Examining network dynamics, neighborhood factors and HIV among drug-using MSM

描述（由申请人提供）：男男性行为者（MSM）仍然是美国当前艾滋病毒流行的最大风险群体，非裔美国男男性行为者受到艾滋病毒的影响不成比例。滥用药物的性少数群体应该得到更多的关注，因为他们更有可能得不到治疗或治疗不足，感染艾滋病毒的风险更高，并且可能成为非吸毒人群与艾滋病毒的桥梁人群。男男性接触者物质使用文献中的一个空白是考虑到酒精和药物使用模式的异质性。识别和确定这些模式可以改善风险群体的具体说明，并更有效地分配治疗和预防资源。潜在分类分析（LCA）是一种被广泛接受的归纳统计方法，它提供了酒精和药物使用模式的数据衍生分类。拟议的研究将使用LCA对现有n=368名与男性发生性关系的非裔美国男性（AA - MSM）数据集的药物和酒精使用模式进行经验定义和表征，并根据使用模式检查艾滋病毒风险的差异。LCA还可以增进对药物使用和艾滋病毒风险的社会和环境背景的了解。人们对网络动态如何随着吸毒和酗酒的模式而变化所知甚少。与疾病传播动态直接相关的社会网络的两个未得到充分研究但至关重要的特征是多样性（例如，性和毒品使用网络的重叠）和性和毒品网络的密度。在拟议的研究中，我们将检查AA男男性行为者的物质使用模式和网络动态之间的关系，以扩大对药物使用和艾滋病毒风险之间交叉的理解。最后，该研究将通过他们的酒精和药物使用模式来检查MSM的空间分布，以研究社区环境如何影响物质使用和艾滋病毒风险之间的交集。这项研究以风险环境框架为依据，研究结果将为制定量身定制的艾滋病毒和药物使用预防干预措施提供经验基础。此外，这项研究将有助于推进国家艾滋病毒/艾滋病战略39的目标，重点关注艾滋病毒/艾滋病严重集中的社区，特别是男同性恋者、非洲裔美国人和药物滥用者。

DESCRIPTION (provided by applicant): Men who have sex with men (MSM) continue to represent the largest risk group in the on-going HIV epidemic in the United States and African American MSM are disproportionately affected by HIV. Substance- abusing sexual minorities warrant increased attention as they are more likely to be untreated or under-utilize treatment, at elevated risk for HIV and a potential HIV bridge population to non-drug using populations. A gap in the MSM substance use literature is consideration of the heterogeneity of alcohol and drug use patterns. Identifying and defining these patterns can improve specification of risk groups and more efficient allocation of treatment and prevention resources. Latent class analysis (LCA) is a well-accepted inductive statistical method that provides data derived classifications of patterns of alcohol and drug use. The proposed study will use LCA to empirically define and characterize drug and alcohol use patterns of an existing dataset of n=368 African American men who have sex with men (AA MSM) and to examine differences in HIV risk by pattern of use. LCA also can improve understanding of the social and environmental context to substance use and HIV risk. Less is known about how network dynamics vary by patterns of drug and alcohol use. Two understudied, but critical features of social networks that directly pertain to disease transmission dynamics are multiplexity (e.g. overlap in sexual and drug use networks) and density of sex and drug networks. In the proposed study we will examine associations between substance use patterns of AA MSM and network dynamics to expand understanding of the intersection between drug use and HIV risk. Finally, the proposed study will examine the spatial distribution of MSM by pattern of their alcohol and drug use to examine how neighborhood context influences the intersection between substance use and HIV risk. This research is informed by the risk environment framework and findings will provide an empirical foundation for developing tailored HIV and substance use prevention interventions. Furthermore, this study will contribute to advancing the goals of the National HIV/AIDS Strategy,39 by focusing on communities with heavy concentration of HIV/AIDS, particularly MSM, African Americans and substance abusers.