African American women contract HIV, and other sexually transmitted and blood borne pathogens, at an unacceptably high rate, despite 15 years of prevention efforts. The continued spread of HIV among women suggests that individual level HIV preventive interventions may not be sufficient to stem the tide of infection among women. One hundred sixty African American women, aged 16 to 40, who used injected or non-injected cocaine, crack and/or heroin in the past 30 days will be street recruited in Bedford Stuyvesant, New York City, a high AIDS prevalence neighborhood, and followed for 18 months at six month intervals. Index women will nominate and assist in recruiting their current drug use and sex risk network members into the study at each interview. The baseline sample 640 subjects will consist of 160 index women and 480 risk network members. We propose to examine the relationships among socioeconomic factors, egocentric risk networks, individual risk behaviors, and the risk of infection. The five specific aims are: (1) establish the baseline seroprevalence of HIV, Hepatitis C (HCV), Hepatitis B (HBV), and syphilis, and the baseline seroincidence of HIV, among index women and their risk network members; (2) describe index women's resource acquisition strategies and the relationship of these strategies to egocentric risk network variables, individual risk behaviors, and infection; (3) assess the seroincidence among index women, as well as changes in the seroprevalence and/or seroincidence among women's egocentric risk network members, of HIV, HCV, HBV and syphilis over time, and the resource, risk network, and behavioral factors that predict incident infection; (4) ascertain changes in index women's egocentric risk networks over time that increase or decrease the risk of exposure to infection and/or participation in risk behaviors, and the relationship of network changes to women's resource acquisition strategies; and (5) using qualitative methods, explore the events, situations or actions that result in changes in network membership. The findings from this study should provide preliminary evidence as to the feasibility of implementing network preventive interventions among women who use drugs.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA014523-02
Application #
6515942
Study Section
Special Emphasis Panel (ZRG1-AARR-7 (01))
Program Officer
Lambert, Elizabeth
Project Start
2001-05-01
Project End
2005-04-30
Budget Start
2002-05-01
Budget End
2003-04-30
Support Year
2
Fiscal Year
2002
Total Cost
$703,283
Indirect Cost
Name
Columbia University (N.Y.)
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
167204994
City
New York
State
NY
Country
United States
Zip Code
10032
Miller, Maureen; Liao, Yuyan; Wagner, Meghan et al. (2008) HIV, the clustering of sexually transmitted infections, and sex risk among African American women who use drugs. Sex Transm Dis 35:696-702
Miller, Maureen; Liao, Yuyan; Gomez, Anu Manchikanti et al. (2008) Factors associated with the prevalence and incidence of Trichomonas vaginalis infection among African American women in New York city who use drugs. J Infect Dis 197:503-9
Miller, M; Korves, C T; Fernandez, T (2007) The social epidemiology of HIV transmission among African American women who use drugs and their social network members. AIDS Care 19:858-65
Miller, Maureen; Serner, Malin; Wagner, Meghan (2005) Sexual diversity among black men who have sex with men in an inner-city community. J Urban Health 82:i26-34
Roche, Brenda; Neaigus, Alan; Miller, Maureen (2005) Street smarts and urban myths: women, sex work, and the role of storytelling in risk reduction and rationalization. Med Anthropol Q 19:149-70
Cespedes, Christian; Said-Salim, Battouli; Miller, Maureen et al. (2005) The clonality of Staphylococcus aureus nasal carriage. J Infect Dis 191:444-52
Miller, Maureen; Mella, Inge; Moi, Harald et al. (2003) HIV and hepatitis C virus risk in new and longer-term injecting drug users in Oslo, Norway. J Acquir Immune Defic Syndr 33:373-9
Miller, Maureen (2003) The dynamics of substance use and sex networks in HIV transmission. J Urban Health 80:iii88-96
Miller, M; Cespedes, C; Vavagiakis, P et al. (2003) Staphylococcus aureus colonization in a community sample of HIV-infected and HIV-uninfected drug users. Eur J Clin Microbiol Infect Dis 22:463-9
Lowy, Franklin D; Miller, Maureen (2002) New methods to investigate infectious disease transmission and pathogenesis--Staphylococcus aureus disease in drug users. Lancet Infect Dis 2:605-12