The Wyoming Meth Use and AIDS: Exploring Culture and Context of Rural Risk (WyMAR) is a revised small grant (RO3) submitted in response to the PA, """"""""Drug Abuse Aspects of HIV/AIDS and other infections"""""""". This research is important because of the high prevalence of methamphetamine (MA) use in rural areas and little research has examined HIV risk for MA users in rural areas, nor among heterosexuals. MA has been a problem in Wyoming since 1992 and continues to be, as seen by the outbreak of hepatitis among heterosexual methamphetamine injectors in 2003. Drug abuse and HIV/AIDS treatment and prevention issues in extremely rural areas are related to geographic isolation, stigma, strong individualism, and lack of treatment facilities. Little is known about cultural and contextual factors unique to rural recruiting and drug use and sexual risk for HIV among rural users. The WyMAR project will recruit MA users and female sexual partners of MA users for in-depth interviews to accomplish the following Specific Aims: 1) To identify individual, social, community and rural cultural factors that affect HIV risk taking behavior among rural heterosexual injecting and non-injecting methamphetamine users; and 2) To identify individual, social, community, and rural cultural factors that facilitate successful recruiting of rural heterosexual methamphetamine users to participate in research activities. This qualitative study includes in-depth interviews with 40 male and 40 female not-in-treatment heterosexual MA users. In addition, since we assume many of the MA users will also be sexual partners of MA users, we will recruit 20 female non-meth using sexual partners who live in the rural state of Wyoming. These women may provide unique information about pressures to initiate MA use, high risk unprotected sex and may represent an important bridge group for HIV infection. In-depth inerviews will be completed, using Bronfenbrenners bio-ecological model as a guide to identifying themes unique to rural culture and context that place rural MA users at risk for contracting HIV. Quantitative questions, field notes, and in-depth interview data will be triangulated to develop a comprehensive picture of themes across the layers of Bronfenbrenners model and to identify facilitators and barriers to research participation. Finally, in addition to interview questions about individual, community and cultural facilitators and barriers to recruiting, we will examine the results of our targeted sampling and pilot a small version of Respondent Driven Sampling to better explicate Aim 2. Data will be used to inform the development of an RO1 to conduct an epidemiology of rural MA use. ? ? ?
| Bowen, Anne; Moring, John; Williams, Mark et al. (2012) An investigation of bioecological influences associated with first use of methamphetamine in a rural state. J Rural Health 28:286-95 |
