A Mixed Methods Evaluation of Violence, Substance Use, and HIV Risk Among a Vulnerable Population of Male Couples

男性夫妇弱势群体中的暴力、药物使用和艾滋病毒风险的混合方法评估

• 批准号: 10546172
• 负责人: Madison Shea Smith
• 金额: $ 6.02万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10546172
• 关键词: AIDS prevention; Address; Agreement; Alcohols; Appointment; Area; Award; Buffers; Cannabis; Clinical; Clinical Investigator; Collaborations; Communication; Competence; Complex; Couples; Data; Data Analyses; Development; Distress; Environment; Evaluation; Exclusion Criteria; Fellowship; Foundations; Funding; Future; Goals; Grant; HIV; HIV Infections; HIV Seropositivity; HIV risk; HIV-1; Health; Heterosexuals; Illicit Drugs; Individual; Institutes; Intervention; Interview; Knowledge; Lead; Link; Literature; Mentorship; Methods; Mission; Modeling; National Institute of Drug Abuse; Participant; Pathway interactions; Patient Self-Report; Personal Satisfaction; Postdoctoral Fellow; Prevention; Prevention program; Process; Publications; Qualitative Methods; Qualitative Research; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Resources; Risk; Risk Behaviors; Safety; Sampling; Science; Scientist; Sexual and Gender Minorities; Sum; Testing; Training; Translating; United States National Institutes of Health; Universities; Unmarried person; Victimization; Violence; Vulnerable Populations; Work; arm; base; career; cisgender; co-infection; comorbidity; condomless anal sex; condoms; experience; gender minority health; in vivo; indexing; innovation; knowledge base; male; male couples; men; men who have sex with men; multilevel analysis; novel; partner aggression; pre-exposure prophylaxis; prevent; preventive intervention; programs; psychosocial; recruit; sex; skills; substance use; therapy development; tool; translational pipeline

Project Summary: A large proportion of new HIV infections occur in the context of primary partnerships among men who have sex with men (MSM), who are themselves disproportionately vulnerable to HIV, suggesting a need to study factors that contribute to this disparity. Intimate partner aggression (IPA) and substance use (SU) are two such factors that are strongly associated with HIV risk behaviors within primary partnerships (e.g., condomless anal sex, breaks in monogamy/non-monogamy relationship agreements), but despite robust evidence that the effects of IPA and SU likely overlap in their influence on HIV risk, formative knowledge on how IPA and SU predict HIV risk in tandem remains missing. This gap in the literature critically limits the foundational knowledge base by which couple-based interventions (which have shown promise in preventing HIV among MSM) can be developed, tested, and optimized. The proposed mixed methods research will: a) conduct complex, multi-level analyses to disentangle the individual, interactive, and dyadic effects of IPA and SU among a large sample of male couples (Aim 1; N=728 couples), and b) collect qualitative data via in-depth interviews to contextualize quantitative effects using the lived experience of men in relationships with other men (N=35) experiencing IPA/SU (Aim 2). Key determinants of risk from quantitative, secondary data analyses (Aim 1) and qualitative, primary data analyses (Aim 2) will be compared to existing interventions to identify prevention gaps and formative targets for future development. The research arm of the present proposal is an ideal fit for the NIH mission since it will document novel pathways to HIV risk among MSM and support future proposals aimed at translating present findings into novel HIV prevention targets -- a critical next step. Although the applicant possesses existing foundational competencies in couple research, psychosocial determinants of health, and advanced quantitative methods, these skills have been accrued via research with cisgender and heterosexual couples. This fellowship will therefore support her in gaining critical new competencies in HIV research, qualitative methods, grantsmanship/publication, and sexual and gender minority (SGM) health by releasing her from grant-related responsibilities currently funding her post-doc appointment. These training and experiential research activities will imbue the applicant with the tools to grow her program of research among male couples and advance towards a career as a NIH-funded independent clinical scientist. Northwestern University’s Institute for Sexual and Gender Minority Health and Wellbeing (ISGMH) is an ideal environment for this fellowship because of the suite of technical, mentorship, intellectual, and instrumental resources it affords to early career researchers. Thus, ISGMH and the present proposal will interact to support the applicant in progressing towards her long-term career goals by providing avenues through which she can gain critical skills, forge collaborations, seek additional funding, and disseminate findings.

项目摘要： 大部分新的艾滋病毒感染发生在发生性行为的男性主要伙伴关系的背景下 与男性（MSM），他们本身不成比例地遭受艾滋病毒的伤害，这表明需要研究因素 这导致了这种差异。亲密的伴侣侵略性（IPA）和药物使用（SU）是两个这样的因素 与主要伙伴关系内的艾滋病毒风险行为密切相关（例如，无避孕套肛交， 一夫一妻制/非婚姻关系协议中断），但dospite有力的证据表明 IPA和SU可能会重叠他们对HIV风险的影响，IPA和SU如何预测HIV的形成性知识 串联的风险仍然缺失。文献中的这一差距严重限制了基础知识基础 哪些基于夫妇的干预措施（在预防MSM中预防HIV有望）可以是 开发，测试和优化。提出的混合方法研究将：a）进行复杂的多层次 分析IPA和SU的个体，互动和二元效应，以分析大量样本 男性夫妻（目标1; n = 728对夫妇），b）通过深入的访谈收集定性数据以进行上下文化 使用男人的现场经验与其他男人的关系（n = 35）经验的定量效果（n = 35） IPA/SU（AIM 2）。来自定量，二级数据分析（AIM 1）和定性的关键风险决定者， 将主要数据分析（AIM 2）与现有干预措施进行比较，以识别预防差距和 未来发展的形成目标。本提案的研究部门非常适合NIH 使命是因为它将记录MSM中的新颖艾滋病毒风险途径，并支持针对未来的提案 将目前的发现转化为新型的HIV预防目标 - 至关重要的下一步。虽然是申请人 在夫妇研究，健康的心理社会决定者和 先进的定量方法，这些技能已通过Cisgender和异性恋进行了研究 夫妻。因此 定性方法，赠款/出版物以及性别和性别少数族裔（SGM）健康 目前从与赠款相关的责任关系中资助了她的大约任命。这些培训和专家 研究活动将使申请人拥有在男性夫妻中发展她的研究计划的工具 并迈向了一名拥有NIH资助的独立临床科学家的职业。西北大学 性和性别少数民族健康与福祉研究所（ISGMH）是理想的环境 奖学金是因为它提供了技术，心态，智力和工具资源的套件 早期职业研究人员。那就是ISGMH和本提案将互动以支持申请人 通过提供可以获得关键技能的途径，朝着她的长期职业目标迈进 锻造合作，寻求额外的资金并传播发现。