Training in Drug Abuse & HIV Prevention for Female & Transgender Sex Workers

药物滥用培训

• 批准号: 8882385
• 负责人: Jeffrey Allen Wickersham
• 金额: $ 16.76万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8882385
• 关键词: AIDS prevention; Accounting; Address; Adopted; Adult; Age; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Amphetamines; Area; Asia; Asians; Behavioral; Career Choice; Client; Complex; Conduct Clinical Trials; Country; Data; Destinations; Discrimination; Drug abuse; Drug usage; Drug user; Enrollment; Ensure; Epidemic; Evidence based intervention; Face; Female; Funding; Future; Gender; General Population; Goals; HIV; HIV Infections; HIV diagnosis; HIV risk; Health; Health Services Accessibility; Healthcare; Heroin; Illicit Drugs; Incidence; Income; Individual; Infection; Infection prevention; International Agencies; Interpersonal Violence; Intervention; Knowledge; Lead; Malaysia; Malaysian; Mediation; Mentors; Mentorship; Meta-Analysis; Pattern; Pharmaceutical Preparations; Population; Prevalence; Prevention strategy; Preventive Intervention; Probability; Productivity; Prophylactic treatment; Public Health; Recommendation; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Research Project Grants; Respondent; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Role; Sampling; Science; Services; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Smoking; Social Network; Southeastern Asia; Substance abuse problem; Surveys; Target Populations; Techniques; Testing; Training; Woman; Women' s Health; Work; biobehavior; career; comparative effectiveness; condoms; design; effectiveness trial; evidence base; experience; improved; innovation; male; men; novel strategies; patient oriented research; prevent; reproductive; research study; self esteem; sex; sexual violence; skills; substance abuse epidemiology; substance abuse prevention; substance use prevention; systematic review; therapy development; transgender; transgender women; transmission process; uptake

DESCRIPTION (provided by applicant): Malaysia's HIV epidemic, historically driven by male people who inject drugs (PWIDs), has transitioned over the last two decades to a generalized epidemic with bridges between substance abuse and sexual transmission. During this period, females have accounted for a growing proportion of new HIV infections (from 1% in 1990 to 25% in 2011), which are overwhelmingly attributed to sexual transmission. Transgender women have also faced a growing HIV burden in the region, with recent evidence suggesting they are one of the highest at-risk subpopulations globally. Sex work and the frequent co-occurrence of substance abuse is a major risk factor for both females and transgender women, especially in Malaysia, which has become a major destination for sex tourism. Despite recommendations by international agencies (WHO, UNODC, UNAIDS) to implement innovative, combination approaches to HIV and substance abuse prevention, especially among women, uptake in Malaysia, and Southeast Asia generally, has been woefully inadequate. Novel approaches to addressing the complex syndemic of sex work and substance abuse among female and transgender sex workers (F/TGSWs) are in demand. The mentored projects proposed here address this need through the conduct of two formative research studies. The first will estimate the prevalence of HIV and STIs among F/TGSWs in Malaysia's Klang Valley, assess sexual and drug risk behaviors, and determine feasibility of behavioral and biomedical approaches to HIV and substance use prevention. The second study will build on the first by adapting behavioral and biomedical interventions to address co-occurring sexual and drug risk behaviors among F/TGSWs in the region. Findings from these projects will contribute to a greater understanding of HIV and substance abuse risk behaviors among the target population and establish the knowledge necessary to develop innovative approaches to addressing them. The candidate, Dr. Wickersham, is uniquely poised to perform this work because of his strong background in gender and women's studies, his research productivity in the area of public health, and his experience with research in the Malaysian context. Over the five years of this proposal, he will achieve his career goals and professional objectives to: 1) develop expertise in research methods necessary to design, perform, and adapt HIV risk reduction interventions and eventually conduct clinical trials relating to HIV and STI prevention among TGW and FSWs in Malaysia; 2) gain experience in intervention development, adaptation, testing, implementation, and dissemination that will address gender-specific barriers to HIV prevention and treatment services; and 3) develop an independent career path in patient-oriented research focused on the interface between HIV, women's health, gender, and substance abuse and prevention. To achieve these goals, Dr. Wickersham has assembled a team of outstanding leaders in the fields of HIV, substance abuse, epidemiology, and behavioral and biomedical intervention science. Under their guidance, he will complete relevant coursework, attend seminars, and conduct research to apply the skills necessary to become an independent investigator in HIV and substance abuse prevention among female and transgender women sex workers in the Malaysian context.

描述（由申请人提供）：马来西亚的艾滋病毒流行，历来是由男性注射吸毒者（PWID）推动的，在过去二十年中已转变为一种普遍的流行病，在药物滥用和性传播之间存在桥梁。在此期间，女性在新发艾滋病毒感染者中所占比例不断增加（从1990年的1%上升到2011年的25%），其中绝大多数归因于性传播。该地区跨性别女性也面临着日益严重的艾滋病毒负担，最近的证据表明她们是全球风险最高的亚人群之一。性工作和频繁发生的药物滥用是女性和变性女性的主要风险因素，特别是在马来西亚，该国已成为性旅游的主要目的地。尽管国际机构（世界卫生组织、毒品和犯罪问题办公室、联合国艾滋病规划署）建议实施创新的综合方法来预防艾滋病毒和药物滥用，特别是在妇女中，但马来西亚和整个东南亚的采用率仍然严重不足。人们需要新的方法来解决女性和变性性工作者 (F/TGSW) 中性工作和药物滥用的复杂问题。这里提出的指导项目通过进行两项形成性研究来满足这一需求。第一个项目将估计马来西亚巴生谷 F/TGSW 中艾滋病毒和性传播感染的流行情况，评估性行为和吸毒风险行为，并确定预防艾滋病毒和药物滥用的行为和生物医学方法的可行性。第二项研究将在第一项研究的基础上，通过调整行为和生物医学干预措施来解决该地区 F/TGSW 中同时发生的性行为和药物危险行为。这些项目的研究结果将有助于更好地了解目标人群中的艾滋病毒和药物滥用风险行为，并建立必要的知识来开发解决这些问题的创新方法。候选人 Wickersham 博士因其在性别和妇女研究方面的深厚背景、在公共卫生领域的研究生产力以及在马来西亚背景下的研究经验而具备独特的能力来完成这项工作。在该提案的五年内，他将实现他的职业目标和专业目标：1）发展设计、执行和调整艾滋病毒风险降低干预措施所需的研究方法方面的专业知识，并最终在人群中进行与艾滋病毒和性传播感染预防相关的临床试验。马来西亚的 TGW 和 FSW； 2) 获得干预措施制定、调整、测试、实施和传播方面的经验，以解决艾滋病毒预防和治疗服务中的性别障碍； 3) 在以患者为导向的研究中开辟一条独立的职业道路，重点关注艾滋病毒、妇女健康、性别以及药物滥用和预防之间的联系。为了实现这些目标，Wickersham 博士组建了一支由艾滋病毒、药物滥用、流行病学以及行为和生物医学干预科学领域的杰出领导者组成的团队。在他们的指导下，他将完成相关课程、参加研讨会并进行研究，以应用必要的技能，成为马来西亚背景下女性和跨性别女性性工作者艾滋病毒和药物滥用预防方面的独立调查员。