The HIV Risk Behavior and the Urban Environment

提出了一种多层次的研究方法，即确定城市环境特征之间的关联性 性和药物使用是艾滋病毒感染的危险因素。虽然目前有几个多站点 旨在将个人高危性行为和吸毒行为降至最低的干预研究出人意料地少 系统的研究探索了城市环境特征、艾滋病毒危险行为、 和疾病发病率(性传播疾病和艾滋病毒)，同时控制相关的个人水平 协变量。这项研究将考察城市社会特征的独立和互动效应 环境(例如，收入分配、社区劣势、种族隔离)和 环境(例如，人口密度、公共交通、建筑环境)，因为它们与性和 吸毒是艾滋病毒感染以及艾滋病毒和性传播疾病流行的危险因素。为达致研究目标，我们会 从24人中招募2000人(包括现在吸毒者、既往吸毒者和从未吸毒者) 在四年的时间里，纽约市的社区。我们将使用聚类分析来定义社区， 人种志测绘和社区协商。参与者将通过多条街道招募 外展技巧。对个人危险行为和潜在的调解人和主持人进行评估 通过面对面的采访。城市环境的特征将从人种学角度进行评估 评估和使用可公开获得的档案信息(例如，纽约市住房和空置率 调查，市长管理报告)。将使用分层多变量建模来确定 城市环境特征与个体危险行为、艾滋病和性病的关系。 识别形成风险行为的城市环境的关键特征可以指导结构 干预措施，提高个人层面行为干预的效率，并确定 城市社区可能表明人口容易受到艾滋病毒快速传播的影响。

Proposed is a multi-level study is to determine the association between features of the urban environment and sexual and drug use risk factors for HIV infection. Although there are at present several multi-site intervention studies that aim to minimize individual high risk sex and drug-use behavior, surprisingly little systematic research has explored the relation between features of the urban environment, HIV risk behavior, and disease morbidity (sexually transmitted diseases and HIV) while controlling for relevant individual-level covariates. This study will examine the independent and interactive effect of features of the urban social environment (e.g., income distribution, neighborhood disadvantage, racial segregation) and the physical environment (e.g., population density, public transportation, built environment) as they relate to sexual and drug use risk factors for HIV infection and to HIV and STD prevalence. To address the study aims, we will recruit 2,000 persons (including current drug users, past drug users, and never drug users) from twenty-four New York City neighborhoods over a four year period. We will define neighborhoods using cluster analysis, ethnographic mapping, and community consultation. Participants will be recruited using a number of street outreach techniques. Individual risk behaviors and potential mediators and moderators will beassessed through in-person interviews. Features of the urban environment will be assessed from the ethnographic assessments and using publicly available archival information (e.g., New York City Housing andVacancy Survey, Mayor's Management Report). Hierarchical multivariate modeling will be used to determine the relations between features of the urban environment and individual risk behavior, HIV, and STDs. Identification of the key features of the urban environment that shape risk behavior can guide structural interventions, increase the efficiency of individual-level behavioral interventions, and identify features of urban neighborhoods that could suggest population vulnerability to rapid transmission of HIV.