Understanding the Role of Power in Drug Use and HIV Risk Behaviors Among Non-Inje

了解权力在非注入者吸毒和艾滋病毒风险行为中的作用

• 批准号: 7841908
• 负责人: ROBERT Edwin BOOTH
• 金额: $ 15.65万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-15 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7841908
• 关键词: AIDS diagnosis; Accident and Emergency department; Accounting; Address; Admission activity; Attention; Behavior; Behavioral; Centers for Disease Control and Prevention (U.S.); Clinic; Clinical Trials; Community Health; Complex; Controlled Clinical Trials; Data; Decision Making; Development; Diagnosis; Drug abuse; Drug usage; Drug user; Educational Background; Empirical Research; Epidemic; Female; Focus Groups; Future; Grant; HIV; Heterosexuals; Illicit Drugs; Individual; Infection; Intervention; Interview; Investigation; Latina; Measures; Methamphetamine; Methods; Mosses; Nature; Phase; Population; Population Attributable Risks; Prevalence; Preventive Intervention; Property; Psychometrics; Public Health; Recording of previous events; Recruitment Activity; Research; Research Personnel; Respondent; Risk; Risk Behaviors; Risk Estimate; Role; Route; Sampling; Sex Behavior; Smoking; Structure; Testing; The Sun; United States; United States Substance Abuse and Mental Health Services Administration; Virus Diseases; Visit; Vulnerable Populations; Woman; base; condoms; consistent condom use; contextual factors; drug of abuse; effective intervention; farmer; high risk; high risk sexual behavior; innovation; instrument; instrumentation; men; men who have sex with men; non-drug; psychosocial; public health relevance; satisfaction; sex risk; sexual relationship; sexual violence; theories; trend

DESCRIPTION (provided by applicant): Infection with the Human Immunodeficiency Virus (HIV) is an increasing public health concern among women. At the beginning of the HIV epidemic relatively few women were infected. However, women currently comprise over a quarter of new diagnoses and the primary mode of infection is heterosexual contact (CDC, 2006). Methamphetamine (MA) is a drug of abuse that has been shown to increase sexual risk behaviors among women (Klee, 1993; Lorvick, Martinez, & Laurne, 2006; Molitor, Truaz, Ruiz, & Sun, 1998; Rawson, Washton, Domier, & Reiber, 2002; Semple, Grant, & Patterson, 2004) and unlike other illicit drugs women appear to be using MA in equal portions to men (Cardona, 2007). Current data indicate that women account for 40% of stimulant related emergency department visits and 45% of MA treatment admissions in the United States (SAMHSA, 2004). Researchers are increasingly recognizing the importance of contextual factors, including power, as essential to understanding HIV risk behaviors among women (Amaro, 1995; Bourgois, 1995; Bourgois, Prince, & Moss, 2004; Epele, 2002; Farmer, Connors, & Simmons, 1996; Gomez & Marin, 1996; Kershaw et al., 2006; Wingood & Di Clemente, 2000; Wingood & DiClemente, 2002). However, few empirical studies have investigated power and its relationship to HIV risk behaviors among drug using women. This study proposes to draw upon structural, psychosocial and behavioral theories to guide the understanding of power among a sample of non-injecting female MA users. The aim of this project is to better understand how power impacts female MA users in relation to drug abuse and HIV-related sex risk behaviors. Through using mixed methods this grant will address the following aims: 1) to understand and describe the multi-level power issues that are salient for MA using women; 2) to modify the SRPS that assesses interpersonal power for this population and to operationalize three additional levels of power (structural, cultural and individual); 3) to assess preliminary psychometric properties of the modified power scale; 4) to explore the prevalence of power issues in this population and their relationship to drug use and HIV-related sex risk behaviors; and 5) to identify intervention strategies that will target the salient levels of power for this population. To date, methodological and empirical research on power is limited and there are no empirical studies of power with MA using women. The preliminary development of an innovative measure to assess power dynamics among MA using women is necessary in order to obtain further empirical information on the relationship between multiple levels of power, drug use and HIV sex risk behaviors. Future research would include validating this scale among other subpopulations and using information from the study to develop an HIV prevention intervention for out-of treatment MA using women that is founded on a multi-level theory of power that could be tested in a larger clinical control trial. PUBLIC HEALTH RELEVANCE: With the increase of HIV infection among women and the prevalence of high risk sex behaviors among methamphetamine (MA) using women, researchers must strive to better understand contextual issues that impact risk behaviors among this population. Through using mixed methods, this study proposes to operationalize and develop a scale to assess power issues for this population on four levels: structural, cultural, interpersonal and individual and to identify relevant intervention strategies to impact the salient levels of power. Future research would include validating this scale among other subpopulations and using information from the study to develop an HIV prevention intervention founded on multi-level theory of power that could be tested in a larger clinical control trial.

