The role of mental health, support and coping on the HIV risk protective and prom

心理健康、支持和应对对艾滋病毒风险保护和预防的作用

• 批准号: 7842811
• 负责人: DAVID J. MALEBRANCHE
• 金额: $ 38.78万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7842811
• 关键词: AIDS prevention; Address; Africa; African; African American; Age; Age Factors; Alcohol or Other Drugs use; Alcohols; Anal Sex; Anus; Area; Behavior; Behavioral; Caribbean region; Centers for Disease Control and Prevention (U.S.); Cognitive; Conflict (Psychology); Country; County; Demographic Factors; Development; Digit structure; Epidemic; Ethnic Origin; Focus Groups; Future; Gender Role; Geographic Locations; Geography; Goals; HIV; Health; High Prevalence; Human immunodeficiency virus test; Intervention; Interview; Knowledge; Life; Link; Literature; Measurement; Mediating; Mental Health; Methods; Modeling; Outcome; Participant; Phase; Population; Population Intervention; Prevention Research; Price; Public Health; Qualitative Methods; Race; Research; Risk; Risk Behaviors; Rivers; Role; Sampling; Sex Behavior; Sex Orientation; Sexual Partners; Social Environment; Socioeconomic Status; Stress; Surveys; Testing; United States; Unsafe Sex; Vagina; Woman; Work; consistent condom use; coping; depression; experience; improved; information gathering; innovation; member; men; men who have sex with men; metropolitan; nonmetropolitan area; protective behavior; public health relevance; racism; sex; sex risk; social

DESCRIPTION (provided by applicant): HIV is disproportionately impacting Black men in the South, and the role of mental health determinants (e.g., perceived stress, depression, gender role conflict) and culturally-specific coping strategies (e.g., John Henryism, Cool Pose items) in this epidemic has been understudied. We plan to examine a socially and demographically diverse group of Black men living in three distinct metropolitan statistical areas (MSA) in Georgia (metropolitan Atlanta, Columbus and Valdosta), and examine how mental health determinants and culturally-specific coping strategies influence their HIV risk promoting (unprotected vaginal/anal sex, multiple sexual partners) and protective (consistent condom use, recent HIV testing) behaviors. Our proposal hypothosizes that mental health determinants will mediate the effects of demographic factors on HIV risk promoting and protective behavior. The study's specific aims are to: 1) Explore how the social context of mental health determinants and culturally-specific coping strategies factor in the lives of Black men and influence their HIV risk promoting and protective behaviors; 2) Assess how mental health determinants and culturally-specific coping strategies predict the HIV risk promoting and protective behaviors of Black men; 3) Examine how mental health determinants mediate the relationship between social (e.g., racism experiences, SES) & demographic (e.g., MSA, age) factors and HIV risk promoting and protective behaviors of Black men; and 4) Investigate how culturally-specific coping strategies of Black men moderate the relationship between mental health determinants and their HIV risk promoting and protective behaviors To achieve these objectives, we will be employing a mixed-methods approach, involving: 1) qualitative one-on-one interviews with 90 men to gain a culturally grounded understanding of the mental health determinants and culturally-specific coping strategies in these men's lives (Phase I); 2) focus groups, cognitive interviews and pilot testing with 30 men to develop survey items from Phase I findings; and 3) quantitative surveys using random digit-dialing (RDD) methods with 1200 participants to test associations between these domains and sexual behavior and HIV testing outcomes (Phase II). Our long term goals are to identify and understand the unique cultural determinants of the mental health and coping strategies among Black men in Georgia that will inform future HIV prevention initiatives. PUBLIC HEALTH RELEVANCE: This project is particularly relevant to public health as it will provide both qualitative and quantitative information on the influence of mental health determinants (e.g., perceived stress, depression and gender role conflict) and culturally-specific coping strategies (e.g. John Henryism, Cool Pose items) on the HIV risk promoting (unprotected vaginal/anal sex, multiple sexual partners) and protective (consistent condom use, recent HIV testing) behaviors among a socially and demographically diverse sample of Black men in Georgia. Despite the high prevalence of HIV among all Black men in this county, few studies have conducted studies outside of predominantly metropolitan and MSM samples of Black men. The information gathered from this innovative study will be invaluable in improving our understanding of the understudied role of mental health determinants and culturally-specific coping strategies in the current HIV epidemic among Black men, but will also be helpful in informing our future general health and HIV interventions for this population.

描述（由申请人提供）：艾滋病毒对南方黑人男性的影响尤为严重，心理健康决定因素（例如感知压力、抑郁、性别角色冲突）和特定文化的应对策略（例如约翰·亨利主义、酷姿势）的作用项目）在这种流行病中尚未得到充分研究。我们计划调查居住在佐治亚州三个不同大都市统计区（MSA）（亚特兰大大都市、哥伦布和瓦尔多斯塔）的社会和人口多样化的黑人男性群体，并研究心理健康决定因素和特定文化的应对策略如何影响他们的艾滋病毒风险促进（无保护的阴道/肛交、多个性伴侣）和保护（持续使用安全套、最近的艾滋病毒检测）行为。 我们的建议假设，心理健康决定因素将调节人口因素对艾滋病毒风险促进和保护行为的影响。该研究的具体目标是： 1) 探索心理健康决定因素的社会背景和特定文化的应对策略如何影响黑人男性的生活并影响他们的艾滋病毒风险促进和保护行为； 2) 评估心理健康决定因素和特定文化的应对策略如何预测黑人男性的艾滋病毒风险促进和保护行为； 3) 研究心理健康决定因素如何调节社会因素（例如种族主义经历、SES）和人口因素（例如 MSA、年龄）与黑人男性的艾滋病毒风险促进和保护行为之间的关系； 4) 调查黑人男性的文化特定应对策略如何调节心理健康决定因素与其艾滋病毒风险促进和保护行为之间的关系 为了实现这些目标，我们将采用混合方法，包括：1) 定性一-对 90 名男性进行一对一访谈，以从文化角度了解这些男性生活中的心理健康决定因素和特定文化的应对策略（第一阶段）； 2) 对 30 名男性进行焦点小组、认知访谈和试点测试，以根据第一阶段的发现制定调查项目； 3) 使用随机数字拨号 (RDD) 方法对 1200 名参与者进行定量调查，以测试这些领域与性行为和 HIV 检测结果之间的关联（第二阶段）。我们的长期目标是确定和了解佐治亚州黑人心理健康的独特文化决定因素和应对策略，这将为未来的艾滋病毒预防举措提供信息。 公共卫生相关性：该项目与公共卫生特别相关，因为它将提供有关心理健康决定因素（例如感知压力、抑郁和性别角色冲突）影响的定性和定量信息以及特定文化的应对策略（例如约翰·亨利主义） 、酷姿势项目）关于社会和人口中艾滋病毒风险促进（无保护的阴道/肛交、多个性伴侣）和保护（持续使用安全套、最近的艾滋病毒检测）行为佐治亚州黑人男性的不同样本。尽管该县所有黑人男性中艾滋病毒感染率很高，但很少有研究在主要是大城市和男男性接触者样本的黑人男性样本之外进行研究。从这项创新研究中收集的信息对于提高我们对心理健康决定因素和文化特定应对策略在当前黑人男性艾滋病毒流行中的尚未充分研究的作用的理解非常宝贵，而且也有助于为我们未来的总体健康和艾滋病毒提供信息。针对这一人群的干预措施。