Migration, Tourism and the HIV-drug use Syndemic in the Dominican Republic

多米尼加共和国的移民、旅游和艾滋病毒吸毒流行病

基本信息

批准号：
8735107
负责人：
MARK B PADILLA
金额：
$ 40.02万
依托单位：
FLORIDA INTERNATIONAL UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-30 至 2018-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8735107
关键词：
AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Affect Africa South of the Sahara Alcohol or Other Drugs use Area Behavior Businesses Caribbean region Centers for Disease Control and Prevention (U.S.)Cocaine Cognitive Communities Country Cross-Sectional Studies Data Data Collection Development Dominican Dominican Republic Drug usage Ecology Educational workshop Environment Epidemic Ethnography Evaluation Evidence based intervention Face Feedback Female Goals Government Growth HIV HIV risk Haiti Health Health Policy Health Promotion Heroin Heterosexuals High Prevalence Illicit Drugs Intervention Interview Investments Island Labor Migrations Link Literature Location Maps Mediation Mediator of activation protein Methods Migrant Workers Nomads Pattern Perception Pharmaceutical Preparations Phase Preparation Prevention Prevention Research Preventive Intervention Procedures Process Prostitution Public Health Recording of previous events Recruitment Activity Research Review Literature Risk Risk Behaviors Route Sales Sampling Self Efficacy Shapes Site Social Environment Social Problems Social isolation Structure Testing Theft Translational Research United States United States National Institutes of Health Work alcohol availability base civil society condoms design drug abuse prevention gang health knowledge high risk high risk behavior high risk sexual behavior interest male men migration peer programs public health relevance public health research rapid growth sex sexual encounter social social stigma trafficking transmission process

项目摘要

DESCRIPTION (provided by applicant): The Caribbean region has the second highest prevalence rates of HIV in the world following sub-Saharan Africa and is one of the region's most affected by illicit drug use and drug trafficking. Focusing on men's changing work, migration, and sexual and drug use behavior in the Dominican Republic, the proposed mixed- methods collaborative study examines how HIV risk and drug use among migrant men are related to (1) patterns of migration and (2) the social environments of tourism areas. We relate contemporary demographic changes to HIV and drug use practices through the notion of tourism ecologies - geographically constrained areas in which five ecological features (social isolation; social stigma; business norms; touristic escapism; and drug and alcohol availability) are hypothesized to contribute to high risk behaviors. Our research relies fundamentally on a long-standing multisectoral Community Advisory Board involving private tourism representatives, government, public health officials, and civil society. Data collection consists o: (1) semi- structured interviews with 36 systematically selected male migrant workers in two coastal tourism areas (two interviews per subject = 72 sessions); (2) ethnographic mapping and spatial analysis using Arc-GIS in two tourism areas; (3) a cross-sectional survey with 400 male migrant workers in two research sites; and (4) the implementation of a pilot intervention with 40 migrant male tourism workers. This study contributes to public health knowledge and health promotion in three key ways. First, it identifies the factors in tourism areas that most contribute to HIV risk and drug use, contributing to the development and piloting of an evidence-based intervention. Second, it draws on an extensive literature to systematically analyze the health effects of tourism environments in high-risk settings for HIV and drug use. Finally, it incorporate a participatory process to research that will strengthen local relevance, research translation, and the impact on health policies and programs.

描述（由申请人提供）：加勒比地区的艾滋病毒患病率位居世界第二，仅次于撒哈拉以南非洲地区，并且是该地区受非法药物使用和贩毒影响最严重的地区之一。拟议的混合方法合作研究重点关注多米尼加共和国男性不断变化的工作、移徙以及性行为和吸毒行为，探讨移徙男性中的艾滋病毒风险和吸毒与（1）移徙模式和（2）旅游区的社会环境。我们通过旅游生态的概念将当代人口变化与艾滋病毒和吸毒行为联系起来——在地理受限的地区，假设有五种生态特征（社会隔离、社会耻辱、商业规范、旅游逃避现实以及毒品和酒精的供应）有助于高风险行为。我们的研究从根本上依赖于长期存在的多部门社区咨询委员会，其中包括私人旅游代表、政府、公共卫生官员和民间社会。数据收集包括： (1) 对两个沿海旅游区系统挑选的 36 名男性农民工进行半结构化访谈（每个主题两次访谈 = 72 次访谈）； (2) 利用Arc-GIS对两个旅游区进行民族志制图和空间分析；（3）对两个研究点的400名男性农民工进行横断面调查； (4)对40名外出务工旅游男性工人进行试点干预。这项研究通过三个关键方式为公共卫生知识和健康促进做出了贡献。首先，它确定了旅游区中贡献最大的因素艾滋病毒风险和药物使用，有助于制定和试点循证干预措施。其次，它利用大量文献系统地分析了艾滋病毒和吸毒高风险环境中旅游环境对健康的影响。最后，它纳入了研究的参与过程，这将加强当地相关性、研究翻译和对卫生政策和计划的影响。