Neighborhood Effects on HIV Risk-Taking

社区对艾滋病毒冒险行为的影响

• 批准号: 7689151
• 负责人: CLAIRE E STERK
• 金额: $ 64.39万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-20 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7689151
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adult; African American; Alcohols; Area; Behavior; Behavioral; Cardiovascular system; Censuses; Characteristics; Classification; Communities; Complex; Crime; Data; Data Sources; Development; Disadvantaged; Disease; Drug usage; Drug user; Enrollment; Environment; Environmental Risk Factor; Epidemic; Evaluation; Gender; Goals; HIV; Health; Home environment; Hot Spot; Individual; Injecting drug user; Injection of therapeutic agent; Intervention; Interview; Lead; Legal; Link; Longitudinal Studies; Malignant Neoplasms; Maps; Modeling; Nature; Neighborhoods; Obesity; Pattern; Perception; Pharmaceutical Preparations; Policy Maker; Prevention approach; Preventive Intervention; Process; Proxy; Public Health; Research; Research Infrastructure; Research Personnel; Respondent; Risk; Risk Behaviors; Risk Reduction; Risk-Taking; Role; Sampling; Sampling Studies; Sex Orientation; Social Disorganizations; Social Environment; Stigmata; Time; Vulnerable Populations; Woman; base; empowered; factor A; follow-up; housing instability; longitudinal design; member; men; men who have sex with men; public health relevance; response; sex; social; social capital; social stigma; success; theories

DESCRIPTION (provided by applicant): HIV risk-reduction interventions traditionally have emphasized individual-centered behavioral prevention approaches. Despite their success, the HIV/AIDS epidemic has not come to a halt, especially not among African Americans, a group that is disproportionately impacted. Structural interventions, which tend to be multilevel, are less common even though structural factors often create vulnerable populations and sustain an environment that is supportive of continued engagement in HIV risk behaviors. In the proposed study, we will investigate how individuals interact with and impact their neighborhood environments. Specifically, we focus on the link between the individual and neighborhood context and the role of structural and environmental factors. We propose a multilevel, longitudinal design and the specific aims are: (1) to investigate the relationships between neighborhood context, neighborhood perceptions, and individual characteristics, and HIV sexual risk-taking and the link between this risk-taking and HIV status; (2) to examine the association between neighborhood context, neighborhood perceptions, individual characteristics, and injection drug use related HIV risk-taking and this risk-taking and HIV status; and (3) to identify the spatial patterns of HIV risk-taking and to investigate neighborhood and individual-level characteristics associated with these spatial patterns. The guiding conceptual model builds on social disorganization theory. Recruitment uses targeted sampling strategies across 50 census block groups, with varied characteristics, and which serve as a proxy for neighborhoods. Our pilot data show these to vary according to key characteristics. In addition, we will explore the local context in which the respondents move. The study sample will consist of 1,500 African American women and men. Comparisons will be drawn based on drug use status, gender, and among the men, sexual orientation. The project comprises distinct data sources, namely: individual interviews, individual HIV status, systematic observations, data from the 2000 U.S. Census, and part 1 crime, drug arrests, and alcohol outlet data. Interviews will be conducted at three time points: baseline and 6 and 12 month follow-up. Systematic observations and a review of crime, drug arrests and alcohol outlet data will occur at baseline and at 12 month follow-up. The analytical approach combines longitudinal multilevel analyses and spatial mapping. The study has theoretical and research significance as its findings may provide useful information for structural interventions, targeting neighborhood structural and environmental factors, that support existing and new HIV prevention approaches. By incorporating partners such as policy-makers, urban planners, economists, legal experts and the wider research community, the public health response to HIV will be enhanced. PUBLIC HEALTH RELEVANCE: The proposed study focuses on the dynamic and complex relationship between individual and neighborhood context. Specifically, the focus is on HIV risk-taking and HIV status among adult African American men and women, including men-who-have-sex-with-men and drug users. The multilevel, longitudinal study will provide information necessary to inform the development, implementation and evaluation of multifaceted HIV risk-reduction interventions, with an emphasis on addressing structural and environmental risk factors.

描述(由申请人提供)：艾滋病毒风险降低干预措施传统上强调以个人为中心的行为预防方法。尽管他们取得了成功，但艾滋病毒/艾滋病的流行并未停止，特别是在非洲裔美国人中，这一群体受到的影响不成比例。往往是多层次的结构性干预措施不太常见，尽管结构性因素往往造成弱势群体，并维持支持持续参与艾滋病毒危险行为的环境。在这项拟议的研究中，我们将调查个人如何与邻里环境互动并对其产生影响。具体地说，我们侧重于个人和邻里环境之间的联系，以及结构和环境因素的作用。我们提出了一个多层次的纵向设计，其具体目标是：(1)调查社区环境、社区感知和个人特征与HIV性行为风险之间的关系，以及这种风险行为与HIV状态之间的联系；(2)考察社区环境、社区感知、个人特征和注射毒品使用与HIV风险行为和HIV状态之间的关系；(3)识别HIV风险行为的空间模式，并调查与这些空间模式相关的社区和个人特征。指导性概念模型建立在社会解体理论的基础上。招募人员在50个人口普查区组中使用有针对性的抽样策略，这些策略具有不同的特点，并作为社区的代表。我们的试点数据显示，这些数据根据关键特征而有所不同。此外，我们还将探讨受访者搬家的当地背景。研究样本将包括1500名非裔美国人女性和男性。将根据吸毒状况、性别以及男性中的性取向进行比较。该项目包括不同的数据来源，即：个人访谈、个人艾滋病毒状况、系统观察、2000年美国人口普查数据，以及第一部分犯罪、毒品逮捕和酒精出口数据。面谈将在三个时间点进行：基线和6个月和12个月的随访。系统的观察和对犯罪、毒品逮捕和酒精出口数据的审查将在基线和12个月的后续行动中进行。分析方法结合了纵向多层次分析和空间制图。这项研究具有理论和研究意义，因为其研究结果可能为结构性干预提供有用的信息，针对社区结构和环境因素，支持现有的和新的艾滋病毒预防方法。通过吸收政策制定者、城市规划者、经济学家、法律专家和更广泛的研究界等合作伙伴，将加强对艾滋病毒的公共卫生反应。 公共卫生相关性：拟议的研究侧重于个人和邻里环境之间动态和复杂的关系。具体地说，重点是成年非裔美国人的艾滋病毒风险承担和艾滋病毒状况，包括男男性行为者和吸毒者。这项多层次的纵向研究将提供必要的信息，以便为制定、实施和评价多方面的艾滋病毒减少风险干预措施提供信息，重点是解决结构性和环境风险因素。