Polysubstance use and mental health outcomes after substance abuse treatment among community-based men of color who have sex with men in Los Angeles living with and without HIV

项目摘要 这篇论文旨在更好地了解什么物质的使用、治疗和心理健康 结果发生在与居住在加利福尼亚州洛杉矶的男性发生性关系的有色人种男性(MoCSM)之后 退出正式的物质滥用治疗(SAT)计划，如果这些结果因人而异 艾滋病毒携带者(PWH)与非艾滋病毒携带者(PWOH)。这项研究的目的是 为了确定哪些社会和结构因素阻碍或促进了积极的SAT参与， 减少物质使用、抑郁和焦虑的结果，以促进更高质量 对于康复中的MoCSM来说，这是生命的一部分。这些目标将使用NIDA资助的mSTUDY的数据来实现 (U01 DA036267)洛杉矶超过500名MoCSM的预期队列，大约一半 谁是PWH，将通过以下目标实现：目标1：使用纵向 来自MoCSM队列(2014-2023年)的数据描述了参与、退出和重新进入SAT。 评估社会人口学因素、基线物质使用和艾滋病毒状况之间的关系 在基线和随访期间进行SAT检查。目标2：评估自我报告频率的变化 MSTUDY参与者的甲基苯丙胺、可卡因、大麻、烟草和酒精使用情况 在治疗后3年内退出药物滥用治疗的患者。在人们之间使用 甲基苯丙胺、可卡因、大麻、烟草或酒精，评估是否有既往 与从未接受过治疗的人相比，SAT使用这些物质的频率较低， 如果使用结果因艾滋病毒状况而异。目标3：评估抑郁或抑郁是否存在差异 SAT后的焦虑症状(分别用CES-D 13和GAD-7 14测量) 有过和没有过SAT的人。评估这些关联是否因艾滋病毒状况而异。其中 处于恢复期的人，评估较高的社会支持得分(由MSPSS 15衡量)是否 与改善抑郁和焦虑的结果有关。结果将在以下方面进行评估 对129名男性进行了4319次研究访问，其中91名男性首次进入 在随访期间坐了下来，以及358名使用药物但从未接受过治疗的男子。 将进行描述性统计和数据可视化，这些结果将 通过多项回归、Logistic回归和广义估计进行评估 方程式，酌情调整相关混杂因素。通过评估 未得到充分研究的长期精神健康、治疗和药物滥用因素如下 药物滥用治疗，并分析这些结果的差异由于结构 因素，这篇论文将有助于理解哪些因素支持更好的恢复结果 洛杉矶以社区为基础的MoCSM感染和不携带艾滋病毒。

Project Abstract This dissertation aims to better understand what substance use, treatment, and mental health outcomes occur after men of color who have sex with men (MoCSM) who live in Los Angeles, CA exit formal substance abuse treatment (SAT) programs, and if these outcomes vary across people living with HIV (PWH) versus people living without HIV (PWOH). The objective of the research is to identify which social and structural factors impede or foster positive SAT engagement, substance use reduction, depression, and anxiety outcomes in order to promote a higher quality of life for MoCSM in recovery. These goals will be met using data from the NIDA-funded mSTUDY (U01 DA036267) prospective cohort of over 500 MoCSM in Los Angeles, approximately half of whom are PWH, and will be accomplished through the following aims: Aim 1: Using longitudinal data from a cohort of MoCSM (2014-2023), describe engagement in, exits, and re-entry into SAT. Assess how sociodemographic factors, baseline substance use, and HIV status are associated with SAT at baseline and during follow up. Aim 2: Evaluate changes in self-reported frequency of methamphetamine, cocaine, cannabis, tobacco, and alcohol use among mSTUDY participants who have exited substance abuse treatment up to 3 years post-treatment. Among people use methamphetamine, cocaine, cannabis, tobacco, or alcohol at baseline, assess if people with prior SAT use those substances at a lower frequency than people who have never been in treatment, and if use outcomes vary by HIV status. Aim 3: Assess if there are differences in depression or anxiety symptoms (respectively measured by CES-D 13 and GAD-7 14) following SAT among people with and without prior SAT. Evaluate if these associations vary by HIV status. Among people in recovery, assess if higher social support scores (measured by MSPSS 15) are associated with improved depression and anxiety outcomes. Outcomes will be assessed across 4,319 study visits conducted across 129 men with prior SAT at baseline, 91 men who first entered SAT during follow-up, and 358 men who use substances but have never received treatment. Descriptive statistics and data visualization will be performed, and these outcomes will be assessed through multinomial regression, logistic regression, and generalized estimating equations, as appropriate, adjusting for relevant confounding factors. Through assessing the understudied, longer-term mental health, treatment, and substance abuse factors following substance abuse treatment, and analyzing the differences in these outcomes due to structural factors, this dissertation will help understand what supports better recovery outcomes among community-based MoCSM living with and without HIV in Los Angeles.