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

描述（由申请人提供）：我们建议调查性风险和性传播感染（STI）的女性甲基苯丙胺（MA）用户在弗朗西斯科，加利福尼亚州之间的相关性。虽然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。这些趋势引发了对同性恋和双性恋男性使用MA与性风险之间关联的深入探索。然而，对女性使用MA的了解较少，尽管她们占美国MA治疗入院人数的40%。少数研究探讨了女性MA使用者中的艾滋病毒风险，发现性风险的流行率很高，包括无保护的肛交和阴道性交，多个性伴侣和性工作。拟议的研究旨在建立一个更全面的了解女性MA用户和与性风险的相关因素，使用定量和定性的方法。我们将使用健康的社会生态模型来构建调查的个人，人际，结构和文化因素影响女性MA用户之间的性风险。具体目标是：目标1：确定哪些个体水平的因素（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。目标二：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，性场所和毒品使用）与女性MA用户的性风险。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用户的性风险相关。定量部分将包括一项横断面研究，采用有针对性的抽样方法，在2年内招募了400名MA女性使用者。研究参与者将接受采访，并筛查性传播感染（淋病，衣原体，疱疹和梅毒）和艾滋病毒。定性部分将通过访谈50名女性MA使用者，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定量和定性研究结果，提出在个人、人际和结构各级采取针对性别和文化上适当的干预措施的建议。这项拟议的研究解决了一个研究不足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.