NeuroAIDS research with disadvantaged drug users

描述（由申请人提供）：随着美国艾滋病预防和治疗工作的成功，艾滋病发病率和流行率的差距越来越大。艾滋病毒现在被认为是社会边缘和被剥夺权利的人的流行病，病例集中在贫困社区的种族和性少数群体中，特别是非洲裔美国人和男男性行为者。在这些群体中，使用兴奋剂等物质的比例很高，这进一步增加了危险性行为的发生。神经行为研究人员正在阐明与风险决策有关的大脑区域，以及药物使用、社会经济劣势和社会边缘化等因素与这些区域的变化有关。了解药物使用和社会不平等如何影响决策，有助于我们为高危群体量身定制艾滋病毒预防干预措施；然而，社会弱势物质使用者很少被纳入神经影像学研究，部分原因是招募策略的不足。拟议的项目整合了培训和研究，旨在培养申请人在功能磁共振成像（fMRI）设计和分析方面的专业知识，以帮助弱势兴奋剂使用者。拟议的项目将建立在申请人在临床心理学方面的坚实基础上，通过提供以下方面的指导培训：(1)药物使用和艾滋病毒/艾滋病的神经行为方面，(2)功能磁共振成像设计，分析和解释，(3)受访者驱动抽样（RDS）和其他招募弱势药物使用者进行神经影像学研究的策略。培训计划包括课程作业、参加研讨会、指导阅读、指导研究、出席全国会议和指导基金写作。拟议的研究将检查社会经济地位和可卡因使用对风险决策和相关神经激活的主要和相互作用效应，使用从nida资助的fMRI研究中收集的数据，由申请人的导师监督。据推测，可卡因的使用和低SES将与实验中的风险决策和减少的神经激活有关。此外，RDS将用于招募100名男男性接触者可卡因使用者，以确定其可行性，并确定与参与功能磁共振成像研究意愿相关的因素。这项研究将为旨在减少弱势药物使用者之间艾滋病毒差异的以患者为导向的研究提供信息。在该奖学金达到顶峰时，申请人将在一个关键需求领域拥有专门知识，并将准备开始

DESCRIPTION (provided by applicant): With the success of HIV prevention and treatment efforts in the United States (US), disparities in HIV incidence and prevalence have grown. HIV is now considered an epidemic of the socially marginalized and disenfranchised, with cases concentrated in racial and sexual minorities in impoverished neighborhoods, particularly African Americans and men who have sex with men (MSM). The rates of substance use, like stimulant use, are high within these groups and further increase engagement in risky sexual behaviors. Neurobehavioral researchers are elucidating brain regions involved in risky decision making, and factors like drug use, socioeconomic disadvantage, and social marginalization have been linked to alterations in these regions. Understanding how substance use and social inequalities influence decision making facilitates our ability to tailor HIV prevention interventions to high-rik groups; however socially disadvantaged substance users are rarely included in neuroimaging research, partly due to a deficiency in recruitment strategies. The proposed project integrates training and research designed to develop the applicant's expertise in functional magnetic resonance imaging (fMRI) design and analysis with disadvantaged stimulant users. The proposed project will build on the applicant's strong foundation in clinical psychology, by providing mentored training in (1) neurobehavioral aspects of substance use and HIV/AIDS, (2) fMRI design, analysis, and interpretation, (3) respondent-driven sampling (RDS) and other strategies for recruiting disadvantaged substance users for neuroimaging research. The training plan includes coursework, participation in seminars, directed readings, mentored research, attendance at national conferences, and mentored grant writing. The proposed research will examine the main and interaction effects of socioeconomic status and cocaine use on risky decision making and associated neural activation using data collected from NIDA-funded fMRI research overseen by the applicant's mentor. It is hypothesized that cocaine use and low SES will be associated with riskier decision making and decreased neural activation during an experimental loss aversion task. Additionally, RDS will be used to recruit 100 MSM cocaine users to determine its feasibility and to identify factors associated with willingness to participae in fMRI research. This research will inform patient-oriented research aimed at reducing HIV disparities among disadvantaged substance users. At the culmination of this fellowship, the applicant will have specialized expertise in an area of critical need and will be prepared to begin a program of patient- oriented research in the fields of neuroAIDS and drug abuse.