Methamphetamine Use in the Suburbs: An Exploratory Study

描述（由申请人提供）：这是R15区域研究的竞争性更新，该研究检查了郊区65名男性和35名女性甲基苯丙胺（MA）使用者的样本中甲基苯丙胺（MA）使用的新趋势。我们发现，郊区环境增加了女性吸毒者的风险因素，包括与人类免疫缺陷病毒（HIV）、丙型肝炎病毒（HCV）和性传播感染（STI）传播相关的风险行为。在扩大我们原来的研究，我们将继续探讨在郊区的MA使用的新趋势，专注于女性MA用户，一个研究不足和被忽视的吸毒人群。此外，生活在郊区的妇女面临着药物治疗和医疗保健的障碍，因为获得医疗服务的机会有限，缺乏与药物有关的风险意识，以及对郊区使用MA的性别歧视，加剧了这一人群的隐藏状态。这项更新研究的广泛目标是更深入地了解性别药物使用轨迹和风险行为模式。我们在这项竞争性更新研究中的具体目标是：（1）扩大我们对使用MA的郊区妇女中药物使用轨迹转折点的探索;（2）更全面地了解影响居住在郊区的女性MA使用者传播HIV、HCV和STI的风险和保护因素;（3）评估郊区女性MA使用者的艾滋病风险意识、风险行为、医疗服务利用和医疗服务可及性。本次更新研究的样本将包括30名郊区女性MA用户（15名以前和15名当前用户）。作为一个新的调查路线，我们将采用纵向设计，在三个时间点收集数据：30个新的深度访谈，随后3 - 6个月的30个跟踪访谈，并在3 - 6个月后，由焦点小组与相同的样本人口。参与者在每次访谈时都会获得风险降低和医疗保健文献。后续访谈的重点是特定药物使用模式的变化，药物使用的社会背景，艾滋病毒风险行为，医疗保健利用，以及获得医疗服务和治疗，这些都是这项更新研究的新领域。数据分析将通过生命历程和符号互动理论进行。首先，研究结果将提供一个更全面的了解性别差异，发现在我们原来的研究在亚特兰大郊区的MA使用。其次，纵向设计将确定艾滋病毒的风险行为之间的郊区女性MA用户和风险行为的变化，随着时间的推移。第三，关于本研究人群中卫生服务利用和获得所需医疗保健的知识将更好地为未来的医疗保健计划提供信息。此外，调查结果将为郊区女性MA用户在个人和社区层面提供针对性别和社会适当干预措施的建议。

DESCRIPTION (provided by applicant): This is a competitive renewal of an R15 AREA study that examined emerging trends in methamphetamine (MA) use among a sample of 65 male and 35 female MA users in the suburbs. We found that the suburban setting increases risk factors for female drug users, including risk behaviors associated with transmission of human immunodeficiency virus (HIV), hepatitis C virus (HCV) and sexually transmitted infections (STIs). In expanding upon our original study, we will continue to explore emerging trends in MA use in the suburbs, focusing exclusively on female MA users, an understudied and neglected population of drug users. Additionally, women living in the suburbs face barriers to drug treatment and healthcare due to restricted access to health services, lack of drug-related risk awareness, and the gendered stigmatization of suburban MA use that intensifies the hidden status of this population. The broad goal of this renewal study is to gain a more in-depth understanding of gendered drug-use trajectories and risk behavior patterns. Our specific aims in this competitive renewal study are (1) to expand our exploration into the turning points in drug use trajectories among suburban women who use MA; (2) to provide a more comprehensive understanding of the risks and protective factors that impact the transmission of HIV, HCV and STIs specific to female MA users living in the suburbs; and (3) to assess HIV risk awareness, risk behaviors, healthcare utilization and accessibility to healthcare services over time for a sub-sample of suburban female MA users. The sample in this renewal study will include 30 suburban female MA users (15 former and 15 current users). As a novel line of investigation, we will use a longitudinal design to collect data at three points: 30 new in-depth interviews, followed 3-6 months later by 30 follow-up interviews, and followed another 3-6 months later by focus groups with the same sample population. Participants are provided risk-reduction and healthcare literature at each interview. Follow-up interviews focus on changes in specific drug use patterns, social context of drug use, HIV- risk behaviors, healthcare utilization, and access to health services and treatment, which are new areas of this renewal study. Data analysis will be informed by life course and symbolic interaction theories. First, the findings will provide a more comprehensive understanding of the gender differences found in our original study on MA use in suburban Atlanta. Second, the longitudinal design will identify HIV-risk behaviors among suburban female MA users and changes in risk behaviors over time. Third, knowledge regarding the utilization of health services and access to needed healthcare among this study population will better inform future healthcare initiatives. Additionally, findings will yield recommendations for gender-specific and socially appropriate interventions at the individual and community levels for suburban female MA users.