Networks and normative influences on sex and drug-related HIV risk in black women

描述（由申请人提供）：黑人/非裔美国妇女（BAAW）通过异性恋传播和与毒品相关的危险行为感染艾滋病毒/艾滋病的风险较高。在加州圣地亚哥县，BAAW占所有女性艾滋病毒病例的26%，尽管他们只占该县人口的5%，而且在圣地亚哥县BAAW中的艾滋病发病率几乎是白人妇女的8倍。针对RFA-DA-14-010，“黑人/非裔美国妇女和年轻男同性恋者中的艾滋病毒/艾滋病和物质使用”，我们将评估BAAW的社会网络结构、社会规范、有影响力的社会网络联系人的经历和行为与艾滋病毒状况、艾滋病毒风险行为和艾滋病毒检测史之间的关系。在这项创新的社会网络研究中，我们将使用自我中心网络方法来评估三个层面的影响力：1)女性自身的行为、信念和经验，2)女性个人社会网络的结构/组成以及女性对其网络成员的行为、信念和经验的感知，以及3)有影响力的网络成员的实际行为、信念和经验。建议的研究有以下具体目的：1。评估社会、性和药物使用网络因素（如网络大小、结构、组成、感知规范）如何与BAAW中的物质使用、艾滋病毒风险行为和艾滋病毒检测相关联。2. 确定BAAW网络成员的文化信仰、经验和行为与BAAW行为之间的关联，并确定BAAW对其网络感知的准确性。3. 确定BAAW的社会网络干预目标，旨在降低风险行为和增加艾滋病毒检测的接受度，并使用定性焦点小组来确定基于网络的干预策略的可接受性和文化适宜性。本研究还具有以下探索性目的：调查社会网络因素与HIV感染状况的关系，以及HIV阳性BAAW与护理的联系和保留。为了实现这些目标，我们提出了一项混合方法的社会网络研究，其中包括加州圣地亚哥100名处于危险中的、自我报告为hiv阴性的BAAW，以及多达500名他们的社会网络联系人（总N=600）。在第一阶段，我们将使用调查和以自我为中心的网络访谈来评估BAAW及其网络报告的个人和网络特征。在第二阶段，我们将进行焦点小组，以评估涉及有影响力的网络成员的基于社会网络的干预的可接受性。拟议的研究将推进总统的国家艾滋病毒/艾滋病战略，以“减少新的感染，增加获得护理的机会，并减少与艾滋病毒相关的健康差距”。

DESCRIPTION (provided by applicant): Black/African American Women (BAAW) are at elevated risk for HIV/AIDS through both heterosexual transmission and drug-related risk behavior. In San Diego County, California, BAAW account for 26% of all female HIV cases, despite only being 5% of the County population and the AIDS rate are almost eight times higher among BAAW in San Diego County than among white women. In response to RFA-DA-14-010, "HIV/AIDS and Substance Use among Black/African American Women and Young MSM," we will evaluate how BAAW's social network structure, social norms, and experiences and behaviors of influential social network contacts are associated with HIV status, HIV risk behavior, and history of HIV testing. In this innovative social- network study, we will use egocentric network methods to assess three levels of influence: 1) women's own behaviors, beliefs, and experiences, 2) the structure/composition of women's personal social networks and women's perceptions of their network member's behaviors, beliefs, and experiences, and 3) the actual behaviors, beliefs, and experiences of influential network members. The proposed study has the following specific aims: 1. Evaluate how social, sexual, and drug use network factors (e.g., network size, structure, composition, perceived norms) are associated with substance use, HIV risk behavior, and HIV testing among BAAW. 2. Determine the association between cultural beliefs, experiences, and behaviors of BAAW's network members and the behavior of BAAW, and determine accuracy of BAAW's perceptions of their network. 3. Identify targets for a social network intervention for BAAW designed to decrease risk behavior and increase uptake of HIV testing, and use qualitative focus groups to determine the acceptability and cultural appropriateness of a network-based intervention strategy. The proposed study also has the following exploratory aim: 4. Investigate the social network factors associated with HIV status and linkage to and retention in care among HIV+ BAAW. To accomplish these aims, we propose a mixed methods social network study with 100 at-risk, self-reported HIV-negative BAAW in San Diego, California and up to 500 of their social network contacts (total N=600). In Phase I we will use surveys and egocentric network interviews to assess individual and network characteristics reported by BAAW and their networks. In Phase II we will conduct focus groups to assess the acceptability of a social network-based intervention involving influential network members. The proposed research will advance the President's National HIV/AIDS Strategy to "reduce new infections, increase access to care, and reduce HIV-related health disparities."