Evolving HIV/STI risk environments of FSWs on the Mexico/U.S. Border

墨西哥/美国不断变化的 FSW 艾滋病毒/性传播感染风险环境

• 批准号: 8689998
• 负责人: Kimberly C Brouwer
• 金额: $ 56.95万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8689998
• 关键词: Accounting; Affect; American; Area; Behavior; Behavioral; Books; Border Crossings; Characteristics; Chlamydia; Cities; Client; Collaborations; Communicable Diseases; Communities; Computer Assisted; Data; Data Analyses; Development; Diffusion; Drug usage; Economics; Environment; Environmental Impact; Environmental Risk Factor; Epidemic; Epidemiology; Evolution; Female; Frequencies; Future; Geographic Information Systems; Geography; Goals; Gonorrhea; HIV; HIV risk; Health; Health Services Accessibility; Herpes zoster disease; Human immunodeficiency virus test; Incidence; Individual; Industry; Institution; Intervention; Interview; Laws; Life; Link; Location; Maps; Measurement; Methods; Mexican; Mexico; Military Personnel; Monitor; Murder; NIH Office of AIDS Research; National Institute of Drug Abuse; Natural experiment; Nature; Outcome; Participant; Pattern; Perception; Pharmaceutical Preparations; Police; Population; Prevalence; Recruitment Activity; Relative (related person); Reporting; Research; Research Personnel; Research Priority; Risk; Risk Behaviors; Rosa; Services; Sex Characteristics; Sexually Transmitted Diseases; Social Characteristics; Social Work; Staging; Substance abuse problem; Surveys; Syphilis; Syringes; Testing; Time; Travel; Unsafe Sex; Urban Renewal; Violence; Woman; Work; Workplace; base; behavior change; condoms; disease transmission; disorder risk; follow-up; influenza outbreak; killings; meetings; migration; novel; novel strategies; prevent; sex; social; social norm; spatial relationship; swine flu; tool; transmission process

DESCRIPTION (provided by applicant): There is growing recognition of the importance of 'place' on individual risk of disease, although most studies fail to capture the dynamic nature of the risk environment and its effect on the sex trade has been understudied. The Mexico/US border region is undergoing profound alterations in the environment in which sex work takes place, providing a 'natural experiment' through which we can explore the relative contributions of individual and structural factors on HIV transmission. The primary goals of this research are to define social, spatial, and physical factors affecting female sex workers (FSWs) in 2 border cities and determine their relevance to HIV epidemiology, drug use, and access to services. Tijuana and Ciudad (Cd.) Juarez have witnessed escalating community-level violence and, for Cd. Juarez, changes in the location and visibility of the 'red light' district. While migration and cross-border interactions are major influences, the recent global economic downturn is dramatically altering migration patterns. Based on the above, the specific aims of this project are to: 1) assess changes in social influences on the sex work risk environment over time in both cities and their effect on risk behaviors, HIV/STI incidence, and access to services; 2) determine the locations where FSWs live, work and engage in other activities and their relationship to risk behaviors, perceptions of violence, and access to services; and 3) determine the extent to which the built environment and other sex work venue characteristics relate to individual-level behaviors and HIV/STI incidence. To meet these aims, we will recruit 600 FSWs (300 per city) and collect sociodemographic, location, and behavioral data through interviews. All will be tested for HIV, syphilis, gonorrhea, and Chlamydia and treated as needed. Follow-up interviews and testing will occur at months 6, 12, and 18. To meet aim 2, we will construct a geographic information system (GIS) of both cities and explore factors in relation to where FSWs live, work, buy/use drugs, and access services. Changing spatial relationships, such as the dispersal of the Cd. Juarez Zona Roja and intra-urban or cross-border mobility, will be analyzed to track patterns of infectious disease spread. We will also conduct in-depth interviews and an activity-travel survey with 30 sex workers per city, stratified by geography and venue (e.g. street, bar, etc.) to create geo-narratives based on time-geographic methods and computer-aided qualitative data analysis in order to explore the impact of recent social, economic, political, and other structural changes on participants' lives. To meet aim 3, field measurements of the built environment and other venue characteristics will be combined with individual-level data to explore their effect on health outcomes. The data collected will provide information vital to reframing HIV and drug use interventions to take into account the structural environment. This project is timely as HIV prevalence is rising along the U.S./Mexico border, presenting a window of opportunity to prevent transition to a generalized epidemic.

