RISK TAKING AND ADJUSTMENT IN WOMEN AFFECTED BY HIV

女性，尤其是有色人种女性， 类艾滋病病例。然而，人们对那些 影响感染艾滋病毒妇女的性决策和吸毒 感染者，他们遇到的压力源的性质，包括影响 艾滋病毒对她们与男性伴侣的关系，她们的应对反应， 心理调适、健康行为与病程的关系。之前 为受艾滋病毒影响的妇女制定有效的干预措施， 重要的是要了解影响他们生活的因素，即性别， 种族和文化上的差异这将确保更多 迅速规划的干预措施将纳入妇女的风险承担 和适应艾滋病毒。拟议的纵向研究将审查 在一个24个月以上的适应，高风险行为和疾病过程中， 400名非裔美国人、拉丁裔和白色异性恋者的多种族样本 育龄妇女（18至45岁）。样本将包括200个 艾滋病不同阶段的艾滋病毒血清阳性者， 各种医院，诊所和社区机构，为健康服务 和社会经济需求的妇女在洛杉矶县。另外还有按 200名血清阴性妇女的社区对照样本， 种族，年龄，婚姻状况，子女的存在，和邻居 200例（100例/组）男性艾滋病毒感染者伴侣的样本 将招募艾滋病毒阳性和阴性妇女。所有参与者将 由一个训练有素的多种族、多文化的女性团队进行评估， 采访者使用一套全面的社会心理， 行为、健康和神经精神测量。妇女将被评估 基线时4小时，每6个月一次，持续2年，每次50美元 上网时段男性将在入组时以及12和24小时进行评估 为期两年，每节25美元。评估的频率将 对于在受试者生命期间发生血清转化的受试者， study.所有措施将预先测试和修订，以确保其 适用于多种族样本。 感染艾滋病毒的女性的调整（AWWH）的概念模型已经被提出 回答了两个主要的研究问题：1）什么角色 社会文化和个人因素影响性决定 和高风险行为？生活压力源， 应对战略以及其他风险和资源对健康的影响， 心理健康和艾滋病课程？第二个目标是 来探索是什么影响了与重要男性伴侣的关系 对女性心理健康、健康行为和健康的影响 status.两个横截面（即，多变量）和纵向（即， 生存分析，结构方程模型）分析将 进行检查高危行为，心理和 受艾滋病毒影响的妇女的身体健康状况和病程。的 这项前瞻性研究的结果将为未来的干预提供信息。 预防艾滋病病毒在异性间传播的研究， 艾滋病毒感染妇女的生活质量。

Women, particularly women of color, constitute the fastest-growing category of AIDS cases. However, little is known about factors that influence sexual decision-making and drug use in women who are HIV infected, the nature of the stressors they encounter, including the impact of HIV on relationships with their male partners, their coping responses, psychological adjustment, health behaviors, and disease course. Before effective interventions can be developed for women affected by HIV, it is important to understand factors affecting their lives that are gender, ethnically and culturally specific. This will ensure that more expeditiously planned interventions will incorporate women's risk taking and adjustment to HIV. The proposed longitudinal study will examine adjustment, high risk behavior and disease course over 24 months in a multi-ethnic sample of 400 African America, Latina and White heterosexual women of child bearing age (18 to 45 years). The sample will include 200 HIV seropositives at different stages of AIDS who are recruited from a variety of hospitals, clinics and community agencies that serve the health and socio-economic needs of women in Los Angeles County. In addition, a neighborhood control sample of 200 seronegative women matched on ethnicity, age, marital status, presence of children, and neighborhood of residence and a sample of 200 (100/group) male partners of the HIV positive and HIV negative women will be recruited. All participants will be assessed by a trained multi-ethnic, multicultural team of female interviewers using a comprehensive interview battery of psychosocial, behavioral, health, and neuropsychiatric measures. Women will be assessed for four hours at baseline and every 6 months for 2 years at $50.00 per session. Men will be assessed for 2 hours at entry and at 12, and 24 months for 2 years at $25 per session. The frequency of assessments will be increased for participants who seroconvert during the life of the study. All measures will be pretested and revised to insure their appropriateness for use with a multi-ethnic samples. A conceptual model of The Adjustment in Women with HIV (AWWH) has been formulated to answer two primary research questions: 1) What role do socio-cultural and personal factors play in influencing sexual decision making and high risk behaviors? and 2) What effects do life stressors, coping strategies and other risks and resources have on health, psychological well-being and HIV-disease course? A secondary goal will be to explore what effects the relationship with the significant male partner have on women's psychological well being, health behaviors and health status. Both cross-sectional (i.e., multivariate) and longitudinal (i.e., survival analysis, structural equation modeling) analyses will be conducted to examine predictors of high risk behaviors, psychological and physical health status and disease course in women affected by HIV. The results from this prospective study will inform future intervention studies to prevent the heterosexual spread of HIV and to improve the quality of life of HIV-infected women.