Women Bar Drinkers: Exploring Risks for HIV

描述(申请人提供)：本申请是对NIAAA的RFA AA-03-004，女性酗酒相关艾滋病毒/艾滋病研究的回应。从1985年到1998年，美国女性中艾滋病病例的比例增加了三倍(CDC，2002)。如果妇女感染艾滋病毒，她们的诊断最有可能发生在30至40岁之间(CDC，2001a)。鉴于艾滋病的潜伏期估计为10-11年，接触艾滋病毒的年龄可能在18至30岁之间。这项拟议的研究试图通过评估300名年轻(18-30岁)女性酒吧饮酒者的酒精使用和行为之间的关系，来扩大我们对艾滋病毒在女性中传播风险的了解。女性报告说，在酒吧里社交是寻找伴侣的一种工具(例如，Parks等人，1998年)。对于女性酒吧饮酒者来说，大量饮酒和酒吧环境中的期望的共同影响可能会通过双方自愿(即危险行为)或非自愿(即受害)的高风险接触，构成艾滋病毒传播的实质性风险。这些关系在研究中受到的关注有限。我们提出了一个远端(如被害史)和近端(如当前饮酒)因素之间关系的概念模型，作为与酒吧环境相关的两厢情愿和非两厢情愿的高风险遭遇的先行因素。拟议研究的目标是：1)探索概念模型中概述的关系；2)评估在酒吧饮酒和高风险接触之间的时间关联；3)比较在酒吧饮酒、不在酒吧饮酒和不饮酒的高风险接触的近邻因素。这项研究采用了一种创新的设计，包括对先期风险因素的初始全球评估，然后是12周的前瞻性数据收集。每日报告(互动语音回应)和基于事件的访谈将被用来评估酒精使用和危险行为。假设将使用结构方程和分层数据建模技术进行检验。这项研究填补了对酒吧知识的一个重大空白，将其作为增加女性遭遇艾滋病毒风险增加的可能性的背景。它还有可能提供可用于制定有效预防计划的信息，以降低妇女感染艾滋病毒的风险。

DESCRIPTION (provided by applicant): This application responds to NIAAA's RFA AA-03-004, Research on Alcohol-related HIV/AIDS in Women. The proportion of AIDS cases occurring among women in the U.S. increased three-fold from 1985 to 1998 (CDC, 2002). If women contract HIV, their diagnosis is most likely to occur between the ages of 30 and 40 years (CDC, 2001a). Given that the incubation period for AIDS is estimated at 10-11 years, exposure to HIV is likely to occur between the ages of 18 and 30 years. The proposed research seeks to expand our knowledge of risks for HIV transmission among women by assessing the relationships among alcohol use and behavior in a sample of 300 young (18-30 years) women bar drinkers. Women report socializing in bars as a vehicle for finding companionship (e.g., Parks et al., 1998). For women bar drinkers, the combined influences of heavy alcohol use and expectations within the bar context may pose a substantial risk for HIV transmission through high-risk encounters that are either consensual (i.e., risky behavior) or nonconsensual (i.e., victimization). These relationships have received limited research attention. We propose a conceptual model of relationships among distal (e.g., history of victimization) and proximal (e.g., current alcohol use) factors as antecedents to consensual and nonconsensual high-risk encounters related to the bar context. The objectives of the proposed research are to: 1) explore the relationships outlined in the conceptual model, 2) assess the temporal association between alcohol use in bars and high-risk encounters, and 3) compare proximal factors for high-risk encounters on days of alcohol use in bars, days of alcohol use not in bars, and days of no alcohol use. This research uses an innovative design that incorporates an initial global assessment of the antecedent risk factors, followed by 12 weeks of prospective data collection. Daily reports (Interactive Voice Response) and event-based interviews will be used to assess alcohol use and risky behavior. Hypotheses will be tested using structural equation and hierarchical data modeling techniques. This research fills a significant gap in knowledge about bars as a context for increasing the likelihood that women will experience encounters that put them at elevated risk for HIV. It also has the potential to provide information that can be used to develop effective prevention programs to reduce women's risk for HIV.