描述（由申请人提供）：尽管大多数研究未能捕获风险环境的动态性质及其对性贸易的影响，但人们对“地点”对个体风险的重要性越来越认识到。墨西哥/美国边境地区正在对性工作进行的环境进行深刻的改变，提供了一个“自然实验”，通过该实验，我们可以探索个人和结构因素对HIV传播的相对贡献。这项研究的主要目标是定义两个边境城市中影响女性性工作者（FSW）的社会，空间和身体因素，并确定其与HIV流行病学，吸毒和获得服务的相关性。蒂华纳（Tijuana）和苏达（Ciudad）（CD。）华雷斯（Juarez）目睹了社区级的暴力和CD的升级。 Juarez，“红灯”区的位置和可见性变化。虽然移民和跨境互动是主要影响，但最近的全球经济低迷正在极大地改变移民模式。基于上述内容，该项目的具体目的是：1）评估社会对性工作风险环境的变化随着时间的流逝，其对风险行为，艾滋病毒/STI发病率以及获得服务的影响； 2）确定FSW居住，工作和从事其他活动及其与风险行为的关系，对暴力的看法以及获得服务的位置； 3）确定建筑环境和其他性工作场所特征与个人级别的行为以及HIV/STI发病率的程度。为了满足这些目标，我们将招募600 FSW（每个城市300），并通过访谈收集社会人口统计学，位置和行为数据。所有这些都将接受艾滋病毒，梅毒，淋病和衣原体的测试，并根据需要进行治疗。后续访谈和测试将在第6、12和18个月进行。为了满足AIM 2，我们将建立一个城市的地理信息系统（GIS），并探索与FSWS居住，工作，购买/使用药物和访问服务有关的因素。改变空间关系，例如CD的分散。 Juarez Zona Roja和城市内或跨境迁移率将进行分析以跟踪传染病扩散的模式。我们还将对每个城市的30个性工作者进行深入的访谈，并通过地理和地点（例如街道，酒吧等）进行一项活动旅行调查，以根据时间地理位置方法和计算机辅助的定性数据分析来创建地理叙事，以探索最近的社会，经济，政治，政治，政治，以及其他对参与者生活的影响的影响。为了满足AIM 3，将对建筑环境和其他场地特征的现场测量与个人级别的数据相结合，以探索其对健康结果的影响。收集的数据将为重新构建HIV和药物使用干预措施的信息提供重要的信息，以考虑到结构环境。该项目是及时的，因为艾滋病毒的患病率正在美国/梅克西科边境沿线上升，这是防止过渡到普遍流行病的机会之窗。

项目成果

The Spatial-Temporal Pattern of Policing Following a Drug Policy Reform: Triangulating Self-Reported Arrests With Official Crime Statistics.

• DOI: 10.1080/10826084.2016.1223689
• 发表时间: 2017-01-28
• 期刊: Substance use & misuse
• 影响因子: 2
• 作者: Gaines TL;Werb D;Arredondo J;Alaniz VM;Vilalta C;Beletsky L
• 通讯作者: Beletsky L

Communication Strategies To Enhance HIV/STI Prevention, Sexual and Reproductive Health, and Safety Among Migrant Sex Workers at the Mexico-Guatemala Border.

加强墨西哥-危地马拉边境移徙性工作者的艾滋病毒/性传播感染预防、性健康和生殖健康以及安全的沟通策略。

• DOI: 10.1353/hpu.2020.0060
• 发表时间: 2020
• 期刊: Journal of health care for the poor and underserved
• 影响因子: 1.4
• 作者: Febres-Cordero,Belen;Brouwer,KimberlyC;Jimenez,TeresitaRocha;Fernandez-Casanueva,Carmen;Morales-Miranda,Sonia;Goldenberg,ShiraM
• 通讯作者: Goldenberg,ShiraM

Spatial patterns of arrests, police assault and addiction treatment center locations in Tijuana, Mexico.

墨西哥蒂华纳逮捕、警察袭击和戒毒中心地点的空间模式。

• DOI: 10.1111/add.13350
• 发表时间: 2016
• 期刊: Addiction (Abingdon, England)
• 作者: Werb,Dan;Strathdee,SteffanieA;Vera,Alicia;Arredondo,Jaime;Beletsky,Leo;Gonzalez-Zuniga,Patricia;Gaines,Tommi
• 通讯作者: Gaines,Tommi