Reducing Sexual Risk Behaviors among Rural African-American Cocaine Users

减少农村非裔美国可卡因使用者的性危险行为

• 批准号: 7881888
• 负责人: Katharine E. Stewart
• 金额: $ 6.96万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-20 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7881888
• 关键词: Address; African American; Alcohol or Other Drugs use; Area; Arkansas; Behavior; Behavior Therapy; Behavioral; Clinical Trials Design; Cocaine; Cocaine Users; Communities; County; Drug usage; Enrollment; Epidemic; Equilibrium; HIV; Health Services Accessibility; Health Status; Housing; Incidence; Individual; Injection of therapeutic agent; Intervention; Intervention Studies; Intervention Trial; Life; Link; Literature; Measures; Mediating; Mediation; Mediator of activation protein; Mental Health; Methamphetamine; Methodology; Methods; Multiple Partners; Outcome; Participant; Patient Self-Report; Pattern; Pharmaceutical Preparations; Population; Poverty; Powder dose form; Prevention education; Property; Race; Random Allocation; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Respondent; Risk; Risk Behaviors; Risk Reduction; Rural; Rural Community; Rural Population; Sampling; Science; Self Efficacy; Sexually Transmitted Diseases; Social support; Target Populations; Testing; Time; Treatment Efficacy; Trust; Woman; Work; active control; base; behavioral clinical trial; cocaine use; cohort; condoms; design; disorder prevention; efficacy testing; experience; follow-up; high risk; high risk sexual behavior; innovation; men; partner violence; peer; post intervention; primary outcome; programs; rapid growth; rural area; sex; sex risk; skills; social; social cognitive theory; theories

PROJECT SUMMARY: HIV and other sexually transmitted infection (STI) rates continue to rise disproportionately among African-Americans, and particularly dramatically among rural populations. Stimulant use, especially cocaine use, among rural African-Americans is also increasing, and is related to multiple risk behaviors for HIV/STI, including sex with multiple partners, exchanging sex for drugs and other commodities, and inconsistent condom use. Despite these documented risk patterns, and the increasing disparities in HIV/STI incidence, few theory-based interventions have been specifically designed and tested for rural African-American populations with high-risk behavioral patterns. The primary aims of this project are to adapt an existing risk reduction program to the needs of rural African-American cocaine users, to test the adapted intervention's efficacy via a behavioral clinical trial, and to answer outstanding questions regarding intraclass correlation and sampling methodologies in the sexual risk reduction literature. The project team will conduct a longitudinal intervention study with stratified group randomization, so that participants receive the sexual risk intervention or an active control intervention condition in groups. Each intervention condition is equivalent in terms of contact time and in terms of number and type of contacts (each participant receives two group sessions, two individual sessions, two community-building sessions, and two follow-up booster sessions over four months). Respondent-driven sampling will be used to recruit and enroll 280 participants across two rural, predominantly African-American counties in the Arkansas Delta region to one of the two intervention conditions. The primary outcome variables will include condom use skills, sexual negotiation skills, and self-reported risk behaviors. Additional measures, including self-efficacy for decreased sexual risk, perceived peer norms for sexual risk, perceived benefits and barriers of sexual risk reduction, social support and social trust, mental health status, partner violence, and substance use, will also be collected to assess their theory-based mediating and moderating influences on the sexual risk skills and behaviors. Assessments will be conducted prior to the intervention, immediately post-intervention, and at 6- and 12-month follow-ups. This project brings together a strong, experienced investigative team which has an established, trusting relationship with the community that will be involved in the study. PROJECT NARRATIVE/RELEVANCE: The project not only will provide critically-needed information about the efficacy of tailored behavioral interventions among rural African-Americans at high risk for HIV/STIs, but also will allow the study team to investigate important methodological questions about the use of respondent- driven sampling approaches in rural settings and about intraclass correlation coefficients for sexual risk measures in tight-knit rural communities. This research can thus make important contributions that address racial disparities in HIV/STIs, provide approaches for slowing the rapid growth of the epidemics in rural areas, and inform methodological innovations of importance to sexual risk reduction science.

项目摘要：艾滋病毒和其他性传播感染（STI）率继续上升 在非裔美国人中，在农村人口中尤其是尤其如此。 在非裔美国人中，刺激性使用，尤其是可卡因的使用也在增加，并且与 HIV/STI的多种风险行为，包括与多个伴侣的性别，将性交换为毒品和其他 商品和不一致的避孕套使用。尽管有这些记录的风险模式以及增加 HIV/STI发病率的差异，很少针对基于理论的干预措施进行专门设计和测试 具有高风险行为模式的农村非裔美国人人口。该项目的主要目的是 适应现有的降低风险计划，适合非裔美国可卡因使用者的需求，以测试 通过行为临床试验改编干预的功效，并回答有关 减少性风险文献中的类内相关性和抽样方法。项目团队将 通过分层的随机分组进行纵向干预研究，以便参与者接受 性风险干预或组的主动控制干预条件。每个干预条件是 在接触时间和联系人的数量和类型方面相同（每个参与者都会收到两个 小组会议，两个个人会议，两个社区建设会议和两个后续助推器 四个月内的会议）。受访者驱动的抽样将用于招募和注册280名参与者 在阿肯色三角洲地区的两个农村地区，主要是非裔美国人县 干预条件。主要结果变量将包括使用避孕套技能，性谈判 技能和自我报告的风险行为。其他措施，包括减少性风险的自我效能感， 感知的性风险，感知的福利和性风险障碍，社会支持的障碍 还将收集社会信任，心理健康状况，伴侣暴力和药物使用，以评估其 基于理论的中介和调节对性风险技能和行为的影响。评估将是 在干预之前，干预后立即进行，并在6个月和12个月的随访中进行。这 项目汇集了一个强大的经验丰富的调查团队，该团队建立了信任的关系 与将参与研究的社区。项目叙述/相关性：该项目不仅将提供有关有关的急需信息 在艾滋病毒/性传播疾病的高风险中，量身定制的行为干预措施的效力，但 还将允许研究团队研究有关受访者使用的重要方法论问题 - 农村环境中的驱动抽样方法和性风险内相关系数 紧密联系的农村社区的措施。因此，这项研究可以做出重要的贡献来解决 艾滋病毒/性传播疾病的种族差异，提供了减缓农村地区流行病快速增长的方法， 并为减少性风险科学的重要性提供方法论创新。