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.

项目概要 新数据显示，黑人同性恋、双性恋和其他群体中冰毒的使用有所增加 男男性行为者 (GBMSM) 与多种身体和社会危害有关，并且具有 可能会加剧现有的健康不平等，影响黑人 GBMSM 的现有预防和治疗。 治疗干预措施没有解决黑人 GBMSM 的独特社会地位或相关健康问题 根据我们的初步研究，我们参与了结构性种族主义和歧视（SRD）的影响。 四种形式的 SRD 可能会影响黑人 GBMSM 中的冰毒使用：住房歧视、中产阶级化、 种族和收入隔离，以及歧视性 LGBT 社区氛围。 各种形式的SRD通过住房不稳定和服务获取不足来运作，从而增加冰毒使用风险 该项目的目标是产生可为多设计提供信息的知识。 水平、文化上一致的结构性方法，以防止黑人使用冰毒和相关危害 GBMSM。我们的研究将在佐治亚州亚特兰大进行——鉴于以下情况，这里是研究这些问题的理想场所。 对美国黑人的文化意义、大量黑人 GBMSM 以及最近与 SRD 相关的 本研究以风险环境框架为理论基础。 追求三个具体目标：(1) 研究人口普查区层面的SRD措施对住房的影响 亚特兰大黑人 GBMSM 的不稳定、服务获取和冰毒使用情况；(2) 引出冰毒使用情况的叙述， 黑人 GBMSM 的住房不稳定、服务获取和 SRD；以及 (3) 检查结构体系； 影响并制定将各种形式的SRD、服务获取、住房和方法联系起来的定性因果图 对于第一个目标，我们将招募 N=300 名黑人 GBMSM 进入纵向队列。 研究，并在两年的随访期内每 6 个月进行一次系列调查。 冰毒使用数据将利用生态瞬时评估技术每月获得。 对于第二个问题，答复将与地理定位的人口普查层面的 SRD 和服务获取衡量指标挂钩。 目标，我们将进行纵向定性研究，包括深度访谈和步行民族志 与 N = 40 名队列参与者一起，收集有关他们在 SRD、住房、服务获取和 对于第三个目标，我们将使用基于社区的系统动力学方法来召集一个小组。 与主要利益相关者（N = 25）举行模型构建研讨会，这将直接导致因果关系的发展 为结构性干预措施提供信息的地图因其重要性而非常重要。 为预防冰毒使用和减轻冰毒相关危害提供有效的结构性战略的潜力 在黑人 GBMSM 中。