Methamphetamine Use in the Suburbs: An Exploratory Study

描述(由申请人提供)：这是R15地区研究的竞争性更新，该研究在郊区65名男性和35名女性吸毒者中调查了甲基苯丙胺(MA)使用的新趋势。我们发现，郊区环境增加了女性吸毒者的风险因素，包括与传播人类免疫缺陷病毒(HIV)、丙型肝炎病毒(丙型肝炎病毒)和性传播感染(STI)相关的危险行为。在我们最初研究的基础上，我们将继续探索郊区吸毒者的新趋势，重点是女性吸毒者，这是一个研究不足和被忽视的吸毒者群体。此外，居住在郊区的妇女面临着药物治疗和保健方面的障碍，原因是获得卫生服务的机会有限，缺乏与毒品有关的风险意识，以及对郊区使用MA的性别污名化，这加剧了这一群体的隐藏状态。这项更新研究的广泛目标是更深入地了解按性别划分的药物使用轨迹和危险行为模式。我们在这项竞争性更新研究中的具体目标是(1)扩大我们对郊区使用吸毒者中药物使用轨迹转折点的探索；(2)更全面地了解影响居住在郊区的女性吸毒者艾滋病毒、丙型肝炎和性传播疾病传播的风险和保护因素；以及(3)评估随时间推移郊区女性吸毒者的艾滋病毒风险意识、风险行为、医疗保健利用和医疗服务的可获得性。本次更新研究的样本将包括30名郊区女性MA使用者(15名以前的使用者和15名现在的使用者)。作为一种新颖的调查路线，我们将使用纵向设计在三个点收集数据：30个新的深度访谈，3-6个月后的30个跟踪访谈，以及3-6个月后的相同样本人群的焦点小组。在每次面试中，参与者都会得到降低风险和医疗保健方面的资料。后续访谈的重点是特定药物使用模式的变化、药物使用的社会背景、艾滋病毒危险行为、医疗保健利用以及获得卫生服务和治疗的机会，这些都是这项更新研究的新领域。数据分析将以生命历程和符号互动理论为指导。首先，这些发现将更全面地理解我们最初对亚特兰大郊区MA使用情况进行的研究中发现的性别差异。其次，纵向设计将确定郊区女性吸毒者中的艾滋病毒危险行为以及危险行为随时间的变化。第三，在这项研究人群中，关于卫生服务利用和获得所需卫生保健的知识将更好地为未来的卫生保健计划提供信息。此外，调查结果将为郊区女性MA使用者在个人和社区层面提出针对性别和社会适当的干预建议。

DESCRIPTION (provided by applicant): This is a competitive renewal of an R15 AREA study that examined emerging trends in methamphetamine (MA) use among a sample of 65 male and 35 female MA users in the suburbs. We found that the suburban setting increases risk factors for female drug users, including risk behaviors associated with transmission of human immunodeficiency virus (HIV), hepatitis C virus (HCV) and sexually transmitted infections (STIs). In expanding upon our original study, we will continue to explore emerging trends in MA use in the suburbs, focusing exclusively on female MA users, an understudied and neglected population of drug users. Additionally, women living in the suburbs face barriers to drug treatment and healthcare due to restricted access to health services, lack of drug-related risk awareness, and the gendered stigmatization of suburban MA use that intensifies the hidden status of this population. The broad goal of this renewal study is to gain a more in-depth understanding of gendered drug-use trajectories and risk behavior patterns. Our specific aims in this competitive renewal study are (1) to expand our exploration into the turning points in drug use trajectories among suburban women who use MA; (2) to provide a more comprehensive understanding of the risks and protective factors that impact the transmission of HIV, HCV and STIs specific to female MA users living in the suburbs; and (3) to assess HIV risk awareness, risk behaviors, healthcare utilization and accessibility to healthcare services over time for a sub-sample of suburban female MA users. The sample in this renewal study will include 30 suburban female MA users (15 former and 15 current users). As a novel line of investigation, we will use a longitudinal design to collect data at three points: 30 new in-depth interviews, followed 3-6 months later by 30 follow-up interviews, and followed another 3-6 months later by focus groups with the same sample population. Participants are provided risk-reduction and healthcare literature at each interview. Follow-up interviews focus on changes in specific drug use patterns, social context of drug use, HIV- risk behaviors, healthcare utilization, and access to health services and treatment, which are new areas of this renewal study. Data analysis will be informed by life course and symbolic interaction theories. First, the findings will provide a more comprehensive understanding of the gender differences found in our original study on MA use in suburban Atlanta. Second, the longitudinal design will identify HIV-risk behaviors among suburban female MA users and changes in risk behaviors over time. Third, knowledge regarding the utilization of health services and access to needed healthcare among this study population will better inform future healthcare initiatives. Additionally, findings will yield recommendations for gender-specific and socially appropriate interventions at the individual and community levels for suburban female MA users.