Prescription Drug Abuse in Club Subcultures: Contexts & Risks

处方（Rx）药物滥用已成为美国年轻人中的一个重要问题。虽然研究表明年轻人滥用Rx药物的模式很明显，但与Rx药物滥用和年轻人相关的风险行为相关的社会，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风险行为和注射药物使用增加艾滋病毒风险。我们的目标是在纽约市（NYC）大都市地区的年轻人中进行Rx药物滥用和冒险的模式和背景的研究。这项拨款申请提出了一项混合方法的研究滥用各类处方药物，包括止痛药，镇静剂和兴奋剂，由年轻人在俱乐部亚文化和青年在他们的网络连接到他们。本研究的目的包括探索a）与年轻人开始使用Rx药物和持续滥用模式相关的背景因素，特别是过渡到非法阿片类药物或注射药物使用，B）性别和性取向如何影响年轻人的Rx药物滥用和风险，以及c）与Rx药物滥用相关的风险，包括性风险。一个混合的方法设计，使用人种学方法，定性访谈，和结构化调查，将被应用。我们将使用人种学方法，包括深入访谈，探讨与Rx药物滥用和风险承担相关的背景因素。深度访谈利用关键事件措施，以绘制出有关的初始经验和经验与最近的使用模式的叙述。除人种学方法外，还将使用结构化调查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。我们将招募400名年龄在18至29岁的Rx药物滥用年轻人在纽约市使用受访者驱动抽样（RDS）。将通过在初始评估后12个月向受试者提供的在线调查进行第二次调查。在这项研究中，这些方法的结合将使发展更全面的背景下了解Rx药物滥用的年轻人及其相关的风险，包括艾滋病毒的风险，这将是有益的健康促进活动和干预措施的发展。

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.