描述（由申请人提供）：感染人类免疫缺陷病毒（HIV）是妇女越来越多的公共卫生问题。在艾滋病毒流行病开始时，相对较少的女性被感染。但是，目前，妇女构成了四分之一的新诊断，主要感染方式是异性恋接触（CDC，2006年）。甲基苯丙胺（MA）是一种滥用药物，已被证明会增加女性的性风险行为（Klee，1993; Lorvick，Martinez和Laurne，＆Laurne，2006; Molitor，Truaz，Ruiz，＆Sun，1998; Rawson，Washton，Washton，Domier，Domier，＆Reiber and Semple，2002; Semple，Grants＆Patterson，＆Patterson，＆Patterson，＆Patterson，＆Patterson，＆Patterson，2004年度的不属性） （Cardona，2007）。当前数据表明，妇女占相关急诊室就诊的40％，在美国占45％的MA治疗入院（Samhsa，2004年）。 Researchers are increasingly recognizing the importance of contextual factors, including power, as essential to understanding HIV risk behaviors among women (Amaro, 1995; Bourgois, 1995; Bourgois, Prince, & Moss, 2004; Epele, 2002; Farmer, Connors, & Simmons, 1996; Gomez & Marin, 1996; Kershaw et al., 2006; Wingood & Di Clemente, 2000; Wingood & Diclemente，2002年）。但是，很少有实证研究调查了使用女性药物中的权力及其与艾滋病毒风险行为的关系。这项研究建议借鉴结构，社会心理和行为理论，以指导对非注射女性MA使用者样本中权力的理解。该项目的目的是更好地了解权力如何影响女性MA使用者与药物滥用和与HIV相关的性风险行为的影响。通过使用混合方法，该赠款将解决以下目的：1）理解和描述使用女性MA的多级功率问题； 2）修改评估该人群人际交往能力的SRP，并运行另外三个级别的权力（结构，文化和个人）； 3）评估改良功率量表的初步心理测量特性； 4）探讨该人群中权力问题的流行及其与毒品使用和与HIV相关的性风险行为的关系； 5）确定将针对该人群的显着权力水平的干预策略。迄今为止，对权力的方法论和实证研究是有限的，并且没有使用女性对MA进行权力的经验研究。为了获得有关多个权力，药物使用和艾滋病毒性风险行为之间关系的进一步经验信息，必须进一步的经验信息来评估MA中使用MA之间的权力动态的创新措施的初步发展。未来的研究将包括验证该量表和其他亚群，并使用研究的信息，使用基于多级权力理论建立的女性为治疗外的MA开发HIV预防干预措施，该理论可以在更大的临床控制试验中进行测试。 公共卫生相关性：随着妇女艾滋病毒感染的增加以及使用妇女甲基苯丙胺（MA）之间高风险性行为的流行，研究人员必须努力更好地理解影响该人群风险行为的上下文问题。通过使用混合方法，本研究提议操作和开发一个规模，以评估该人群的四个层面：结构，文化，人际和个人，并确定相关的干预策略以影响显着的权力水平。未来的研究将包括验证该量表和其他亚群，并使用研究中的信息来开发基于多层次权力理论建立的HIV预防干预措施，该理论可以在更大的临床控制试验中进行测试。