The Construction of Power, IPV and HIV risk among Meth-Using Men and Women

 描述(由申请人提供)：亲密伴侣暴力(IPV)，指的是现任或前任亲密伴侣实施的身体和性暴力，在美国造成了严重的公共卫生问题。根据疾控中心2010年全国亲密伴侣和性暴力调查，超过三分之一的女性和超过四分之一的男性报告曾经历过IPV。研究支持一些主要与女性受害有关的风险因素，包括：社会人口变量、性危险行为、吸毒、既往滥用等，以及新出现的证据表明，受虐待男性特有的风险因素包括性别期望、耻辱和社会支持不足。关于吸毒与IPV之间关系的文献表明，在男性、女性和夫妇吸毒者中，甲基苯丙胺(冰毒)的使用与IPV独立相关。冰毒的使用与判断力受损、决策能力差和性关系能力差(SRP)有关，所有这些都会增加性行为风险，从而导致艾滋病毒感染。权力被定义为一个多维概念，涉及资源分配的一定程度的不公平，体现在一个人的个人控制和影响他人行为的能力上。虽然权力在IPV研究中通常以SRP的形式被概念化，但最近的研究证明了社会和结构性权力来源在预测艾滋病毒和IPV风险方面的作用。拟议项目的具体目标是：1)评估艾滋病毒阴性、异性使用冰毒的男女之间的性关系权力(SRP)和IPV之间的关系，以及2)使用2001-2005年进行的艾滋病毒行为干预研究(FASTLANE2)的现有数据集，检查与最近IPV相关的风险因素(如社会人口变量、SRP、避孕套使用、药物使用)的性别差异。这项研究还旨在定性地：3)描述个人、社会和结构层面的权力构建，以及这与IPV和性风险承担之间的关系，以及 4)描述在冰毒使用的背景下，权力、IPV和性冒险行为之间的关系。对于这项研究的定性部分，我们将招募居住在圣地亚哥县的60名异性使用冰毒的男性和女性(30名男性和30名女性)。参与者将被要求完成一次深度访谈，其中包括关于个人特征、吸毒、性危险行为、IPV经历、他们关系中的权力以及邻里和社会支持特征的封闭式和开放式问题。这项研究将通过以下方式补充目前的文献：1)探索与IPV相关的风险因素的性别差异；2)描述个人、社会和结构层面的权力构建及其对艾滋病毒危险行为和IPV的影响；3)描述在冰毒使用的背景下，权力、IPV和性风险承担之间的关系。这项工作的长期目标是为针对IPV和艾滋病毒的具体风险因素制定干预措施，包括吸食冰毒的男子和妇女面临的电力不足和相关的性风险。

 DESCRIPTION (provided by applicant): Intimate partner violence (IPV), defined as physical and sexual violence by a current or former intimate partner, poses a significant public health problem in the United States. According to CDC's 2010 National Intimate Partner and Sexual Violence Survey, more than 1 in 3 women and more than 1 in 4 men reported ever having experienced IPV. Research supports a number of risk factors related primarily to female victimization including: socio-demographic variables, sexual-risk behaviors, drug use, past abuse, etc. as well as emerging evidence for risk factors unique to abused males including gender expectations, stigma, and poor social support. Literature on the relationship between drug use and IPV indicates that methamphetamine (meth) use is independently associated with IPV among male, female and couple drug-users. Meth-use has been associated with impaired judgment, poor decision-making ability, and poor sexual relationship power (SRP), all which contribute to increased sexual risk behaviors and consequently, HIV infection. Power is defined as a multidimensional concept that involves a degree of inequity in the distribution of resources and is embodied in one's personal control and ability to influence the behaviors of others. While power is most commonly conceptualized in the form of SRP within IPV research, more recent studies have documented the role of social and structural sources of power in predicting risk of HIV and IPV. The specific aims of the proposed project are to quantitatively: 1) assess the relationship between sexual relationship power (SRP) and IPV among HIV-negative, heterosexual meth-using women and men, and 2) examine gender differences in risk factors (e.g. socio-demographic variables, SRP, condom use, drug use) associated with recent IPV using an existing data set from an HIV behavioral intervention study (FASTLANE2) conducted in 2001-2005. This study also aims to qualitatively: 3) describe the construction of power at the individual, social and structural levels and how this is related to IPV and sexual risk-taking, and 4) describe the relationship between power, IPV and sexual risk-taking behaviors within the context of meth-use. For the qualitative portion of this study we will recruit a sample of 60 heterosexual meth-using men and women (30 men and 30 women) who reside in San Diego County. Participants will be asked to complete one in-depth interview consisting of close and open-ended questions on personal characteristics, drug use, sexual risk behaviors, experience of IPV, power within their relationship, and neighborhood and social support characteristics. This research will add to the current literature by: 1) exploring gender differences in the risk factors related to IPV, 2) describing the construction of power at the individual, social and structural levels and how this impacts HIV risk behaviors and IPV; and 3) describing the relationship between power, IPV and sexual risk-taking within the context of meth-use. The long term goal of this work is to inform the creation of interventions tailored to the specific risk facors of IPV and HIV including poor power and related sexual-risk taking faced by meth-using men and women.