Dyadic influences on HIV risk behavior and substance abuse among young men who have sex with men and their partners

项目摘要： 艾滋病毒和药物滥用是对青年男子造成不成比例影响的两种流行病 与男性发生性关系的人（YMSM）YMSM中的大多数艾滋病毒传播发生在 严重关系的背景下，主要是由于较高的无避孕套肛交（CAS）率， 严重相比，休闲合作伙伴和缺乏PrEP吸收的关系。不幸的是， 关于艾滋病毒和药物滥用风险因素的研究主要集中在有以下症状的个人身上： 对二分体的关注有限。除了所有夫妇都经历过的压力外， 经历与其性少数地位相关的独特压力（例如，歧视、污名）。 这种额外的压力可能会导致关系功能的问题（例如，不满，冲突， 亲密伴侣暴力），这可能会导致健康风险行为的参与， 例如化学文摘社和物质使用。描述这些过程至关重要， 优化关系运作和减少健康差距的二元预防战略 在YMSM中。拟议的研究将利用来自一个大型， 种族/民族多样化的YMSM群体，他们目前正在为NIDA资助的 U01这个群体是通过让YMSM招募他们认真的关系伙伴进入 研究，提供了独特的机会，研究对艾滋病毒风险行为的双重影响， YMSM及其合作伙伴之间的物质使用。该提案还将为申请人提供 在艾滋病毒和药物使用研究方面接受博士后培训， 二元数据，和granitary，所有这些都是必要的，以启动他的职业生涯， 独立科学家申请人将学习如何实施演员合作伙伴 相互依赖模型，它在统计上解释了二元数据的非独立性 通过同时估计演员效应（一个人对自己行为的影响）， 伴侣效应（一个人受伴侣影响的程度）。该模型将允许 申请人检查个人和合作伙伴层面的压力对风险行为的影响。 此外，二元数据提供了检查 伴侣之间压力的一致性/不一致性会增加每个伴侣的艾滋病毒风险 行为和物质的使用超出了个体演员和合作伙伴的影响。总之， 本研究的目标是：（1）行为者和伴侣的压力对艾滋病毒的影响 风险行为和物质使用;（2）一致性/不一致性之间的关联 伴侣之间的压力和艾滋病毒危险行为和物质使用;（3） 作为这些联系的中介。这一建议具有建设性 研究青年男男性接触者健康危险行为的双向影响是必要的 采取步骤，以制定以证据为基础的预防和干预方案， 艾滋病毒传播风险最高的环境（浪漫二人组）。这项研究的结果将 通过将个人和伙伴层面的问题分开， 对高危人群（不同的YMSM）的HIV风险行为和物质使用的影响。

Project Summary: HIV and substance abuse represent two epidemics that disproportionately affect young men who have sex with men (YMSM). The majority of HIV transmissions among YMSM occur in the context of serious relationships, largely due to higher rates of condomless anal sex (CAS) with serious compared to casual partners and lack of PrEP uptake in relationships. Unfortunately, research on risk factors for HIV and substance abuse has largely focused on individuals with limited attention to dyads. In addition to stress experienced by all couples, coupled YMSM experience unique stress related to their sexual minority status (e.g., discrimination, stigma). This added stress may lead to problems in relationship functioning (e.g., dissatisfaction, conflict, intimate partner violence), which may then contribute to engagement in health risk behaviors, such as CAS and substance use. Delineating these processes is critically important to inform dyadic prevention strategies to optimize relationship functioning and reduce health disparities among YMSM. The proposed study will utilize data from a subsample of a large, racially/ethnically diverse cohort of YMSM who are currently being recruited for a NIDA-funded U01. The cohort is being built by having YMSM recruit their serious relationship partners into the study, providing the unique opportunity to examine dyadic influences on HIV risk behavior and substance use among YMSM and their partners. This proposal will also provide the applicant with postdoctoral training in HIV and substance use research, statistical methods for analyzing dyadic data, and grantsmanship, all of which are necessary to launch his career as an independent scientist. The applicant will learn how to implement the Actor-Partner Interdependence Model, which statistically accounts for the nonindependence of data in dyads by simultaneously estimating actor effects (a person’s influence on his own behavior) and partner effects (how much a person is influenced by his partner). This model will allow the applicant to examine the influences of individual- and partner-level stressors on risk behaviors. Further, dyadic data provide the opportunity to examine the extent to which concordance/discordance of stress between partners contributes to each partner’s HIV risk behavior and substance use above and beyond the individual actor and partner effects. In sum, the goals of the proposed study are to examine: (1) actor and partner effects of stress on HIV risk behavior and substance use; (2) the associations between concordance/discordance of stress between partners and HIV risk behavior and substance use; and (3) problems in relationship functioning as mediators of these associations. This proposal represents formative research on dyadic influences on health risk behavior among YMSM, which is a necessary first step in order to develop evidence-based prevention and intervention programs that target the context in which HIV risk transmission is highest (romantic dyads). Findings from this study will inform our understanding of health disparities by disentangling individual- and partner-level influences on HIV risk behavior and substance use in a high-risk population (diverse YMSM).