THE ROLE OF TRAUMA EXPOSURE IN DRUG USE AND HIV RISK

描述（由申请人提供）：拟议的三年研究要求资金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，但新出现的大量证据表明，暴力和其他类型的创伤暴露与这两个公共卫生问题有着内在的联系。拟议的研究的中心目的是记录这些协会和调查的作用，创伤发挥。更清楚地了解这三种流行病之间的联系是制定有效的公共卫生对策的关键。这些知识可以帮助我们改善对受害者或受创伤者的治疗，设计更有效的艾滋病毒风险预防计划，更好地针对药物预防计划，并指导制定更有效的药物治疗计划。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提供政策和计划，这些政策和计划可以打破受所有三种流行病影响最严重的弱势社区的暴力，吸毒和疾病的循环。这项拟议的研究将在600人中进行，其中包括大约相同数量的静脉注射毒品使用者（IDUs）、非静脉注射毒品使用者（NIU）和非非法毒品使用者（NU），这些人来自哈莱姆和布朗克斯的社区，我们之前的研究中已知这些社区有高水平的毒品使用和艾滋病毒风险行为。我们在以往的研究中采用了以街道为基础的有针对性的抽样方法，将用于招聘。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的异质组合，其中女性人数众多。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）相结合来管理。拟议的研究的具体目的是：目的1：描述的类型和程度的创伤暴露在这个社区的IDUs，NIU和NU的样本。目的2：评估创伤暴露与HIV危险行为之间的关系。目标3：探讨心理因素在创伤暴露与艾滋病危险行为之间的中介作用，并作为干预的有效切入点。

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.