HIV risk in Urban populations of Black men who have sex with men and women

在美国，每年每2名艾滋病毒感染者中就有1人是非裔美国人。最近有大量文献--包括学术和流行的--关于与男性和女性发生性行为的黑人男子(BMSMW)传播艾滋病毒的问题。然而，BMSMW人群中HIV的心理健康状况、认知、动机以及可能的性传播保护因素相对未知。了解BMSMW中艾滋病毒传播的性行为模式，对于制定与解决非裔美国人社区内艾滋病毒传播问题有关的方案和干预措施至关重要。因此，有必要更好地了解这一人群的心理健康状况和性行为。有一小部分文献表明，不安全的依恋方式与性行为风险增加和精神健康下降(例如，更多的抑郁)有关。这些研究主要是在异性恋参与者的队列中进行的，忽略了性少数群体的参与。了解依恋方式与性行为和心理健康的关系可以帮助健康社区的许多方面(例如，咨询、公共卫生、社会工作等)。为那些可能面临更高传播风险的人量身定做艾滋病毒预防工作。目的：本研究是一项探索性研究，有两个具体目的：1)描述黑人MSMW人群每周的压力、抑郁和性风险行为水平；2)采用混合方法，了解依恋风格、压力、抑郁和性风险行为之间的关系。方法：80名BMSMW将在网上完成为期12周的结构化日记。日记将包括抑郁清单、压力清单、成人依恋清单和性行为问题。为期1小时的开放式面试将从最初的80名样本中抽取12名男性进行。这些问题将主要集中在评估参与者与儿童主要照顾者的关系可能如何影响他们成年后的心理健康和性行为。分析：成长曲线建模将被用来从结构化日记数据中检测依恋、压力、抑郁和性风险之间的任何现有关系。本文将采用扎实的理论方法对定性访谈进行分析。我在这份申请中提出的培训计划将使我不仅发展定量和定性研究的方法论技能来进行论文研究，而且还将帮助我获得成为一名学术研究人员所需的学术专业技能。

In the United States, 1 in every 2 people infected with HIV each year are African American. There is a large body of recent literature--both academic and popular--concerning the transmission of HIV from Black men who have sex with men and women (BMSMW). However, the mental health status, cognitions, motivations, and possible protective factors against sexual transmission of HIV in populations of BMSMW are relatively unknown. An understanding of sexual modes of HIV transmission among BMSMW is crucial to creating programming and interventions concerned with addressing HIV transmission within African American communities. Thus, the need to better understand the mental health status and sexual behaviors of this population is imperative. There has been a small body of literature that suggests that insecure attachment style is related to increased sexual risk behavior and decreased mental health (e.g., more depression). These studies have been primarily conducted with cohorts of heterosexual participants and have neglected to include sexual minorities. Understanding how attachment style relates to sexual behavior and mental health can help many facets of the health community (e.g., counseling, public health, social work, etc.) tailor HIV prevention efforts for those who may be at increased risk of transmission. Aims: The current study is an exploratory study with two specific aims: 1) to describe the weekly levels of stress, depression, and sexual risk behavior among Black MSMW, and 2) using a mixed-methods approach, to understand what the relationships between attachment style, stress, depression and sexual risk behavior among BMSMW. Methods: 80 BMSMW will complete an online 12-week structured diary. The diary will include a depression inventory, stress inventory, adult attachment inventory, and sexual behavior questions. 1-hour open ended interviews will be conducted with 12 men drawn from the original sample of 80. The questions will mainly focus on assessing how participants' relationship with their primary childhood caregiver may have affected their mental health and sexual behavior as adults. Analysis: Growth Curve Modeling will be used to detect any existing relationships between attachment, stress, depression, and sexual risk from the structured diary data. A grounded theory approach will be used to analyze the qualitative interviews. The training program I have proposed in this application will allow me to not only develop the quantitative and qualitative research methodology skills to carry out my dissertation research but it also will help me obtain the necessary academic professional skills to become an academic researcher.