Crossing Borders: HIV and Substance use at the Gateway to North America

跨境：北美门户的艾滋病毒和药物使用

基本信息

批准号：
8699733
负责人：
Kimberly C Brouwer
金额：
$ 52.16万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-15 至 2016-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8699733
关键词：
AIDS prevention Acquired Immunodeficiency Syndrome Address Adult Affect Alcohol or Other Drugs use American Anti-Retroviral Agents Antiretroviral drug resistance Area Automobile Driving Behavior Border Crossings Central America Central American Cocaine Collaborations Consumption Corridor Disease DA10 Data Development Drug resistance Drug usage Economic Conditions Epidemic Epidemiology Female Focus Groups Fostering Geography Goals Grant Guatemala Guatemalan HIV HIV Seropositivity HIV-1 Head Health Services Accessibility Hepatitis C virus Human Herpesvirus 2 Human immunodeficiency virus test Infection Institution International Intervention Interview Knowledge Latin America Marketing Measures Methods Mexican Mexico Migrant Workers Molecular Molecular Epidemiology Monitor National Institute of Drug Abuse Nomads North America Pattern Persons Pharmaceutical Preparations Population Predisposition Prevalence Prevention program RNA-Directed DNA Polymerase Recombinants Recording of previous events Recruitment Activity Research Research Personnel Respondent Risk Risk Behaviors Role Route Sampling Seeds Sexually Transmitted Diseases Side Site South America South American Staging Subgroup Substance abuse problem Syphilis Virulence Work Youth age group aged base cocaine use cohort contextual factors disease transmission high risk injection drug use instrument meetings men who have sex with men migration peer pol genes prevent resistant strain response sex stem trafficking transmission process vaccine development young woman

项目摘要

DESCRIPTION (provided by applicant): The overarching goal of this study is to explore the context of rising drug use along the Mexico/Guatemala border and define its relationship to the local epidemiology and phylo-geography of HIV and sexually transmitted infections (STIs). Shifting drug trafficking routes, poor economic conditions, and increasing popularity of hard drugs among youth may be some of the factors driving substance use. Numerous regional and international migrants passing through the area likely contribute to the spread of HIV and STIs. However, data is lacking on the relationship between drug use and HIV/STIs in the region. Based on the above, the specific aims of this project are to: 1) describe the contextual factors affecting drug use and patterns of use in high risk populations along the Mexico/Guatemala border; 2) determine the prevalence and correlates of HIV, hepatitis C virus (HCV), and STIs among substance users; and 3) explore the phylo-geography and molecular epidemiology of HIV-1 infection in at-risk groups. To meet Aim 1, 20 in-depth interviews with a diverse sample of substance users in Tapachula/Ciudad Hidalgo, Mexico and 20 in the Teczn Uman/Quetzaltenango area of Guatemala will be conducted to provide contextual data on risk behaviors and help refine study instruments and methods. Additionally, focus groups with substance using men who have sex with men (MSM), female sex workers (FSW), and migrants, as well as with organizations serving those at-risk for HIV will be conducted. To meet Aim 2, three consecutive cross-sectional cohorts (n=400, 200 on each side of the border) will be recruited using respondent-driven sampling (RDS). Face-to-face interviews will collect information on sociodemographics, HIV/STI knowledge, risk behaviors, and access to health services. All will be tested for HIV, syphilis, herpes simplex virus-2, and HCV, and treated as needed. Round 1 will comprise substance using FSWs; Round 2 will focus on the MSM population; and Round 3 will begin with peer recruiters ("seeds") drawn from "mobile" persons- including truck drivers, deportees and regional and international migrants. We anticipate and will be able to measure the overlap between these risk groups. For Aim 3, we will sequence the HIV-1 pol gene, including reverse transcriptase, from those infected with HIV which will enable us to assess if recombinants or drug resistant strains of HIV-1 have emerged in this region and the extent to which there is mixing between at-risk groups. As migration routes have been identified as important corridors of disease transmission in other settings, they may be one of the first places new HIV subtypes will be identified. This project will create and expand ties among investigators in Mexico, Guatemala, and the U.S. and increase regional research capacity. Findings will help inform the development of subsequent HIV interventions and prevention programs that intervene upon risky substance use behaviors before they become further entrenched. Since the HIV epidemic in most of Latin America is still concentrated, there is a critical window of opportunity to prevent transition to a generalized epidemic.

