The proposed study will launch a multidisciplinary effort to examine the diffusion of HIV and sexually transmitted diseases (STDs including gonorrhea, chlamydia, and syphilis) in drug users in L.A. County to identify the individual level factors, partner-level factors, and environmental factors that promote the spread of these diseases. L.A. County is the second largest epicenter of AIDS cases in the nation, yet injection drug use (IDU) accounts for only a minority (13%) of cases, while the majority of cases involve MSM (70%). Recent, disproportionate increases of HIV infection for women and people of color in L.A. County imply the virus is moving from relatively contained groups into larger segments. This 5-year study proposes to establish a representative cohort of individuals thought to represent the behavioral """"""""bridges"""""""" for these pathogens to enter the larger population: drug using MSM (n=240), drug using MSM/W (n=240) a comparison group of non-drug using MSM/W (n=240), and the male (n=288) and female (n=192) sexual partners of these individuals (total=1,200). Assessments will be collected at baseline, 6- and 12-months after enrollment. Data collected will address these study aims: (1) Measure associations between drug involvement (methamphetamine user, other drug user, non-drug user), IDU status, sexual risk behavior (MSM, MSM/W, WSM), and HIV/STDs; (2) Evaluate the types of sexual partnerships and dynamics of the partnerships of these individuals and how these are associated with HIV/STD transmission; and (3) Apply mathematical models to the data on partnerships to study how the incidence of HIV/STDs reflect the size and interconnectedness of the sexual networks of each of the groups and to determine the impact of sexual network structure in future transmission of HIV in L.A. within and beyond MSM and heterosexual drug using groups. The study will use methods of behavioral epidemiology, ethnography, viral analysis of HIV, and mathematical modeling to yield a comprehensive set of information to predict the spread of HIV and STDs from sexual networks of high HIV prevalence (drug using MSM) to those of low prevalence (heterosexuals). Outcomes from the proposed cohort study of IDU and non-lDU methamphetamine-using MSM and MSM/W and their sexual partners should provide evidence to guide policy and prevention efforts in response to the spread of HIV and STDs.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project--Cooperative Agreements (U01)
Project #
3U01DA017394-03S1
Application #
7074956
Study Section
Special Emphasis Panel (ZDA1)
Program Officer
Lambert, Elizabeth
Project Start
2003-09-30
Project End
2008-06-30
Budget Start
2005-07-01
Budget End
2006-06-30
Support Year
3
Fiscal Year
2005
Total Cost
$98,683
Indirect Cost
Name
University of California Los Angeles
Department
Psychiatry
Type
Schools of Medicine
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Murphy, Ryan D; Gorbach, Pamina M; Weiss, Robert E et al. (2013) Seroadaptation in a sample of very poor Los Angeles area men who have sex with men. AIDS Behav 17:1862-72
Cranston, R D; Murphy, R; Weiss, R E et al. (2012) Anal human papillomavirus infection in a street-based sample of drug using HIV-positive men. Int J STD AIDS 23:195-200
Shoptaw, S; Stall, R; Bordon, J et al. (2012) Cumulative exposure to stimulants and immune function outcomes among HIV-positive and HIV-negative men in the Multicenter AIDS Cohort Study. Int J STD AIDS 23:576-80
Niccolai, Linda M; Verevochkin, Sergei V; Toussova, Olga V et al. (2011) Estimates of HIV incidence among drug users in St. Petersburg, Russia: continued growth of a rapidly expanding epidemic. Eur J Public Health 21:613-9
Young, Sean D; Shoptaw, Steven; Weiss, Robert E et al. (2011) Predictors of unrecognized HIV infection among poor and ethnic men who have sex with men in Los Angeles. AIDS Behav 15:643-9
Ober, Allison J; Iguchi, Martin Y; Weiss, Robert E et al. (2011) The relative role of perceived partner risks in promoting condom use in a three-city sample of high-risk, low-income women. AIDS Behav 15:1347-58
Grau, Lauretta E; White, Edward; Niccolai, Linda M et al. (2011) HIV disclosure, condom use, and awareness of HIV infection among HIV-positive, heterosexual drug injectors in St. Petersburg, Russian Federation. AIDS Behav 15:45-57
Mackesy-Amiti, Mary Ellen; McKirnan, David J; Ouellet, Lawrence J (2010) Relationship characteristics associated with anal sex among female drug users. Sex Transm Dis 37:346-51
Shoptaw, Steven; Weiss, Robert E; Munjas, Brett et al. (2009) Homonegativity, substance use, sexual risk behaviors, and HIV status in poor and ethnic men who have sex with men in Los Angeles. J Urban Health 86 Suppl 1:77-92
Gorbach, Pamina M; Murphy, Ryan; Weiss, Robert E et al. (2009) Bridging sexual boundaries: men who have sex with men and women in a street-based sample in Los Angeles. J Urban Health 86 Suppl 1:63-76

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