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

在美国，每年每两个感染艾滋病毒的人中就有一个是非洲裔美国人。最近有大量的文献-包括学术文献和流行文献-关于与男性和女性发生性关系的黑人男子传播艾滋病毒的问题。然而，心理健康状况，认知，动机，以及可能的保护因素对性传播艾滋病毒的BMSMW人群是相对未知的。了解BMSMW中艾滋病毒传播的性模式对于制定有关解决非裔美国人社区内艾滋病毒传播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，不安全的依恋风格与性风险行为增加和心理健康下降有关（例如，更多的抑郁症）。这些研究主要是在异性恋参与者中进行的，而忽略了包括性少数群体。了解依恋风格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）针对那些可能面临更大传播风险的人开展艾滋病毒预防工作。目的：当前的研究是一项探索性研究，有两个具体目标：1）描述黑人MSMW每周的压力、抑郁和性风险行为水平，2）使用混合方法方法，了解依恋风格之间的关系，压力，抑郁和BMSMW中的性风险行为。方法：80名BMSMW将完成12周的在线结构化日记。日记将包括抑郁量表、压力量表、成人依恋量表和性行为问题。1-将对从80名原始样本中选出的12名男子进行1小时的开放式访谈。这些问题将主要集中在评估参与者与他们的主要童年照顾者的关系如何影响他们成年后的心理健康和性行为。分析：生长曲线模型将用于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。定性访谈采用扎根理论方法进行分析。我在本申请中提出的培训计划将使我不仅能够发展定量和定性研究方法论技能来进行论文研究，而且还将帮助我获得必要的学术专业技能，成为一名学术研究人员。

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.