描述（由申请人提供）：这项研究的总体目标是探索沿着墨西哥/危地马拉边界沿线使用药物增加的背景，并确定其与局部流行病学和艾滋病毒的植物学地理和性传播感染（STIS）的关系。转移毒品贩运路线，经济状况差以及硬毒品在青年中的普及可能是驱动药物使用的某些因素。经过该地区的许多区域和国际移民可能导致艾滋病毒和性传播感染的传播。但是，该地区的药物使用与HIV/性传播感染之间的关系缺乏数据。基于上述内容，该项目的具体目的是：1）描述影响墨西哥/危地马拉边境高风险种群使用药物使用模式的上下文因素； 2）确定艾滋病毒，丙型肝炎病毒（HCV）的患病率和相关性以及药物使用者中的性传播感染； 3）探索高危组中HIV-1感染的植物地理和分子流行病学。为了满足AIM 1，在Tapachula/ciudad Hidalgo，墨西哥，墨西哥，Teczn Uman/Quetzaltenango区域中的20种药物使用样本的深入访谈，将提供有关风险行为的上下文数据，并帮助改进研究工具和方法。此外，将进行使用与男性发生性关系（MSM），女性性工作者（FSW）和移民的男性以及为艾滋病毒危险人士服务的组织以及为艾滋病毒危险服务的组织而进行的焦点小组。为了满足AIM 2，将使用受访者驱动的采样（RDS）连续三个连续的横截面队列（n = 400，200）。面对面的访谈将收集有关社会人口统计学，HIV/STI知识，风险行为和获得卫生服务的信息。所有这些都将测试HIV，梅毒，单纯疱疹病毒-2和HCV，并根据需要进行治疗。第1轮将使用FSW构成物质；第2轮将重点关注MSM人口；第3轮将从从“移动”人员中汲取的同伴招聘人员（包括卡车司机，被驱逐出境以及地区和国际移民）开始。我们预期并将能够衡量这些风险群体之间的重叠。对于AIM 3，我们将从感染HIV感染的HIV-1 POL基因（包括逆转录酶）中对HIV的转录酶进行序列，这将使我们能够评估该区域中是否出现了HIV-1的重组或抗药性菌株以及处于高危组之间的混合程度。由于迁移路线已被确定为在其他环境中疾病传播的重要走廊，因此可能是新的HIV亚型的最初位置之一。该项目将在墨西哥，危地马拉和美国的调查人员之间建立和扩大联系，并提高区域研究能力。调查结果将有助于告知随后的HIV干预措施和预防计划，这些计划在进一步牢牢牢牢牢牢牢牢之前就干预了风险的物质使用行为。由于大多数拉丁美洲的艾滋病毒流行仍然集中，因此有一个关键的机会窗口可以防止过渡到普遍的流行病。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Enhancing the Ethical Conduct of HIV Research with Migrant Sex Workers: Human Rights, Policy, and Social Contextual Influences.

DOI：
10.1371/journal.pone.0155048
发表时间：
2016
期刊：
PloS one
影响因子：
3.7
作者：
Goldenberg SM;Brouwer KC;Jimenez TR;Miranda SM;Mindt MR
通讯作者：
Mindt MR

Intercepted journeys: Associations between migration and mobility experiences and depressive symptoms among substance using migrants at the Mexico-Guatemala border.

截获的旅程：墨西哥-危地马拉边境吸毒移民的移民和流动经历与抑郁症状之间的关联。

DOI：
10.1080/17441692.2020.1866637
发表时间：
2022
期刊：
Global public health
影响因子：
3.3
作者：
Rocha-Jiménez,Teresita;Fernández-Casanueva,Carmen;Suárez-Lopéz,JoséR;Zúñiga,MaríaLuisa;Crespo,Noe;Morales-Miranda,Sonia;Goldenberg,ShiraM;Silverman,JayG;Brouwer,KimberlyC
通讯作者：
Brouwer,KimberlyC

Structural and Interpersonal Benefits and Risks of Participation in HIV Research: Perspectives of Female Sex Workers in Guatemala.