Understanding substance use and incident HIV/STI among young black MSM

了解年轻黑人男男性接触者的药物使用和艾滋病毒/性传播感染事件

• 批准号: 9057496
• 负责人: Eli Samuel Rosenberg
• 金额: $ 64.38万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-15 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9057496
• 关键词: Abstinence; Accounting; Address; African American; Age; Alcohol consumption; Alcohol or Other Drugs use; Biological Markers; Cocaine; Cohort Studies; Community Networks; Complex; Consensus; Data; Data Collection; Drug usage; Employee Strikes; Environment; Epidemic; Ethnic group; Event; HIV; HIV Infections; HIV Seropositivity; HIV risk; HIV/STD; Heavy Drinking; Incidence; Individual; Infection; Interdisciplinary Study; Intervention; Interview; Laboratories; Link; Literature; Marijuana; Measures; Pathway interactions; Patient Self-Report; Pattern; Pharmaceutical Preparations; Population; Poverty; Preclinical Drug Evaluation; Prevalence; Prospective Studies; Research; Research Infrastructure; Risk; Risk Behaviors; Role; Screening Result; Sentinel; Sex Behavior; Sexual Partners; Structure; Subgroup; Time; Unsafe Sex; Urine; Validity of Self Report; Visit; abstracting; base; black men who have sex with men; caucasian American; cocaine use; cohort; community partnership; design; experience; follow-up; high risk; high risk sexual behavior; marijuana use; men; men who have sex with men; methamphetamine use; prospective; public health relevance; racial and ethnic; racial and ethnic disparities; racial disparity; resilience; sex risk; success; transmission process

DESCRIPTION (provided by applicant): Understanding substance use and incident HIV/STI among young black MSM Project Summary/Abstract Racial/ethnic disparities in HIV have been a hallmark of the US HIV epidemic for decades, with black/African Americans experiencing higher rates of HIV infection than white Americans. These disparities are also observed in men who have sex with men (MSM), among whom the highest incidence rates are in young black/African American MSM (YBAAMSM). Despite a rich literature demonstrating the prevalent levels of drug and alcohol use among MSM and the potential relationships between these substances and high-risk sexual behaviors, individual risk behaviors do not explain why black MSM and YBAAMSM are more likely to become infected with HIV, compared to other MSM. Studies of self-reported use have collectively demonstrated no greater substance use among black MSM than among white MSM. However, a key finding of our previous R01, which examined factors associated with prevalent and incident HIV infection among a prospective cohort of black and white MSM in Atlanta, was that black MSM had substantially lower validity of self-reported drug use, compared to white MSM. Biomarker-classified drug use was also more predictive of HIV seroconversions than self-reported sexual behavior measures, suggesting that, in this population, substance use may be a marker of high-risk partners and environments. Furthermore, the racial disparity in prevalent HIV infection was most associated with differences in network and community factors rather than individual factors. Despite emerging data on sexual partners and structures among YBAAMSM, little is known about the overlap of sexual and substance-use networks, though this might amplify HIV/STI transmission risk. Therefore, we propose to conduct a new prospective cohort study of 300 HIV-negative YBAAMSM in Atlanta, GA, to understand prospective patterns of biomarker-supported substance use in YBAAMSM, as well as its antecedents, contexts, and consequences. This new project will build on the strong institutional infrastructure, community partnerships, theoretical frameworks, analytical approaches, and multidisciplinary research that contributed to the success of our previous cohort study. Results will provide a more detailed understanding of the multilevel associations between substance use and HIV risk, and will yield new opportunities for combination interventions that address the syndemics of HIV/STI and drug use among YBAAMSM.

描述（由申请人提供）：了解年轻黑人男男性接触者的物质使用和艾滋病毒/性传播感染事件项目摘要/摘要艾滋病毒的种族/民族差异几十年来一直是美国艾滋病毒流行的标志，黑人/非洲裔美国人的艾滋病毒感染率高于白色美国人。在男男性行为者（MSM）中也观察到这些差异，其中发病率最高的是年轻的黑人/非洲裔美国人MSM（YBAAMSM）。尽管有丰富的文献证明了MSM中药物和酒精使用的普遍水平以及这些物质与高风险性行为之间的潜在关系，但个体风险行为并不能解释为什么黑人MSM和YBAAMSM与其他MSM相比更容易感染艾滋病毒。对自我报告使用情况的研究共同表明，黑人男男性行为者使用药物的情况并不比白色男男性行为者多。然而，我们之前的R 01研究的一个关键发现是，与白色MSM相比，黑人MSM自我报告的药物使用有效性明显较低。R 01研究了亚特兰大黑人和白色MSM的前瞻性队列中与流行和事件HIV感染相关的因素。生物标记物分类的药物使用也比自我报告的性行为措施更能预测艾滋病毒血清转化，这表明，在这一人群中，物质使用可能是高风险伴侣和环境的标志。此外，流行的艾滋病毒感染的种族差异与网络和社区因素的差异，而不是个人因素。尽管关于YBAAMSM中性伴侣和结构的数据不断出现，但对性和物质使用网络的重叠知之甚少，尽管这可能会放大艾滋病毒/性传播感染的风险。因此，我们建议在佐治亚州亚特兰大对300名HIV阴性YBAAMSM进行一项新的前瞻性队列研究，以了解YBAAMSM中生物标志物支持物质使用的前瞻性模式，以及其前因、背景和后果。这个新项目将建立在强大的机构基础设施，社区伙伴关系，理论框架，分析方法和多学科研究的基础上，这些研究有助于我们以前的队列研究的成功。结果将提供一个更详细的了解物质使用和艾滋病毒风险之间的多层次关联，并将产生新的机会，联合干预措施，解决艾滋病毒/性传播感染和吸毒之间的YBAAMSM的综合症。