Correlates of Sexual Risk for HIV/STI Among Women Who Use Methamphetamine

描述（由申请人提供）：我们建议在加利福尼亚州旧金山的女性甲基苯丙胺（MA）使用者中调查性风险和性传播感染（STIs）的相关性。尽管在西海岸流行了几十年，但MA的使用在全国范围内是一个迅速增长的问题。这些趋势引发了对男同性恋和双性恋男性使用MA与性风险之间关系的深入探索。然而，尽管女性占美国MA治疗入院人数的40%，但对女性MA的使用情况知之甚少。少数研究探讨了女性MA使用者的艾滋病毒风险，发现性风险很高，包括无保护的肛交和阴道性交、多个性伴侣和性工作。本研究旨在采用定量和定性方法，更全面地了解女性手机使用者及其与性风险相关的因素。我们将使用健康的社会生态模型，根据影响女性MA使用者性风险的个人、人际、结构和文化因素来构建调查框架。目标1：确定哪些个人因素（MA使用模式、多种药物使用、心理发病率和其他因素）与女性MA使用者的性风险相关。目的2：确定哪些人际层面的因素（伴侣类型、亲密关系特征、受抚养子女）与女性MA使用者的性风险相关。目标3：确定哪些结构层面的因素（无家可归、监禁、性场所和吸毒）与女性MA使用者的性风险相关。目的4：确定哪些文化层面的因素（种族/民族、性别规范、宗教）与女性MA使用者的性风险相关。定量部分将包括一项对400名女性MA用户的横断面研究，该研究采用目标抽样方法，招募时间超过2年。研究参与者将接受访谈和性传播感染（淋病、衣原体、疱疹和梅毒）和艾滋病毒筛查。定性部分将通过采访50名女性MA用户，详细调查特定性风险的背景和情况。拟议研究的最后阶段将综合数量和质量的结果，提出在个人、人际和结构各级采取具体性别和文化上适当的干预措施的建议。拟议的研究解决了一个未被充分研究的重要公共卫生问题：妇女使用MA。

DESCRIPTION (provided by applicant): We propose to investigate correlates of sexual risk and sexually transmitted infections (STIs) among female methamphetamine (MA) users in San Francisco, CA. While prevalent on the West Coast for decades, MA use is a rapidly growing problem nationwide. These trends have sparked intensive exploration of associations between MA use and sexual risk among gay and bisexual men. However, less is known about MA use among women, even though they represent 40% of MA treatment admissions in the United States. The handful of studies that have explored HIV risk among female MA users have found a high prevalence of sexual risks, including unprotected anal and vaginal intercourse, multiple sexual partners, and sex work. The proposed study seeks to establish a more comprehensive understanding of female MA users and the factors associated with sexual risk among them, using quantitative and qualitative methods. We will use the social ecological model of health to frame the investigation in terms of individual, interpersonal, structural, and cultural factors that affect sexual risk among female MA users. Specific Aims are: Aim 1: To determine what individual-level factors (patterns of MA use, polydrug use, psychological morbidities, and other factors) are associated with sexual risk among female MA users. Aim 2: To determine what interpersonal-level factors (partner type, intimate relationship characteristics, dependent children) are associated with sexual risk among female MA users. Aim 3: To determine what structural-level factors (homelessness, incarceration, venues of sex and drug use) are associated with sexual risk among female MA users. Aim 4: To determine what cultural-level factors (race/ethnicity, gender norms, religion) are associated with sexual risk among female MA users. The quantitative component will consist of a cross-sectional study of 400 female MA users recruited over 2 years using targeted sampling methods. Study participants will be interviewed and screened for STIs (gonorrhea, chlamydia, herpes, and syphilis) and HIV. The qualitative component will investigate in detail the context and circumstances of specific sexual risks by interviewing 50 female MA users. The final phase of the proposed research will synthesize the quantitative and qualitative findings to yield recommendations for gender-specific and culturally appropriate interventions at the individual, interpersonal, and structural levels. The proposed study addresses an understudied and important public health issue: MA use among women.