Understanding Pathways between Intimate Partner Violence and HIV risk for Men

了解男性亲密伴侣暴力与艾滋病毒风险之间的关系

• 批准号: 10320546
• 负责人: Erin M Kahle
• 金额: $ 74.99万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10320546
• 关键词: AIDS prevention; ATOD; Address; Behavioral; Behavioral Research; Biological; Biological Markers; Bisexual; Cohort Studies; Communities; Complex; Data; Epidemic; FOXP3 gene; Female; Foundations; Frequencies; Gays; HIV; HIV Infections; HIV Seronegativity; HIV risk; HLA-DR Antigens; Heterosexuals; IL2RA gene; Immune; Immune System Diseases; Immunologic Markers; Immunologics; Incidence; Interruption; Intervention; Knowledge; Link; Measures; Mediating; Michigan; Minority; Monitor; Outcome; Pathway interactions; Phase; Prevalence; Process; Recommendation; Recording of previous events; Regulatory T-Lymphocyte; Reporting; Research; Research Activity; Research Personnel; Risk; Risk Behaviors; Role; Sampling; Sex Behavior; Shapes; Social support; Stress; Structure; Theoretical model; Time; Trauma; United States National Institutes of Health; Victimization; Violence; Woman; alcohol, tobacco, and other drug use; behavioral response; biological adaptation to stress; cohort; coping; design; emotional abuse; experience; inattention; innovation; intimate partner violence; male; men; men who have sex with men; perpetrators; prospective; psychological distress; psychosocial; recruit; resilience; sexual violence; social factors; social stigma; stressor; substance use; synergism; therapy development; violence victimization

PROJECT SUMMARY/ABSTRACT There is increasing evidence that gay, bisexual and other men who have sex with men (GBMSM) experience dual epidemics of HIV and intimate partner violence (IPV), yet understanding of the synergies between these two epidemics is underdeveloped. Estimated prevalence for receipt of IPV among GBMSM range from 12% to 78%. Emergent evidences demonstrates associations between the experience of IPV among GBMSM and participation in risk behaviors that heighten the risk of HIV (i.e. substance use). Beyond the indirect behavioral associations between IPV and HIV, less is known about direct pathways through which IPV may increase HIV acquisition risk among GBGBMSM. According to Schafer’s theoretical model, IPV not only contributes to behavioral risk, but also to immunologic change that impacts HIV risk – but all of this evidence comes from studies of heterosexual women. With the identification of HIV-specific immunologic dysfunction associated with IPV, we are able to further investigate upstream factors, including minority stressors that may contribute to such changes, as well as protective measures such as coping and resiliency processes. We hypothesize that experiences of IPV (including victimization, perpetration, and bi-directional IPV), in the context of minority stress, increases both indirect behavioral (sexual behavior, substance use), and direct biological (STI) and immunologic risks for HIV infection among GBMSM. To fill the critical gap in knowledge, we propose an innovative 24-month cohort study of partnered HIV-negative GBMSM in SE Michigan, to identify the pathways and points of intervention between IPV and HIV risk for GBMSM. Prior research is limited by cross-sectional designs, inconsistent measures of violence, and inattention to important psychosocial and structural factors that co-occur with both IPV and HIV, and may moderate or mediate relationships. We address these limitations by employing a rigorous cohort design, measures of IPV that are specific for GBMSM, considering the role of IPV victimization, perpetration and bi-directional IPV, and consider the multiple minority stressors and stress response behaviors that may shape both IPV and HIV risk behaviors, and measure indicators of HIV-specific immunologic dysfunction, biological risk (STI) and behavioral risk. The proposed research activities include a prospective 24- month cohort of 360 HIV-negative partnered GBMSM (>18 years) recruited in SE Michigan. The overall aim of the proposed activities is to provide new knowledge of how victimization or perpetration of IPV shapes engagement in HIV prevention and risk behaviors.

项目概要/摘要 越来越多的证据表明同性恋、双性恋和其他男男性行为者 (GBMSM) 经历着双重经历 艾滋病毒和亲密伴侣暴力 (IPV) 的流行，但了解这两者之间的协同作用 GBMSM 中的 IPV 感染率估计为 12% 至 78%。 新证据表明 GBMSM 的 IPV 体验与参与之间存在关联 增加艾滋病毒风险的危险行为（即物质使用）。 IPV 和 HIV 之间的关系，对于 IPV 可能增加 HIV 感染的直接途径知之甚少 根据 Schafer 的理论模型，IPV 不仅会导致行为风险， 还涉及影响艾滋病毒风险的免疫变化——但所有这些证据都来自以下研究 随着异性恋女性与 IPV 相关的 HIV 特异性免疫功能障碍的确定，我们 能够进一步调查上游因素，包括可能导致这种情况的少数压力源 变化，以及应对和弹性流程等保护措施。 在少数群体压力的背景下，IPV（包括受害、犯罪和双向 IPV）的增加 间接行为（性行为、物质使用）以及直接生物（STI）和免疫风险 GBMSM 中的 HIV 感染为了填补这一知识空白，我们提出了一个创新的 24 个月队列。 在密歇根州东南部开展 HIV 阴性 GBMSM 合作研究，以确定干预途径和要点 GBMSM 的 IPV 和 HIV 风险之间的关系 先前的研究受到横断面设计的限制，不一致。 暴力措施以及对同时发生的重要社会心理和结构因素的忽视 IPV 和 HIV，并且可以通过采用严格的方法来缓和或调解关系。 队列设计，针对 GBMSM 的 IPV 测量，考虑 IPV 受害的作用， 实施和双向IPV，并考虑多种少数压力源和压力反应行为 可能会影响 IPV 和 HIV 风险行为，并测量 HIV 特异性免疫学指标 拟议的研究活动包括前瞻性 24- 在密歇根州东南部招募的 360 名 HIV 阴性伴侣 GBMSM（> 18 岁）月队列的总体目标。 拟议的活动旨在提供有关 IPV 受害或犯罪如何形成的新知识 参与艾滋病毒预防和危险行为。