Reducing Sexual Risk Behaviors among Rural African-American Cocaine Users

减少农村非裔美国可卡因使用者的性危险行为

• 批准号: 7417379
• 负责人: Katharine E. Stewart
• 金额: $ 62.51万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-20 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7417379
• 关键词: Address; African American; Alcohol or Other Drugs use; Area; Arkansas; Behavior; Behavior Therapy; Behavioral; Cocaine; Cocaine Users; Communities; Condition; County; Drug usage; Enrollment; Epidemic; Equilibrium; HIV; Health Services Accessibility; Health Status; Housing; Incidence; Individual; Injection of therapeutic agent; Intervention; Intervention Studies; Intervention Trial; Life; Link; Literature; Measures; Mediating; Mediation; Mediator of activation protein; Mental Health; Methamphetamine; Methodology; Methods; Multiple Partners; Numbers; Outcome; Participant; Patient Self-Report; Pattern; Pharmaceutical Preparations; Population; Poverty; Powder dose form; Prevention education; Property; Public Health; Race; Random Allocation; Randomized; Randomized Controlled Trials; Rate; Recruitment Activity; Research; Respondent; Risk; Risk Behaviors; Risk Reduction; Rural; Rural Community; Rural Population; Sampling; Science; Self Efficacy; Sexually Transmitted Diseases; Social support; Target Populations; Testing; Time; Treatment Efficacy; Trust; Woman; Work; base; behavioral clinical trial; cohort; condoms; design; disorder prevention; experience; follow-up; high risk sexual behavior; innovation; men; partner violence; peer; programs; rapid growth; rural area; sex; skills; social; social cognitive theory; theories

DESCRIPTION (provided by applicant): HIV and other sexually transmitted infection (STI) rates continue to rise disproportionately among African-Americans, and particularly dramatically among rural populations. Stimulant use, especially cocaine use, among rural African-Americans is also increasing, and is related to multiple risk behaviors for HIV/STI, including sex with multiple partners, exchanging sex for drugs and other commodities, and inconsistent condom use. Despite these documented risk patterns, and the increasing disparities in HIV/STI incidence, few theory-based interventions have been specifically designed and tested for rural African-American populations with high-risk behavioral patterns. The primary aims of this project are to adapt an existing risk reduction program to the needs of rural African-American cocaine users, to test the adapted intervention's efficacy via a behavioral clinical trial, and to answer outstanding questions regarding intraclass correlation and sampling methodologies in the sexual risk reduction literature. The project team will conduct a longitudinal intervention study with stratified group randomization, so that participants receive the sexual risk intervention or an active control intervention condition in groups. Each intervention condition is equivalent in terms of contact time and in terms of number and type of contacts (each participant receives two group sessions, two individual sessions, two community-building sessions, and two follow-up "booster" sessions over four months). Respondent-driven sampling will be used to recruit and enroll 280 participants across two rural, predominantly African-American counties in the Arkansas Delta region to one of the two intervention conditions. The primary outcome variables will include condom use skills, sexual negotiation skills, and self-reported risk behaviors. Additional measures, including self-efficacy for decreased sexual risk, perceived peer norms for sexual risk, perceived benefits and barriers of sexual risk reduction, social support and social trust, mental health status, partner violence, and substance use, will also be collected to assess their theory-based mediating and moderating influences on the sexual risk skills and behaviors. Assessments will be conducted prior to the intervention, immediately post-intervention, and at 6- and 12-month follow-ups. This project brings together a strong, experienced investigative team which has an established, trusting relationship with the community that will be involved in the study. PUBLIC HEALTH RELEVANCE The project not only will provide critically-needed information about the efficacy of tailored behavioral interventions among rural African-Americans at high risk for HIV/STIs, but also will allow the study team to investigate important methodological questions about the use of respondent- driven sampling approaches in rural settings and about intraclass correlation coefficients for sexual risk measures in tight-knit rural communities. This research can thus make important contributions that address racial disparities in HIV/STIs, provide approaches for slowing the rapid growth of the epidemics in rural areas, and inform methodological innovations of importance to sexual risk reduction science.

描述（由申请人提供）：在非裔美国人中，艾滋病毒和其他性传播感染率（STI）率不成比例地上升，尤其是在农村人群中尤其如此。在非裔美国人中，刺激性使用，尤其是可卡因的使用也正在增加，并且与艾滋病毒/性传播感染的多种风险行为有关，包括与多个伴侣的性别，将性别交换为毒品和其他商品，以及不一致的避孕套。尽管有这些记录的风险模式以及HIV/STI发病率的差异的增加，但很少有基于理论的干预措施被专门设计和测试了具有高风险行为模式的非裔非裔美国人人口。该项目的主要目的是使现有的降低风险计划适应非裔美国人可卡因使用者的需求，以通过行为临床试验来测试改编的干预措施的功效，并回答有关减少性风险风险的阶级相关性和抽样方法的杰出问题。项目团队将通过分层随机进行纵向干预研究，以便参与者接受性风险干预或组中的主动控制干预条件。每个干预条件在接触时间和联系人的数量和类型方面都是等效的（每个参与者都会在四个月内接受两个小组会议，两个单独的会议，两个社区建设会议和两个后续的“助推器”课程）。受访者驱动的抽样将用于招募和招募280名参与者，遍及阿肯色三角洲地区的两个农村，主要是非裔美国人县，以达到两个干预条件之一。主要结果变量将包括使用避孕套技能，性谈判技巧和自我报告的风险行为。还将收集其他措施，包括对性风险减少的自我效能感，感知的性风险的同伴规范，感知到的降低性风险的福利，社会支持和社会信任的障碍，心理健康状况，伴侣暴力和使用物质，以评估其基于理论的调解以及对性风险技能和行为的影响。评估将在干预之前，干预后立即进行，并在6个月和12个月的随访中进行。该项目汇集了一个强大的经验丰富的调查团队，该团队与将涉及研究的社区建立了建立，信任的关系。 公共卫生相关性该项目不仅将提供有关艾滋病毒/性传播疾病高风险的非裔非裔美国人中量身定制行为干预措施的效力的急需信息，而且还将允许研究团队研究有关在农村环境和内内相关系数中使用受访者驱动的采样方法的使用的重要方法论问题。因此，这项研究可以做出重要的贡献，以解决艾滋病毒/性传播疾病中种族差异的问题，为农村地区流行病快速增长的方法提供了方法，并为减少性风险降低科学的重要性创新提供了依据。