Dyadic influences on HIV risk behavior and substance abuse among young men who have sex with men and their partners

项目总结： 艾滋病毒和药物滥用是两种流行病，对年轻男性的影响不成比例 与男性发生性关系(基督教青年会)。基督教男同性恋者中的艾滋病毒传播大多发生在 严重关系的背景，主要是由于无套肛交(CAS)的比率较高 与临时伴侣相比严重，在人际关系中缺乏PrEP理解。不幸的是， 对艾滋病毒和药物滥用风险因素的研究主要集中在有 对双星的关注有限。除了所有情侣都会感受到的压力外，结对的YMSM 经历与他们的性少数地位有关的独特压力(例如，歧视、耻辱)。 这种额外的压力可能会导致关系运作中的问题(例如，不满意，冲突， 亲密伴侣暴力)，这可能会导致参与健康危险行为， 如CAS和物质使用。描述这些过程是至关重要的，需要告知 优化关系运作和减少健康差距的二元预防战略 在基督教青年会中。拟议的研究将利用来自大样本的数据， 种族/民族不同的基督教男同性恋者队列，他们目前正在被NIDA资助的 U01。这一队列的建立是通过让基督教青年会招募他们认真的关系伙伴到 研究，提供了独特的机会来检查二元性对艾滋病毒危险行为和 基督教青年会及其合作伙伴的药物使用情况。这份提案还将为申请人提供 通过博士后培训进行艾滋病毒和药物使用研究，统计分析方法 二元数据和授权，所有这些都是他作为一名 独立科学家。申请者将学习如何实施参与者-合作伙伴 相互依赖模型，它在统计上解释了数据在对偶中的非独立性 通过同时估计演员效果(一个人对自己行为的影响)和 伴侣效应(一个人受伴侣的影响有多大)。此型号将允许 申请人检查个人和伴侣层面的压力因素对危险行为的影响。 此外，二元数据提供了检查以下情况的机会 伴侣之间的压力协调/不协调会导致每个伴侣的艾滋病毒风险 行为和物质的使用超出了个体演员和伴侣的影响。总而言之， 这项拟议研究的目标是检查：(1)演员和伴侣压力对艾滋病毒的影响 危险行为与物质使用；(2)危险行为的一致性/非一致性之间的关系 伴侣之间的压力与艾滋病毒危险行为和药物使用；以及(3) 作为这些协会的调解人的关系。这项提议代表了形成性 青年男性接触者对健康危险行为的二元影响研究是必要的 采取步骤，制定以循证为基础的预防和干预方案，目标是 艾滋病毒传播风险最高的背景(浪漫二人组)。这项研究的发现将 通过理清个人和伴侣层面的关系，了解我们对健康差异的理解 对高危人群(不同类型的青年男性接触者)艾滋病毒危险行为和物质使用的影响。

Project Summary: HIV and substance abuse represent two epidemics that disproportionately affect young men who have sex with men (YMSM). The majority of HIV transmissions among YMSM occur in the context of serious relationships, largely due to higher rates of condomless anal sex (CAS) with serious compared to casual partners and lack of PrEP uptake in relationships. Unfortunately, research on risk factors for HIV and substance abuse has largely focused on individuals with limited attention to dyads. In addition to stress experienced by all couples, coupled YMSM experience unique stress related to their sexual minority status (e.g., discrimination, stigma). This added stress may lead to problems in relationship functioning (e.g., dissatisfaction, conflict, intimate partner violence), which may then contribute to engagement in health risk behaviors, such as CAS and substance use. Delineating these processes is critically important to inform dyadic prevention strategies to optimize relationship functioning and reduce health disparities among YMSM. The proposed study will utilize data from a subsample of a large, racially/ethnically diverse cohort of YMSM who are currently being recruited for a NIDA-funded U01. The cohort is being built by having YMSM recruit their serious relationship partners into the study, providing the unique opportunity to examine dyadic influences on HIV risk behavior and substance use among YMSM and their partners. This proposal will also provide the applicant with postdoctoral training in HIV and substance use research, statistical methods for analyzing dyadic data, and grantsmanship, all of which are necessary to launch his career as an independent scientist. The applicant will learn how to implement the Actor-Partner Interdependence Model, which statistically accounts for the nonindependence of data in dyads by simultaneously estimating actor effects (a person’s influence on his own behavior) and partner effects (how much a person is influenced by his partner). This model will allow the applicant to examine the influences of individual- and partner-level stressors on risk behaviors. Further, dyadic data provide the opportunity to examine the extent to which concordance/discordance of stress between partners contributes to each partner’s HIV risk behavior and substance use above and beyond the individual actor and partner effects. In sum, the goals of the proposed study are to examine: (1) actor and partner effects of stress on HIV risk behavior and substance use; (2) the associations between concordance/discordance of stress between partners and HIV risk behavior and substance use; and (3) problems in relationship functioning as mediators of these associations. This proposal represents formative research on dyadic influences on health risk behavior among YMSM, which is a necessary first step in order to develop evidence-based prevention and intervention programs that target the context in which HIV risk transmission is highest (romantic dyads). Findings from this study will inform our understanding of health disparities by disentangling individual- and partner-level influences on HIV risk behavior and substance use in a high-risk population (diverse YMSM).