THE ROLE OF TRAUMA EXPOSURE IN DRUG USE AND HIV RISK

描述（由申请人提供）：拟议的为期三年的研究申请资金，以调查创伤暴露在艾滋病毒风险行为中的作用。虽然吸毒与艾滋病毒/艾滋病流行之间的联系是众所周知的，但越来越多的证据表明，暴力和其他类型的创伤暴露与这两个公共卫生问题有着不可分割的联系。这项研究的中心目的是记录这些联系，并调查创伤所起的作用。更清楚地了解这三种流行病之间的联系是制定有效公共卫生对策的关键。这些知识可以让我们改善对受害者或受创伤个体的治疗，设计更有效的艾滋病毒风险预防方案，更好地针对药物预防方案，并指导更有效的药物治疗方案的发展。此外，了解这些公共卫生问题之间的相互关系可能会为我们指明政策和方案，这些政策和方案可以在受这三种流行病影响最严重的弱势社区打破暴力、吸毒和疾病的循环。这项拟议的研究将在600人身上进行，其中包括大约相同数量的静脉注射吸毒者（IDUs），非静脉注射吸毒者（NIUs）和非非法药物使用者（NUs），这些人来自哈莱姆区和布朗克斯的社区，根据我们之前的研究，这些社区经历了高水平的药物使用和艾滋病毒风险行为。招募将采用我们以前研究中采用的基于街道的目标抽样方法。根据我们之前的研究，我们希望招募非裔美国人和拉丁裔参与者，其中有相当数量的女性。研究参与者将完成一次持续约75分钟的评估会议。该工具将通过完全结构化的面对面访谈和计算机辅助自我管理访谈（a - casi）的组合进行管理。该研究的具体目的是：目的1：描述该社区内注射吸毒者、niu和NUs样本中创伤暴露的类型和程度。目的2：评估创伤暴露与HIV危险行为之间的关系。目的3：研究创伤暴露与HIV风险行为之间可能存在的心理因素，以及可能作为有效干预点的心理因素。

DESCRIPTION (provided by applicant): The proposed three-year study requests funds to investigate the role of trauma exposure in HIV risk behavior. While the link between the drug use and HIV/AIDS epidemics is well known, there is an emerging body of evidence suggesting that violence and other types of trauma exposure are integrally connected to these two public health problems. The central purpose of the proposed study is to document these associations and to investigate the role that traumatization plays. A clearer understanding of the associations among the three epidemics is a key to crafting an effective public health response. Such knowledge may allow us to improve the treatment of victimized or traumatized individuals, to design more effective HIV risk prevention programs, to better target drug prevention programs, and to guide the development of more effective drug treatment programs. In addition, understanding the interrelations among these public health problems may point us toward policies and programs that can break the cycle of violence, drug use and disease in those disadvantaged communities that have been most affected by all three epidemics. This proposed research would be conducted on 600 persons comprised of approximately equal numbers of intravenous drug users (IDUs), non-intravenous drug users (NIUs), and non-users of illicit drugs (NUs) drawn from communities in Harlem and the Bronx that are known from our prior research to experience high levels of drug use and HIV risk behavior. A street-based targeted sampling methodology, employed in our previous research, will be used for recruitment. Based on our prior research, we expect to recruit a heterogeneous mix of African-American and Latino participants, with significant numbers of females. Study participants will complete one assessment session of approximately 75 minutes duration. The instrument will be administered via a combination of fully structured face-to-face interview and computer-assisted self-administered interview (A-CASI). The specific aims of the proposed study are: Aim 1: To describe the types and extent of trauma exposure within the samples of IDUs, NIUs, and NUs in this community. Aim 2: To assess the association between trauma exposure and HIV risk behaviors. Aim 3: To examine the psychological factors that may mediate the relationship between trauma exposure and HIV risk behaviors and that may serve as effective points of intervention.