Structural Influences on Methamphetamine Use among Black Gay and Bisexual Men in Atlanta

亚特兰大黑人男同性恋和双性恋男性吸食甲基苯丙胺的结构性影响

• 批准号: 10631104
• 负责人: Sophia A. Hussen
• 金额: $ 69.41万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10631104
• 关键词: Bisexual; Black American; Black Populations; Black race; Censuses; Climate; Communities; Data; Destinations; Development; Discrimination; Disparity population; Ecological momentary assessment; Economics; Educational workshop; Environment; Epidemic; Ethnography; Exposure to; Foundations; Freedom; Gays; General Population; Goals; Harm Reduction; Health; Health Services Accessibility; Healthcare; Homelessness; Housing; Income; Individual; Intervention; Interview; Knowledge; Lead; Lesbian Gay Bisexual Transgender; Link; Location; Longitudinal cohort study; Maps; Measures; Mediating; Mediator; Mental Health; Methamphetamine; Methamphetamine prevention; Methamphetamine use disorder; Methods; Participant; Pathway interactions; Personal Satisfaction; Persons; Pharmaceutical Preparations; Population; Prevention; Public Health; Race; Reporting; Research; Risk; Science; Services; Social Work; Social status; Structural Racism; Surveys; System; Technology Assessment; United States; United States National Institutes of Health; Walking; Work; behavior change; cohort; community engaged research; community organizations; comorbidity; design; dynamic system; examination questions; experience; follow-up; health inequalities; homonegativity; housing instability; improved; innovation; insight; men; men who have sex with men; methamphetamine use; model building; outcome disparities; prevent; prospective; recruit; residential segregation; response; segregation; service providers; social; social vulnerability; substance use treatment

PROJECT SUMMARY Emerging data demonstrates a rise in methamphetamine (meth) use among Black gay, bisexual and other men who have sex with men (GBMSM). Meth is associated with myriad physical and social harms, and has the potential to exacerbate existing health inequities impacting Black GBMSM. Existing meth prevention and treatment interventions do not address the unique social position of Black GBMSM or the related health impacts of structural racism and discrimination (SRD). Based on our preliminary studies, we hypothesize that four forms of SRD are likely to influence meth use among Black GBMSM: housing discrimination, gentrification, racial and income segregation, and discriminatory LGBT community climate. Additionally, we posit that these forms of SRD operate through housing instability and inadequate service access to increase risk for meth use among Black GBMSM. The goal of this project is to generate knowledge that will inform the design of multi- level, culturally congruent structural approaches to prevent meth use and associate harms among Black GBMSM. Our study will be based in Atlanta, Georgia – an ideal setting to examine these questions given the cultural significance for Black Americans, large population of Black GBMSM, and recent SRD-related demographic shifts. Drawing on the risk environment framework as its theoretical foundation, this study will pursue three specific aims: (1) to examine the impacts of census-tract level measures of SRD on housing instability, service access and meth use among Black GBMSM in Atlanta; (2) to elicit narratives of meth use, housing instability, service access and SRD among Black GBMSM; and (3) to examine systems of structural influence and develop qualitative causal maps linking various forms of SRD, service access, housing and meth use among Black GBMSM. For the first aim, we will recruit N=300 Black GBMSM into a longitudinal cohort study, and conduct serial surveys every 6 months over a two-year follow-up period. Additional location and meth use data will be obtained monthly using ecological momentary assessment technology. Individual survey responses will be linked to geolocated census-tract level measures of SRD and service access. For the second aim, we will conduct a longitudinal qualitative study including in-depth interviews and walking ethnographies with N=40 cohort participants, to gather insights on their experiences with SRD, housing, service access and meth use. For the third aim, we will use a community-based system dynamics approach to convene a group model building workshop with key stakeholders (N=25), which will lead directly to the development of causal maps that will inform structural interventions. The proposed research is highly significant because of its potential to inform effective structural strategies for preventing meth use and ameliorating meth-related harms among Black GBMSM.

项目摘要 新兴数据表明，黑人同性恋，双性恋和其他 与男人发生性关系的人（GBMSM）。 潜力加剧影响黑色GBMSM的健康健康不平等 治疗干预措施不会增加黑色GBMSM或相关健康的独特社会地位 基于我们的原始研究的结构种族主义和公开的影响 四种形式的SRD可能会影响黑色的甲基苯丙胺使用 种族和收入隔离以及歧视性的LGBT社区气候。 Srd的形式运营Thuce House住房不稳定和服务服务不足的服务访问Methe使用风险 在黑色GBMSM中。 级别，在文化上恭喜您可以防止黑色的使用和关联危害 GBMSM。我们的研究将位于佐治亚州亚特兰大 - 鉴于 黑人美国人，大量黑人GBMSM和最近与SRD有关的文化意义 人口统计学的变化是理论基础的风险环境框架 追求三个具体目的：（1）检查SRD的人口普查水平措施对住房的影响 亚特兰大的黑色GBMSM之间的不稳定性，服务访问和甲基苯丙胺的使用； 黑色GBMSM中的房屋不稳定性，服务访问和SRD； 影响和开发定性因果地图，将各种形式的SRD，服务访问，住房和甲基苯丙胺联系起来 在黑色GBMSM中使用。 在两年的随访期间进行研究，每6个月进行连续调查 使用生态瞬时评估技术将获得甲基苯丙胺的使用数据 响应将链接到第二个SRD的地理普查水平衡量标准 目的，我们将进行纵向定性研究 n = 40个队列参与者，以了解他们在SRD，住房，服务访问和 甲基苯丙胺用于第三个目标，我们将使用社区的系统动态 使用关键股权持有人（n = 25）的模型建造车间，这将直接导致因果关系的发展 将为结构介入的地图提供了启动的研究。 潜力为预防甲基甲基甲基甲基甲基甲基甲基甲基甲基甲基甲基甲基甲基甲基相关危害提供有效的结构策略 在黑色GBMSM中。