Community Factors, HIV and Related Health Outcomes in Men Who Have Sex With Men

男男性行为者的社区因素、艾滋病毒和相关健康结果

• 批准号: 8097311
• 负责人: BERYL A KOBLIN
• 金额: $ 56.36万
• 依托单位: NEW YORK BLOOD CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8097311
• 关键词: Accounting; Address; Affect; Alcohol consumption; Alcohol or Other Drugs use; Area; Attention; Behavior Therapy; Bisexual; Characteristics; Clinic; Communities; Community Developments; Consultations; Crime; Cross-Sectional Studies; Data; Data Reporting; Databases; Development; Discrimination; Disease; Disease Outcome; Drug usage; Enrollment; Environment; Ethnic Origin; Gays; HIV; HIV Infections; Health; Health Professional; Health behavior; Height; Heterosexuals; Household; Household Heads; Individual; Intervention; Interview; Investigation; Lead; Lesbian; Long-Term Effects; Maps; Measurement; Measures; Mental Depression; Methods; Modeling; Neighborhoods; New York City; Outcome; Outcome Study; Participant; Pattern; Perception; Personal Satisfaction; Phase; Policies; Policy Developments; Policy Maker; Population; Poverty; Prevention; Qualitative Methods; Race; Recruitment Activity; Research; Research Personnel; Resources; Risk; Risk Behaviors; Risk Factors; Role; Sampling; Series; Services; Sex Behavior; Sexual Partners; Sexually Transmitted Diseases; Shapes; Social Disorganizations; Socioeconomic Status; Staging; Surface; Surveys; Testing; Time; Translations; Variant; Washington; Work; analytical method; base; density; design; experience; member; men; men who have sex with men; neighborhood association; outreach; prevention service; response; sex; sex risk; social; transgender

DESCRIPTION (provided by applicant): Previous research has identified individual-level and situation-specific risk factors for sexual risk behaviors among men who have sex with men (MSM), with substance use and depression having a particularly adverse impact. HIV behavioral interventions have shown reductions in sexual risk behaviors among MSM, but there are a limited number of efficacious interventions and most do not address multi-level factors which could affect risk behaviors. Research has shown that neighborhood characteristics influence disease outcomes and health behaviors. Our preliminary data suggest that neighborhood does matter for sexual risk among MSM. Our results lead to further questions as to the specific effects of where men reside (residential neighborhood) and where men spend most of their time socializing (social neighborhood) on sexual risk behaviors, substance use and depression. The purpose of this multi-level, cross sectional study is to identify key neighborhood-level characteristics that may influence sexual risk behaviors, substance use and depression among MSM. The specific aims of this study are to: 1) identify neighborhood characteristics that MSM consider likely to influence their sexual behavior, substance use and depression, using qualitative methods, to inform our measures; 2) characterize neighborhood variation in sexual risk behaviors, substance use and depression among MSM using quantitative methods; 3) characterize the associations between objectively measured neighborhood-level characteristics and risk behaviors, substance use and depression among MSM after accounting for individual level factors; 4) characterize the associations between perceived neighborhood-level characteristics and risk behaviors, substance use and depression among MSM after accounting for individual level factors; and 5) determine the role of individual-level characteristics in shaping perceptions of neighborhood and modifying the influence of neighborhood characteristics on risk behaviors, substance use and depression among MSM. To achieve these aims, we will enroll a geographically and ethnically diverse sample of 1500 MSMs in New York City. Participants will provide information via ACASI on their sexual risk behaviors and substance use and depression, perceptions of residential and social neighborhoods and individual-level covariate data. Using data reported by participants, spatial analytical methods will be used to create surface density maps of neighborhood characteristics. This will be added to information from an existing extensive geospatial database of New York City neighborhood characteristics for a comprehensive picture of relevant urban characteristics. Key hypotheses will be tested using multi-level hierarchical modeling to capture independent neighborhood level effects. The results will add new information to a growing understanding of whether and how the urban environment influences sexual risk behaviors, substance use and depression and may have direct implications for design of structural, community-based and outreach interventions for MSM. PUBLIC HEALTH RELEVANCE: The purpose of this study is to identify key characteristics of neighborhoods and perceptions of neighborhoods within urban environments that may influence sexual risk behaviors, drug and alcohol use and depression among men who have sex with men. This study will have direct implications for the design of structural, community-based and outreach interventions for men who have sex with men.

描述（由申请人提供）：先前的研究已经确定了男男性行为者（MSM）中性危险行为的个体水平和特定情况的风险因素，其中药物滥用和抑郁症具有特别不利的影响。艾滋病毒行为干预措施已显示男男性行为者中性危险行为的减少，但有效的干预措施数量有限，而且大多数都没有解决可能影响危险行为的多层次因素。研究表明，社区特征会影响疾病结果和健康行为。我们的初步数据表明，邻里关系确实对男同性恋者的性风险很重要。我们的研究结果引发了进一步的问题，即男性居住的地方（住宅区）以及男性大部分时间社交的地方（社交社区）对性危险行为、药物滥用和抑郁症的具体影响。这项多层次、横断面研究的目的是确定可能影响 MSM 中性危险行为、药物滥用和抑郁症的关键社区特征。本研究的具体目的是：1）使用定性方法，确定 MSM 认为可能影响其性行为、物质使用和抑郁的社区特征，为我们的措施提供信息； 2) 使用定量方法描述 MSM 中性危险行为、物质使用和抑郁的邻里差异； 3) 在考虑个人水平因素后，描述客观测量的邻里水平特征与 MSM 中的危险行为、物质使用和抑郁之间的关联； 4) 在考虑个人层面因素后，描述 MSM 中感知到的邻里层面特征与风险行为、物质使用和抑郁之间的关联； 5) 确定个人层面的特征在塑造邻里认知以及改变邻里特征对 MSM 的危险行为、物质使用和抑郁的影响方面的作用。为了实现这些目标，我们将在纽约市招募 1500 名来自不同地域和种族的 MSM 样本。参与者将通过 ACASI 提供有关其性风险行为、药物滥用和抑郁症、对住宅和社会社区的看法以及个人层面协变量数据的信息。使用参与者报告的数据，空间分析方法将用于创建邻域特征的表面密度图。这些信息将被添加到现有的纽约市社区特征的广泛地理空间数据库中，以全面了解相关城市特征。将使用多级分层模型来测试关键假设，以捕获独立的邻里级效应。研究结果将为人们进一步了解城市环境是否以及如何影响性危险行为、药物滥用和抑郁症提供新的信息，并可能对 MSM 的结构性、基于社区和外展干预措施的设计产生直接影响。公共卫生相关性：本研究的目的是确定城市环境中可能影响男男性接触者的性危险行为、毒品和酒精使用以及抑郁症的社区关键特征和社区观念。这项研究将对针对男男性行为者的结构性、基于社区的和外展干预措施的设计产生直接影响。