Neighborhood Effects on HIV Risk-Taking

项目摘要/摘要 艾滋病毒风险降低干预措施传统上强调以个人为中心的行为预防 接近了。尽管取得了成功，但艾滋病毒/艾滋病的流行并未停止，特别是在 非洲裔美国人，这是一个受到不成比例影响的群体。结构性干预，这往往是 尽管结构性因素往往会造成弱势群体并维持 支持持续从事艾滋病毒危险行为的环境。在建议的研究中，我们 将调查个人如何与邻里环境互动并对其产生影响。具体来说，我们 关注个人和邻里环境之间的联系，以及结构性和 环境因素。我们提出了多层次的纵向设计，具体目标是：(1) 调查邻里环境、邻里观念和个人之间的关系 特征、艾滋病毒性行为风险以及这种风险行为与艾滋病毒状况之间的联系；(2)检查 邻里环境、邻里认知、个体特征和 与注射毒品使用有关的艾滋病毒风险承担和这种冒险行为以及艾滋病毒状况；和(3)确定空间 艾滋病毒风险接受模式，并调查与之相关的社区和个人特征 有了这些空间模式。指导性概念模型建立在社会解体理论的基础上。招聘 在50个人口普查区组中使用有针对性的抽样战略，这些战略具有不同的特点，并作为 社区的代言人。我们的试点数据显示，这些数据根据关键特征而有所不同。此外，我们 将探索受访者搬家的当地背景。研究样本将包括1500名非洲人 美国的女人和男人。将根据吸毒状况、性别以及男性之间的情况进行比较， 性取向。该项目包括不同的数据来源，即：个人访谈、个人艾滋病毒 现状、系统观察、2000年美国人口普查数据，以及第一部分犯罪、毒品逮捕和酗酒 插座数据。面谈将在三个时间点进行：基线和6个月和12个月的随访。 将对犯罪、毒品逮捕和酒精出口数据进行系统观察和审查。 术后12个月随访。分析方法结合了纵向多层次分析和空间分析 映射。这项研究具有理论和研究意义，其研究结果可能会提供有用的信息 针对社区结构和环境因素的结构性干预，支持现有的 和新的艾滋病毒预防方法。通过吸收政策制定者、城市规划者、 经济学家、法律专家和更广泛的研究界，公共卫生对艾滋病毒的反应将是 增强版。

PROJECT SUMMARY/ABSTRACT HIV risk-reduction interventions traditionally have emphasized individual-centered behavioral prevention approaches. Despite their success, the HIV/AIDS epidemic has not come to a halt, especially not among African Americans, a group that is disproportionately impacted. Structural interventions, which tend to be multilevel, are less common even though structural factors often create vulnerable populations and sustain an environment that is supportive of continued engagement in HIV risk behaviors. In the proposed study, we will investigate how individuals interact with and impact their neighborhood environments. Specifically, we focus on the link between the individual and neighborhood context and the role of structural and environmental factors. We propose a multilevel, longitudinal design and the specific aims are: (1) to investigate the relationships between neighborhood context, neighborhood perceptions, and individual characteristics, and HIV sexual risk-taking and the link between this risk-taking and HIV status; (2) to examine the association between neighborhood context, neighborhood perceptions, individual characteristics, and injection drug use related HIV risk-taking and this risk-taking and HIV status; and (3) to identify the spatial patterns of HIV risk-taking and to investigate neighborhood and individual-level characteristics associated with these spatial patterns. The guiding conceptual model builds on social disorganization theory. Recruitment uses targeted sampling strategies across 50 census block groups, with varied characteristics, and which serve as a proxy for neighborhoods. Our pilot data show these to vary according to key characteristics. In addition, we will explore the local context in which the respondents move. The study sample will consist of 1,500 African American women and men. Comparisons will be drawn based on drug use status, gender, and among the men, sexual orientation. The project comprises distinct data sources, namely: individual interviews, individual HIV status, systematic observations, data from the 2000 U.S. Census, and part 1 crime, drug arrests, and alcohol outlet data. Interviews will be conducted at three time points: baseline and 6 and 12 month follow-up. Systematic observations and a review of crime, drug arrests and alcohol outlet data will occur at baseline and at 12 month follow-up. The analytical approach combines longitudinal multilevel analyses and spatial mapping. The study has theoretical and research significance as its findings may provide useful information for structural interventions, targeting neighborhood structural and environmental factors, that support existing and new HIV prevention approaches. By incorporating partners such as policy-makers, urban planners, economists, legal experts and the wider research community, the public health response to HIV will be enhanced.