力水平的干预策略。迄今为止，关于权力的方法论和实证研究是有限的，并且没有针对女性的 MA 权力的实证研究。有必要初步制定一项创新措施，利用女性来评估 MA 中的权力动态，以便获得有关多层次权力、吸毒和艾滋病毒性危险行为之间关系的进一步实证信息。未来的研究将包括在其他亚人群中验证这一量表，并利用该研究中的信息，为未接受治疗的 MA 女性制定艾滋病毒预防干预措施，该干预措施建立在多层次权力理论的基础上，可以在更大规模的临床对照试验中进行测试。 公共卫生相关性：随着女性艾滋病毒感染率的增加以及使用甲基苯丙胺 (MA) 的女性高风险性行为的普遍存在，研究人员必须努力更好地了解影响该人群危险行为的背景问题。通过使用混合方法，本研究建议实施并制定一个量表，从结构、文化、人际和个人四个层面评估该人群的权力问题，并确定影响显着权力水平的相关干预策略。未来的研究将包括在其他亚人群中验证这一规模，并利用该研究的信息来开发基于多层次权力理论的艾滋病毒预防干预措施，该干预措施可以在更大规模的临床对照试验中进行测试。