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

对男男性行为者及其伴侣发生性行为的年轻男性的艾滋病毒风险行为和药物滥用的二元影响

• 批准号: 9391233
• 负责人: Brian Feinstein
• 金额: $ 0.25万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-12-01 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9391233
• 关键词: Affect; Agreement; Alcohol or Other Drugs use; Alcohols; Anal Sex; Attention; Behavior; Conflict (Psychology); Coupled; Couples; Data; Discrimination; Epidemic; Funding; General Population; Goals; HIV; HIV risk; Health; Health Benefit; Individual; Lead; Learning; Lesbian; Marijuana; Mediating; Mediator of activation protein; Modeling; National Institute of Drug Abuse; Pattern; Persons; Population; Prevention program; Prevention strategy; Process; Recruitment Activity; Reporting; Research; Research Training; Risk Behaviors; Risk Factors; Scientist; Specificity; Statistical Methods; Stress; Substance abuse problem; Sum; Victimization; career; cohort; ethnic diversity; evidence base; experience; health disparity; high risk behavior; high risk population; illicit drug use; intervention program; intimate partner violence; men who have sex with men; post-doctoral training; pre-exposure prophylaxis; racial and ethnic; sex; sexual minority; social stigma; stressor; transmission process; uptake; young men who have sex with men

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).

项目摘要： 艾滋病毒和药物滥用代表了两集对年轻人的影响不成比例 与男人发生性关系的人（YMSM）。 YMSM之间的大多数HIV传播发生在 严重关系的背景，很大程度上是由于无避孕套肛交的率（CAS）与 与休闲伴侣相比，严重的人际关系中缺乏预期吸收。很遗憾， 研究艾滋病毒和药物滥用危险因素的研究主要集中在 对二元组的关注有限。除了所有夫妻所经历的压力外，还耦合YMSM 经历与他们的性少数群体状况有关的独特压力（例如，歧视，污名）。 这种增加的压力可能会导致关系功能的问题（例如，不满，冲突， 亲密的伴侣暴力），这可能有助于参与健康风险行为， 例如CAS和药物使用。描述这些过程至关重要 二元预防策略以优化关系功能并降低健康差异 在YMSM中。拟议的研究将利用来自大型的子样本的数据 YMSM的种族/种族多元化队列，目前正在招募NIDA资助 U01。通过让YMSM招募他们认真的关系合作伙伴来建立该队列 研究，提供了独特的机会来检查对艾滋病毒风险行为的二元影响和 YMSM及其合作伙伴中的物质使用。该建议还将为申请人提供 随着艾滋病毒和药物使用研究的博士后培训，分析的统计方法 二元数据和授予技巧，所有这些都是为了启动他的职业 独立科学家。申请人将学习如何实施演员合作伙伴 相互依存模型，从统计上说明数据中数据的非独立性 通过简单地估计演员效应（一个人对自己的行为的影响）和 伴侣效果（一个人受他的伴侣影响多少）。该模型将允许 申请人检查个人和伴侣级压力源对风险行为的影响。 此外，二元数据提供了检查的机会 伴侣之间压力的一致性/不一致有助于每个伴侣的艾滋病毒风险 行为和物质的使用超出了个人演员和伴侣的影响。总而 拟议的研究的目标是检查：（1）压力对艾滋病毒的演员和伴侣影响 风险行为和物质使用； （2）一致性/不一致的关联 伴侣与艾滋病毒风险行为和药物使用之间的压力； （3）问题 关系充当这些关联的介体。该提议代表形成性 研究二元对YMMM健康风险行为的影响，这是必要的 步骤以制定基于证据的预防和干预计划，以 艾滋病毒风险传播最高的上下文（浪漫二元）。这项研究的发现将 通过解开个人和合作伙伴级别来告知我们对健康差异的理解 对高风险人群（不同YMSM）的艾滋病毒风险行为和物质使用的影响。