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病，历史上是由注射毒品（PWID）的男性驱动的，在过去的二十年中，已转变为普遍的流行病，并在药物滥用和性传播之间桥梁。在此期间，女性占了新的HIV感染的比例越来越多（从1990年的1％到2011年的25％），这绝对归因于性传播。跨性别妇女在该地区也面临着越来越多的艾滋病毒负担，最近的证据表明，在全球处于危险中，他们是最高风险的亚种群之一。性工作和频繁的药物滥用同时发生是女性和跨性别妇女的主要危险因素，尤其是在马来西亚，这已成为性旅游的主要目的地。尽管国际机构（谁，纽约市企业，联合国署）建议实施创新的，但对预防艾滋病毒和药物滥用的结合方法，尤其是在妇女中，马来西亚的吸收，东南亚的吸收，通常是不足的。需求解决女性和变性性工作者（F/TGSW）中性工作和滥用药物滥用的复杂综合性的新方法。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。第一个将估计马来西亚克兰谷的F/TGSW中艾滋病毒和性传播感染的患病率，评估性和毒品风险行为，并确定艾滋病毒和预防药物使用的行为和生物医学方法的可行性。第二项研究将在第一个研究基础上通过调整行为和生物医学干预措施来解决该地区的F/TGSW中共同发生的性和药物风险行为。这些项目的发现将有助于对目标人群中的艾滋病毒和滥用毒品滥用风险行为有所帮助，并建立开发创新方法来解决这些艾滋病毒的知识。候选人威克瑟姆（Wickersham）博士独特地准备执行这项工作，因为他在性别和妇女研究方面具有强大的背景，他在公共卫生领域的研究生产力以及他在马来西亚背景下的研究经验。在这项提案的五年中，他将实现自己的职业目标和专业目标：1）在设计，执行和适应降低HIV风险的研究方法方面发展专业知识，并最终在马来西亚的TGW和TGW和FSW中进行与HIV和STI预防有关的临床试验； 2）在干预开发，适应，测试，实施和传播方面获得经验，这些经验将解决针对艾滋病毒预防和治疗服务的性别特定障碍； 3）在以患者为导向的研究中发展独立的职业道路，该研究重点是艾滋病毒，妇女健康，性别，滥用药物和预防之间的界面。为了实现这些目标，威克瑟姆博士召集了一支在艾滋病毒，滥用药物，流行病学以及行为和生物医学干预科学领域的杰出领导人团队。在他们的指导下，他将完成相关的课程，参加研讨会并进行研究，以运用在马来西亚的女性和跨性别女性性工作者中成为艾滋病毒和滥用毒品滥用的独立调查员所必需的技能。