HIV-Related Behavior among Rural African American, Young Adult Men

描述（由申请人提供）：在全国范围内，在农村和城市地区，非洲裔美国男性与女性发生性关系（MSW）的艾滋病毒感染率几乎是白人MSW报告的10倍，并且自2004年以来每年都在增加。这种增长在南方的小城镇和农村社区尤为明显。高中毕业后的几年是一个关键时期，在这个时期，农村非裔美国人的生活垃圾特别容易参与增加他们感染艾滋病毒和其他性传播疾病风险的行为。很少有人上大学，而且在南方农村，能找到稳定职业的工作机会很少。由于传统的教育或职业体系没有任何利益关系，向劳动力的过渡可能会让人士气低落，而且旷日持久。有些人看不到获得足够生计或实现个人目标的途径，可能会经历愤怒和其他负面情绪的增加，从而鼓励使用物质；破坏稳定的一夫一妻制关系；并妥协保护性行为。根据医学研究所（IOM）的预防科学处方，有效预防计划的发展需要病原学模型，将环境因素与近端风险和保护机制联系起来，预测特定目标人群中与艾滋病毒相关的风险行为。目前，这一信息并不存在于非裔美国人的一般城市生活垃圾或农村城市生活垃圾中。尽管项目开发人员可能在没有必要的科学数据的情况下为非洲裔美国农村城市垃圾创建或调整项目，但实施不基于可靠病因模型的项目将破坏其对公共卫生的影响。与国际移民组织的建议一致，拟议的研究将为制定有效的非洲裔美国农村城市生活垃圾预防艾滋病毒干预措施提供必要的下一步。我们建议对500名年龄在18-21岁的非裔美国农村男性进行抽样调查，他们居住在佐治亚州中部一个典型的非裔美国人聚居的南部农村地区。该地区男性将每12个月提供3次调查数据。指导本研究的概念模型包含以下过程：(a)背景风险因素，包括经济机会和压力源、种族歧视和促进风险的同伴关系和规范；(b)近端风险机制，包括消极情绪、促进风险的男性意识形态和性关系动态；(c)保护性因素，包括种族自豪感，自我调节能力，以及与父母和非正式导师之间的风险威慑关系，以及(d)与艾滋病毒相关的行为，包括药物使用，无保护的性交，以及多重和同时发生的性伙伴关系。

DESCRIPTION (provided by applicant): Nationally, rates of HIV among African American men who have sex with women (MSW) in both rural and urban areas are nearly 10 times as high as those reported for Caucasian MSW and have increased annually since 2004. This increase is particularly evident in small towns and rural communities in the South. The years following high school are a critical period when rural African American MSW are particularly vulnerable to engaging in behaviors that increase their risk for HIV and other STIs. Few attend college and, in the rural South, job opportunities that lead to stable occupations are scarce. With no stake in conventional educational or occupational systems, the transition to the workforce can be demoralizing and protracted. Some who see no pathway to adequate subsistence or attainment of personal goals may experience increases in anger and other negative emotions that encourage substance use; undermine stable, monogamous relationships; and compromise protective sexual behavior. Based on the Institute of Medicine's (IOM) prescription for prevention science, the development of effective prevention programs requires etiological models that link contextual factors with proximal risk and protective mechanisms that forecast HIV-related risk behavior in a specified target population. Currently, this information does not exist for African American MSW in general or rural MSW in particular. Although program developers may create or adapt programs for rural African American MSW without the necessary scientific data, implementing programs that are not based on sound etiological models will undermine their public health impact. Consistent with IOM recommendations, the proposed research will provide the necessary next step for the development of efficacious HIV prevention interventions for rural African American MSW during young adulthood. We propose to sample 500 rural African American men age 18-21 who live in a region of central Georgia typical of areas in the rural South with large proportions of African American residents. Men from this region will provide survey data 3 times at 12-month intervals. The conceptual model that guides the study incorporates the following processes: (a) contextual risk factors including economic opportunities and stressors, racial discrimination, and risk-promoting peer affiliations and norms; (b) proximal risk mechanisms including negative emotionality, risk-promoting masculine ideology, and sexual relationship dynamics; (c) protective factors including racial pride, self-regulatory competence, and risk-deterring relationships with parents and informal mentor figures, and (d) HIV-related behaviors including substance use, unprotected intercourse, and multiple and concurrent sexual partnerships.