Assessing Patterns of HIV Risk Among IDUs in Neighborhood Environments over Time

评估社区环境中注射吸毒者随时间的艾滋病毒风险模式

基本信息

批准号：
8113416
负责人：
ALEXANDER H KRAL
金额：
$ 47.04万
依托单位：
RESEARCH TRIANGLE INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-08-01 至 2013-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8113416
关键词：
AIDS prevention AIDS/HIV problem Accounting Alcohol or Other Drugs use Area Behavior Behavioral Model California Censuses Characteristics Cities Cluster Analysis County Crime Data Data Set Databases Disadvantaged Drug usage Economically Deprived Population Effectiveness Environment Environmental Risk Factor Epidemiology Exhibits Geographic Distribution Glean HIV Health Health Services Health Services Accessibility Health behavior Human immunodeficiency virus test Individual Injecting drug user Injection of therapeutic agent Interview Investigation Knowledge Light Link Location Maps Methods Modeling Needle Sharing Needle-Exchange Programs Neighborhoods Outcome Pathway interactions Pattern Pharmaceutical Preparations Policy Maker Population Population Study Principal Investigator Provider Publications Publishing RQ2 Randomized Relative (related person)Reporting Research Research Personnel Risk Risk Behaviors Role Sampling San Francisco Secondary to Selection Bias Services Site Source Syringes Techniques Time Unsafe Sex Urban Health Vulnerable Populations Work analytical method base deprivation design high risk innovation insight metropolitan multilevel analysis prevention service relational database social treatment program

项目摘要

DESCRIPTION (provided by applicant): The proposed study responds to PAR 07-143 "Research on Pathways Linking Environments, Behaviors and HIV/AIDS" by using innovative methods to examine the space-time patterns of HIV risk behaviors among injection drug users (IDUs) and HIV prevention services in the San Francisco Bay Area from 1987 to 2005. We propose to model the relationship among neighborhood characteristics, neighborhood HIV prevention services, and individual HIV risk behavior outcomes among IDUs. Research on HIV and illicit substance use has traditionally focused solely on individual-level characteristics that confer risk. Emerging research in the areas of HIV and illicit substance use has identified the importance of considering social environmental factors, including access to health care services, when studying individual health behaviors. The proposed study involves applying newly emergent spatial analytical methods to secondary datasets in order to refine the knowledge regarding how neighborhood characteristics might be associated with access to HIV prevention services and HIV risk among street-based IDUs. Our work will adapt the well-known Behavioral Model of Vulnerable Populations to incorporate a well-developed conceptualization of the spatial interaction between contextual variables and individual behavior. We have individual-level and HIV test data from 35,000 serial cross-sectional interviews among street-based IDUs from the Urban Health Study from 1987 to 2005. Other data to be used include archival data derived from the U.S. Census, the Census Neighborhood Change Database, HIV/AIDS reports, crime reports, and geocoded locations of HIV prevention services (including HIV testing sites, drug treatment programs, and syringe exchange programs). The specific aims include Specific Aim 1: To describe the geographic distribution of neighborhood characteristics, HIV prevention services, and HIV risk behaviors among street-based IDUs in San Francisco Bay Area census tracts over a 19-year period; and Specific Aim 2: To examine the statistical associations among neighborhood characteristics (e.g., neighborhood disadvantage or deprivation), HIV prevention services (e.g., drug treatment, syringe exchange, HIV testing) and HIV risk behaviors of IDUs (e.g., syringe sharing, unprotected sex) in the San Francisco Bay Area. Aim 1 will involve the creation of census-tract-level maps to illustrate the geographic distributions of key variables over time. Aim 2 will examine the cross-sectional and temporal associations among neighborhood characteristics, HIV prevention services, and HIV risk behaviors. Analytical methods will include multilevel selection bias models and spatial regression models. This project is among the first to utilize a rich set of geospatial contextual data in conjunction with a unique serial cross-section of 19 years of individual-level data, using advanced spatial analytic methods to better understand the relationships between contextual variables and HIV risk behaviors among street-based IDUs. PUBLIC HEALTH RELEVANCE: This project is among the first to utilize a rich set of geospatial contextual data in conjunction with a unique serial cross-section of 19 years of individual-level data, using advanced spatial analytic methods to better understand the relationships between contextual variables and HIV risk behaviors among street-based injection drug users (IDUs). This work will advance our methodological understanding of how best to study this population using cutting-edge methods that examine the spatial patterns of HIV risk behaviors and the relationship between neighborhood context and availability of HIV prevention services in metropolitan areas. The findings will benefit policy makers, service providers, and researchers.

