Prescription Drug Abuse in Club Subcultures: Contexts & Risks

处方(Rx)药物滥用已经成为美国年轻人中的一个严重问题。虽然研究表明年轻人滥用Rx药物的模式很昂贵，但与Rx药物滥用和年轻人中相关风险承担相关的社会、心理和亚文化背景需要进一步解释，特别是考虑到它可能通过性行为风险和注射吸毒增加艾滋病毒风险。我们的目标是对纽约市(NYC)大都会地区年轻人滥用Rx药物和冒险的模式和背景进行研究。这项拨款申请提出了一项混合方法研究，研究俱乐部亚文化中的年轻人及其网络中与他们有联系的年轻人滥用各种Rx药物的情况，包括止痛药、镇静剂和兴奋剂。这项研究的目标包括探讨a)与Rx药物开始和年轻人持续滥用模式有关的背景因素，特别是转向非法鸦片类药物或注射药物使用，b)性别和性取向如何影响Rx药物滥用和年轻人的风险，以及c)与Rx药物滥用相关的风险，包括性风险。将采用混合方法设计，使用人种学方法、定性访谈和结构化调查。我们将使用包括深度访谈在内的人种学方法来探索与Rx药物滥用和冒险有关的背景因素。深度访谈利用关键事件测量方法来描述成长经历和最近使用模式的经验。除了人种学方法，还将使用结构化调查来获得流行病学数据和与Rx药物滥用和风险相关的因素数据。我们将在纽约市通过响应者驱动抽样(RDS)招募400名18至29岁的滥用Rx药物的年轻人。这项调查将在最初评估后12个月通过向受试者提供的在线调查进行第二次。这项研究中这些方法的结合将使人们能够更全面地了解年轻人中的Rx药物滥用及其相关风险，包括艾滋病毒风险，这将有助于制定健康促进活动和干预措施。

Prescription (Rx) drug abuse has emerged as a significant problem among young adults in America. While research indicates a dear pattern of abuse of Rx drugs by young adults, the social, psychological, and subcultural contexts associated with Rx drug abuse and related risk taking among young adults need further explication, particularly given that it may elevate HIV risk via sexual risk taking and injection drug use. Our goal is to conduct a study of the patterns and contexts of Rx drug abuse and risk taking among young adults in the New York City (NYC) metropolitan area. This grant application proposes a mixed-methods study of the abuse of various classes of Rx drugs, including pain killers, sedatives, and stimulants, by young adults in club subcultures and the youth in their networks to whom they are connected. The goals of the study include explorations of a) the contextual factors associated with Rx drug initiation and continued patterns of abuse among young adults, in particular transitions to illegal opiates or injection drug use, b) how gender and sexual orientation bear upon Rx drug abuse and risk among young adults, and c) the risks associated with Rx drug abuse, including sexual risk taking. A mixed-methods design, using ethnographic methods, qualitative interviews, and structured surveys, will be applied. We will use ethnographic methods including in-depth interviews to explore contextual factors related to Rx drug abuse and risk taking. The in-depth interviews utilize Critical Incident Measures to draw out narratives about initiation experiences and experiences with recent patterns of use. Beyond ethnographic methods, a structured survey will be used to obtain epidemiological data and data on factors related to Rx drug abuse and risk. We will recruit 400 Rx drug abusing young adults aged 18 to 29 in NYC using Respondent Driven Sampling (RDS). The survey will be administered a second time through an on-line survey provided to subjects at 12-months following the original assessment. The combination of these methods in this study will enable the development of a fuller contextual understanding of Rx drug abuse among young adults and its associated risks, including HIV risk, which will be instrumental in the development of health promotion activities and interventions.