GENDER AND HIV CONSEQUENCES: HEALTH CARE AND RISK

描述（由申请人提供）：尽管疾病控制中心和医学研究所最近提出的公共卫生预防策略是基于将预防与治疗艾滋病毒感染人群联系起来，但人们对卫生保健利用与性危险行为之间的关系知之甚少。在美国，女性在艾滋病毒感染者中所占的比例越来越大。了解社会和卫生系统因素如何导致治疗和结果方面的性别差异，以及这种差异是否以及如何影响艾滋病毒阳性男性和女性的性风险行为，是很重要的。与男性发生性关系的男性相比，女性更有可能决定禁欲，这一选择消除了艾滋病毒性传播的风险。然而，女性也比不与男性发生性关系的男性更有可能发生无保护措施的性行为。本研究将检验(1)资源、护理障碍、关系暴力和艾滋病毒风险知识的差异是否有助于解释艾滋病毒感染者男女卫生保健利用的差异，以及(2)医疗和其他社会服务、资源、护理障碍、关系暴力和艾滋病毒风险知识的差异是否有助于解释艾滋病毒感染者男女危险行为的差异。拟议的研究将把艾滋病毒风险行为研究的后续数据与HCSUS三波访谈的核心数据联系起来。这些相互关联的数据为我们提供了一个独特的机会，可以探索艾滋病毒阳性妇女和男子在卫生保健利用方面的差异，并检查这是否与他们的危险行为有关。拟议研究的结果将有助于减少艾滋病毒传播的努力。

DESCRIPTION (provided by applicant): Although the Centers for Disease Control and Institute of Medicine's recently proposed public health prevention strategies are based on linking prevention to treatment of the HIV infected population, little is know about the relationships between health care utilization and sexual risk behavior. Women represent an increasing proportion of people living with HIV in the U.S. It is important to understand how social and health system factors contribute to gender disparities in treatment and outcomes and whether and how such disparities affect HIV+ men's and women's sexual risk behavior. Women are more likely than men who have sex with men to decide to be abstinent, a choice which eliminates the risk of sexual transmission of HIV. However, women are also more likely than men who do not have sex with men to have unprotected sex. The proposed study will examine (1) whether differences in resources, barriers to care, relationship violence, and knowledge about HIV risk help to explain differences between the health care utilization of HIV-infected men and women, and (2) whether differences in medical treatment and other social services, resources, barriers to care, relationship violence, and knowledge about HIV risk help to explain differences between the risk behavior of HIV-infected men and women. The proposed study will link follow-up data from a study of HIV risk behavior with core data from the 3 waves of HCSUS interviews. These linked data give us a unique opportunity to explore how HIV+ women and men differ in health care utilization, and to examine whether this is related to their risk behavior. Results from the proposed study will contribute to efforts to reduce the spread of HIV.