A LONGITUDINAL STUDY OF SUBSTANCE ABUSE AND HIV RISK AMONG ADULT LATINA MOTHER-DA

描述(由申请人提供)：在美国，拉美裔女性的艾滋病毒感染率是非拉美裔白人女性的六倍。拉丁裔正在遭受药物使用障碍的不同负面后果，包括亲密伴侣暴力、监禁、无家可归和医疗疾病。我们的长期目标是减少拉丁裔中与艾滋病毒和药物滥用有关的健康差距的发生率。这项申请是追求这一目标的重要一步，其目的是确定以社区为基础的拉丁裔母女样本的药物使用(合法和非法)和艾滋病毒危险行为轨迹如何受到家庭机制(母女关系或依恋)、文化进程以及药物滥用和艾滋病毒危险行为的其他社会决定因素随时间的变化的影响。研究设计包括四波数据收集。基线数据是在由NIDA资助的关于拉丁裔母亲和女儿代际药物使用和艾滋病毒危险行为的横断面试点研究中收集的(R24DA014260，PI：Mario de La Rosa，Ph.D.)。提议对基线评估采取后续行动进行三项新的纵向评估。第一次新的后续评估将与最初研究的基线评估相隔大约5年。其余两次后续评估将在前一次后续评估的一年后进行。我们的第一个目标是确定文化和社会决定因素对拉丁裔母女社区样本中药物使用和艾滋病毒危险行为变化轨迹的影响。工作假设是，经历(1)更多地适应美国文化；(2)更差的社会经济条件；(3)失去人际支持；(4)较少的宗教参与；(5)参与刑事司法系统；(6)亲密伴侣暴力；(7)更大的就业、关系和/或居住相关的慢性压力；或(8)自基线评估以来心理健康和医疗状况下降的拉丁裔母亲和女儿将在7年的评估期间内表现出药物使用和艾滋病毒危险行为的高比率增加或保持较高水平。我们的第二个目标是确定母女依恋对物质使用和HIV危险行为变化轨迹的影响。拉丁裔母亲和女儿要么增加了依恋水平，要么保持了持续的高依恋水平，他们将在7年内报告减少或持续降低药物使用和艾滋病毒危险行为的水平。我们的第三个目标是确定母女依恋在有害的社会决定因素的经历和物质使用的变化轨迹与艾滋病毒危险行为之间的关联上的调节作用。

DESCRIPTION (provided by the applicant): The HIV contraction rate for Latina women in the U.S. is six times the rate for non-Latina, White women. Latinas are suffering disparate negative consequences from substance use disorders, including intimate partner violence, incarceration, homelessness, and medical ailments. Our long-term goal is to reduce the incidence of HIV and substance abuse related health disparities among Latinas. The objective of this application, which is a significant step in pursuit of this goal, is to determine how substance use (both licit and illicit) and HIV risk behavior trajectories of a community-based sample of Latina mothers and daughters are influenced by changes in familial mechanisms (mother-daughter acoplamiento or attachment), cultural processes, and other social determinants of substance abuse and HIV risk behaviors over time. The study design involves four waves of data collection. Baseline data were collected in a cross-sectional pilot study of intergenerational drug use and HIV risk behaviors among Latina mothers and daughters funded by NIDA (R24DA014260, PI: Mario De La Rosa, Ph.D.). Three new longitudinal assessments are proposed to follow-up on baseline assessment. The first new follow-up assessment will be spaced approximately 5 years from the original study's baseline assessment. The remaining two follow-up assessments will occur 1 year from the preceding follow-up assessment. Our first aim is to determine the influence of cultural and social determinants on trajectories of change for substance use and HIV risk behaviors among a community-based sample of Latina mothers and daughters. The working hypothesis is that Latina mothers and daughters who experience (1) more acculturation to U.S. culture; (2) poorer socioeconomic conditions; (3) a loss of interpersonal supports; (4) less religious involvement; (5) involvement with the criminal justice system; (6) intimate partner violence; (7) greater employment, relationship, and/or residential related chronic stress; or (8) declining mental health and medical status since their baseline assessment will exhibit either an increase in or maintenance of high rates of substance use and HIV risk behaviors over the 7 year assessment time period. Our second aim is to determine the influence of mother-daughter attachment on trajectories of change for substance use and HIV risk behaviors. Latina mothers and daughters who either increase their levels of attachment or maintain consistently high levels of attachment will report reduced or consistently lower levels of substance use and HIV risk behaviors over a 7 year time period. Our third aim is to determine the moderating role of mother-daughter attachment on associations between experiences of detrimental social determinants and trajectories of change for substance use and HIV risk behaviors.