Institute for Infectious Disease Research, National Development and Research Institutes, Inc., 71 West 23rd Street, Fourth Floor, New York, NY, 10010, USA.
Center for Drug Use and HIV Research, New York, NY, USA.
AIDS Behav. 2020 Jan;24(1):257-273. doi: 10.1007/s10461-019-02582-w.
Large-scale structural interventions and "Big Events" like revolutions, wars and major disasters can affect HIV transmission by changing the sizes of at-risk populations, making high-risk behaviors more or less likely, or changing contexts in which risk occurs. This paper describes new measures to investigate hypothesized pathways that could connect macro-social changes to subsequent HIV transmission. We developed a "menu" of novel scales and indexes on topics including norms about sex and drug injecting under different conditions, experiencing denial of dignity, agreement with cultural themes about what actions are needed for survival or resistance, solidarity and other issues. We interviewed 298 at-risk heterosexuals and 256 men who have sex with men in New York City about these measures and possible validators for them. Most measures showed evidence of criterion validity (absolute magnitude of Pearson's r ≥ 0.20) and reliability (Cronbach's alpha ≥ 0.70). These measures can be (cautiously) used to understand how macro-changes affect HIV and other risk. Many can also be used to understand risk contexts and dynamics in more normal situations. Additional efforts to improve and to replicate the validation of these measures should be conducted.
大规模的结构干预措施和“重大事件”，如革命、战争和重大灾害，可以通过改变高危人群的规模、增加或减少高危行为的可能性，或改变风险发生的环境，从而影响 HIV 的传播。本文描述了新的措施来研究假设的途径，这些途径可以将宏观社会变化与随后的 HIV 传播联系起来。我们开发了一系列新的量表和指标，涉及在不同条件下的性和注射毒品规范、尊严被否定的经历、对文化主题的认同（如为了生存或抵抗需要采取哪些行动）、团结等主题。我们在纽约市采访了 298 名高危异性恋者和 256 名男男性接触者，了解了这些措施以及可能的验证方法。大多数措施都显示出了标准效度（皮尔逊 r 的绝对大小≥0.20）和可靠性（克朗巴赫 α≥0.70）的证据。这些措施可用于（谨慎地）了解宏观变化如何影响 HIV 和其他风险。许多措施也可用于了解更正常情况下的风险环境和动态。应该进一步努力改进和复制这些措施的验证。
