National Survey on HIV Risk for African-American Women

描述（申请人提供）：在妇女中，非洲裔美国妇女占艾滋病病例的63%，从1999年7月到2000年6月占艾滋病毒感染的69.2%。因此，拟议的国家，纵向研究（N= 1000）的目的是检查与艾滋病毒的风险在非洲裔美国妇女超过24个月的随访期的性别因素。该提案是埃默里大学和专业调查研究公司ORC Macro之间的合作努力。我们建议使用三阶段的比例分层随机数字拨号方法来招募样本。第一阶段包括确定三个层次：城市，郊区和农村地区在48个美国大陆。第二阶段是确定这些阶层中符合条件的家庭。第三阶段是确定每个家庭中符合条件的个人。合格的受访者必须是18至44岁的非洲裔美国妇女，未婚，在筛查后90天内性活跃，并提供同意。在女性返回书面知情同意书后，ORC Macro的面试官将进行计算机辅助电话面试。访谈以性别与权力理论为指导。Wingood博士和DiClemente博士对该方法进行了扩展和调整，以检查与妇女艾滋病毒风险相关的因素。这一理论有三个结构，劳动的性别分工（检查社会经济影响），权力的性别分工（检查合作伙伴和机构的影响）和可能影响妇女的艾滋病毒风险的cathexis结构（检查规范和情感影响）。结构方程模型将用于检查以下研究目标： 确定性劳动分工，特别是教育程度，就业状况，健康保险状况，家属人数，生活安排，经济困难，邻里居住，社会凝聚力，对合作伙伴的经济依赖和收入预测无保护性交和多个合作伙伴在两年的随访期。 为了确定性权力分工，特别是性虐待，身体虐待，创伤性生活事件，性骚扰，暴露于性辱人格的媒体，种族歧视，合作伙伴的沟通，合作伙伴的阻力使用避孕套，男性合作伙伴和女性的使用酒精和药物预测无保护性交和多个合作伙伴在两年的随访期。 确定Cathexis的结构，特别是怀孕的愿望，性别规范，灵性，伴侣可用性，伴侣年龄，关系状态，关系长度，关系承诺，关系满意度，艾滋病毒耻辱和性功能障碍，预测无保护性交和多个合作伙伴在两年的随访期。 确定三个潜在结构（劳动的性别分工，权力的性别分工和Cathexis结构）中的每一个在两年的随访期内在模型中解释的独特差异。

DESCRIPTION (provided by applicant): Among women, African-American women comprised 63% of AIDS cases and 69.2% of HIV infections from July 1999 through June 2000. Thus, the proposed national, longitudinal study (N= 1000) is designed to examine gendered factors associated with HIV risk in African-American women over a 24-month follow-up period. The proposal is a collaborative effort between Emory University and ORC Macro, a professional survey research firm. We propose using a three-stage proportionate stratified random digit dial methodology to recruit the sample. Stage one involves identifying three strata: city, suburban, and rural regions in the 48 continental United States. Stage two involves identifying eligible households in these strata. Stage three involves identifying eligible individuals in each household. Eligible respondents must be African American women, 18 to 44 years of age, who are unmarried, sexually active within 90 days of the screening, and provide consent. After women return their written informed consent, an interviewer from ORC Macro will administer the Computer-Assisted Telephone Interview. The interview is guided by the theory of Gender and Power. which has been extended and adapted by Drs. Wingood and DiClemente to examine factors associated with HIV risk in women. This theory has three structures, the sexual division of labor (examines socioeconomic influences), the sexual division of power (examines partner and institutional influences) and the structure of cathexis (examines norms and affective influences) that may influence women's HIV risk. Structural equation modeling will be used to examine the following study aims: To determine if the Sexual Division of Labor, specifically, educational attainment, employment status, health insurance status, number of dependents, living arrangements, economic hardship, neighborhood residence, social cohesion, economic dependence on the partner and income predict unprotected sexual intercourse and multiple partners over the two-year follow-up period. To determine if the Sexual Division of Power, specifically, sexual abuse, physical abuse, traumatic life events, sexual harassment, exposure to sexually degrading media, racial discrimination, partner communication, partner resistance to condom use, male partner's and women's use of alcohol and drugs predict unprotected sexual intercourse and multiple partners over the two-year follow-up period. To determine if the Structure of Cathexis, specifically, pregnancy desire, gender norms, spirituality, partner availability, partner age, relationship status, relationship length, relationship commitment, relationship satisfaction, HIV stigma and sexual dysfunction, predict unprotected sexual intercourse and multiple partners over the two-year follow-up period. To determine the unique variance that each of the three latent constructs (Sexual Division of Labor, Sexual Division of Power and Structure of Cathexis) explains in the model over the two-year follow-up period.