National Survey on HIV Risk for African-American Women

描述(申请人提供)：从1999年7月到2000年6月，在妇女中，非洲裔美国妇女占艾滋病病例的63%，占艾滋病毒感染的69.2%。因此，这项拟议的全国性纵向研究(N=1000)的目的是在24个月的随访期内检查与非裔美国妇女艾滋病毒风险相关的性别因素。该提案是埃默里大学和专业调查研究公司ORC Macro的合作成果。我们建议使用三阶段比例分层随机数字拨号方法来招募样本。第一阶段包括确定美国大陆48个地区的三个阶层：城市、郊区和农村地区。第二阶段是确定这些阶层的合资格家庭。第三阶段涉及确定每个家庭中符合条件的个人。符合条件的受访者必须是非洲裔美国女性，年龄在18岁至44岁之间，未婚，在筛查后90天内性行为活跃，并提供同意。在女性提交书面知情同意书后，ORC Macro的一名面试官将管理计算机辅助电话面试。采访是以性别与权力理论为指导的。WinGood博士和DiClemente博士对其进行了扩展和修改，以检查与女性艾滋病毒风险相关的因素。这一理论有三个结构，性别分工(考察社会经济影响)，性别权力分工(考察伴侣和制度影响)，以及可能影响女性艾滋病毒风险的疏导结构(考察规范和情感影响)。将使用结构方程模型来检验以下研究目标： 为了确定性别分工，特别是教育程度、就业状况、医疗保险状况、受抚养人数量、生活安排、经济困难、邻里居住、社会凝聚力、对伴侣的经济依赖和收入，是否可以预测在两年的随访期内无保护的性行为和多个伴侣。 为了确定权力的性分工，具体地说，性虐待、身体虐待、创伤生活事件、性骚扰、暴露于性贬低媒体、种族歧视、伴侣交流、伴侣拒绝使用避孕套、男性伴侣和女性使用酒精和毒品是否预测在两年的随访期内无保护的性行为和多个伴侣。 为了确定宣泄的结构，特别是怀孕欲望、性别规范、灵性、伴侣可获得性、伴侣年龄、关系状况、关系长度、关系承诺、关系满意度、艾滋病毒污名和性功能障碍，预测在两年的随访期内无保护的性行为和多个伴侣。 为了确定三个潜在结构(性别分工、性别权力分工和宣泄结构)在两年随访期内在模型中解释的独特差异。

DESCRIPTION (provided by applicant): Among women, African-American women comprised 63% of AIDS cases and 69.2% of HIV infections from July 1999 through June 2000. Thus, the proposed national, longitudinal study (N= 1000) is designed to examine gendered factors associated with HIV risk in African-American women over a 24-month follow-up period. The proposal is a collaborative effort between Emory University and ORC Macro, a professional survey research firm. We propose using a three-stage proportionate stratified random digit dial methodology to recruit the sample. Stage one involves identifying three strata: city, suburban, and rural regions in the 48 continental United States. Stage two involves identifying eligible households in these strata. Stage three involves identifying eligible individuals in each household. Eligible respondents must be African American women, 18 to 44 years of age, who are unmarried, sexually active within 90 days of the screening, and provide consent. After women return their written informed consent, an interviewer from ORC Macro will administer the Computer-Assisted Telephone Interview. The interview is guided by the theory of Gender and Power. which has been extended and adapted by Drs. Wingood and DiClemente to examine factors associated with HIV risk in women. This theory has three structures, the sexual division of labor (examines socioeconomic influences), the sexual division of power (examines partner and institutional influences) and the structure of cathexis (examines norms and affective influences) that may influence women's HIV risk. Structural equation modeling will be used to examine the following study aims: To determine if the Sexual Division of Labor, specifically, educational attainment, employment status, health insurance status, number of dependents, living arrangements, economic hardship, neighborhood residence, social cohesion, economic dependence on the partner and income predict unprotected sexual intercourse and multiple partners over the two-year follow-up period. To determine if the Sexual Division of Power, specifically, sexual abuse, physical abuse, traumatic life events, sexual harassment, exposure to sexually degrading media, racial discrimination, partner communication, partner resistance to condom use, male partner's and women's use of alcohol and drugs predict unprotected sexual intercourse and multiple partners over the two-year follow-up period. To determine if the Structure of Cathexis, specifically, pregnancy desire, gender norms, spirituality, partner availability, partner age, relationship status, relationship length, relationship commitment, relationship satisfaction, HIV stigma and sexual dysfunction, predict unprotected sexual intercourse and multiple partners over the two-year follow-up period. To determine the unique variance that each of the three latent constructs (Sexual Division of Labor, Sexual Division of Power and Structure of Cathexis) explains in the model over the two-year follow-up period.