描述（由申请人提供）：拟议的研究对第07-143款响应“有关将环境，行为和艾滋病毒/艾滋病联系起来的研究”，通过使用创新方法来检查注射吸毒者（IDUS）中的HIV风险行为（IDUS）（IDUS）和艾滋病毒预防服务中的艾滋病毒风险行为的时空模式，从1987年到2007年，我们之间的跨越跨越了2005年的企业，我们对企业进行了跨性别范围。 IDU中的结果。传统上，关于艾滋病毒和非法物质使用的研究仅关注赋予风险的个人级别特征。在研究个人健康行为时，在艾滋病毒和非法物质使用领域的新兴研究确定了考虑社会环境因素，包括获得医疗保健服务，包括获得医疗保健服务的重要性。拟议的研究涉及将新的新兴空间分析方法应用于辅助数据集，以完善有关邻里特征如何与街道基于街道的IDU中获得邻里特征与获得HIV预防服务和HIV风险相关的知识。我们的工作将适应易受攻击的人群的著名行为模型，以结合上下文变量与个人行为之间空间相互作用的发达概念化。我们从1987年至2005年的城市健康研究中的35,000个串行横截面访谈中提供了个人级别和HIV测试数据。其他数据包括在美国人口普查，人口普查邻里变更数据库，HIV/艾滋病/艾滋病报告，犯罪报告，犯罪报告和艾滋病毒预测计划（包括HIV预测计划）（包括HIV预测计划）（包括HIV预测计划）（包括HIV预测计划）（包括HIV预测计划）（包括HIV疗法）（包括HIV疗法）（包括HIV疗法）（包括HIV疗法）（包括HIV培训）（包括HIV的档案）。具体目的包括特定目的1：描述旧金山湾地区街头基于街道的IDU的邻里特征，艾滋病毒预防服务和艾滋病毒风险行为的地理分布，并在19年的时间内人口普查。和具体目的2：检查邻里特征（例如邻里劣势或剥夺）之间的统计关联，HIV预防服务（例如，IDUS的毒品治疗，注射器交换，HIV测试）和HIV风险行为（例如，Sanfrancisco Coco Bay区域）。 AIM 1将涉及创建人口普查提取级别地图，以说明随着时间的推移，关键变量的地理分布。 AIM 2将研究邻里特征，艾滋病毒预防服务和艾滋病毒风险行为之间的横断面和时间关联。分析方法将包括多级选择偏差模型和空间回归模型。该项目是最早使用高级空间分析方法来更好地了解上下文变量与街道基于街道IDU之间的上下文变量与HIV风险行为之间的关系的独特串行横截面，其中最早利用了丰富的地理空间上下文数据。公共卫生相关性：该项目是第一个利用丰富的地理空间上下文数据的项目之一使用先进的空间分析方法，结合了19年的个人级别数据的独特串行横截面，以更好地了解上下文变量与街头注入药物使用者（IDU）之间的上下文变量与HIV风险行为之间的关系。这项工作将提高我们对如何使用最佳研究该人群进行最佳研究的方法学理解，这些方法使用尖端的方法来研究艾滋病毒风险行为的空间模式以及大都市地区的邻里环境和艾滋病毒预防服务之间的关系。这些发现将使政策制定者，服务提供商和研究人员受益。