MASLIHAT Intervention for Tajik Male Migrants Who Inject Drugs

MASLIHAT 对注射毒品的塔吉克男性移民的干预

基本信息

批准号：
10401872
负责人：
MARY ELLEN MACKESY-AMITI
金额：
$ 56.43万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-01 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10401872
关键词：
AIDS prevention AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adopted Alcohol consumption Alcohols Awareness Behavior Behavior Therapy Behavioral Behavioral Mechanisms Belief Centers for Disease Control and Prevention (U.S.)Central Asia China Cluster randomized trial Cognitive Control Groups Country Destinations Development Disease model Drug usage Education Enrollment Epidemic Evaluation Evidence based intervention HIV HIV risk HIV/HCV Heavy Drinking Home Individual Influentials Injecting drug user Intercept Intervention Knowledge Labor Migrations Learning Life Linear Regressions Logistic Regressions Measures Mediation Mediator of activation protein Migrant Modeling Moscow Movement Needle Sharing Network-based Outcome Participant Persons Pharmaceutical Preparations Population Populations at Risk Prevention Preventive service Randomized Clinical Trials Research Risk Risk Behaviors Russia Self Efficacy Sex Behavior Sexual Partners Social Network South Africa Southeastern Asia Tajikistan Testing Theoretical model Training Unemployment United States Unsafe Sex Vulnerable Populations Work Yang alcohol behavior behavior change behavior influence design efficacy testing evidence base group intervention health care availability health care service high risk improved injection drug use interest male marginalized population member men migration peer pilot test post intervention preventive intervention psychosocial psychosocial wellbeing recruit role model self help sexual risk behavior social social culture social exclusion theories transmission process

项目摘要

PROJECT SUMMARY Labor migration is a major contributor to fueling the global AIDS epidemic and also the movement of HIV across country borders and populations. Migrants who inject drugs while in a host country are at especially high risk. Tajikistan, a small country in Central Asia, exports more than a million Tajiks annually, many of whom inject drugs, to work temporarily outside of their own country. Our earlier research on Tajik labor migrants in Moscow showed them to be at alarmingly high normative and behavioral risk for HIV due to risky drug use, needle sharing, alcohol consumption, and unsafe sex with casual and paid sex partners. To help curb transmission in this vulnerable population, we developed and pilot tested the "Migrants' Approached Self- Learning Intervention in HIV/AIDS for Tajiks" (MASLIHAT) prevention model. The model recruits and trains current and former Tajik migrants who inject drugs as "peer educators" in delivering the intervention to others in their social networks while simultaneously reducing their own risk. The MASLIHAT Intervention and our research efforts build synergistically on 3 theoretical models: social-cognitive-behavioral theory, social network theory and Yang's Theory of Migration. The model itself culturally adapts the successful SHIELD model, which is a CDC- designated evidence-based best practice intervention in the U.S., for use with Tajik labor migrants in Russia who inject drugs. This study will test the efficacy of the MASLIHAT intervention against a control condition designed to be equal to the intervention condition in the number of sessions, duration, and interest level. We will deliver MASLIHAT and control group interventions over 5 sessions with groups of 5 to 9 Tajik male migrants who inject drugs for a total of 10 groups for each intervention. The peer educators will share what they learned with others in their social networks, including the 2 network members who inject drugs whom they recruited for enrollment in the study. We will assess MASLIHAT and control participants and their Tajik male social network members at baseline and at 3, 6, 9 and 12 months post-intervention. We will conduct repeated measures linear and logistic regressions using mixed effect models with random person intercepts to test: (1) if greater changes in HIV risk behaviors, prevention self-efficacy, and behavioral norms occur among MASLIHAT participants (peer educators) compared to control participants, and (2) if greater changes in HIV risk behaviors, prevention self-efficacy, and behavioral norms occur among peer educator network members compared to control group network members. By transforming their own risk behavior, and encouraging others at risk to do so as well, migrant peer educators can initiate positive changes at the individual and social network levels in both their host country and also their home country when they return. The impact of the proposed study lies in the development of a much needed scientifically tested intervention that reduces HIV transmission among migrants who inject drugs within and across country borders.

项目概要劳务移民是助长全球艾滋病流行以及艾滋病毒传播的主要因素跨越国界和人口。在东道国注射吸毒的移民尤其容易受到伤害高风险。塔吉克斯坦是中亚的一个小国，每年出口超过一百万塔吉克斯坦人，其中许多人注射毒品、暂时出国工作。我们早期对塔吉克斯坦劳工移民的研究莫斯科表明，由于危险药物的使用，他们的艾滋病毒规范和行为风险非常高，共用针头、饮酒以及与临时和付费性伴侣发生不安全的性行为。帮助遏制为了在这一弱势群体中传播，我们开发并试点了“移民接近自我传播” 塔吉克人艾滋病毒/艾滋病学习干预（MASLIHAT）预防模型。该模型招募和培训现任和前任塔吉克移民作为“同伴教育者”注射毒品，向他人提供干预措施在他们的社交网络中，同时降低自己的风险。 MASLIHAT 干预和我们的研究工作协同建立在三种理论模型之上：社会认知行为理论、社交网络理论和杨氏移民理论。该模型本身在文化上适应了成功的神盾局模型，是美国疾病预防控制中心 (CDC) 指定的基于证据的最佳实践干预措施，适用于塔吉克斯坦劳工移民俄罗斯人注射毒品。本研究将测试 MASLIHAT 干预措施相对于对照的有效性条件设计为等于干预条件的会话次数、持续时间和兴趣等级。我们将在 5 次会议上为 5 至 9 名塔吉克人提供 MASLIHAT 和对照组干预措施注射吸毒的男性移民每次干预共 10 组。同伴教育者将分享他们在社交网络中从其他人那里学到了什么，包括 2 名注射毒品的网络成员他们招募了参加这项研究的人。我们将评估 MASLIHAT 并控制参与者及其塔吉克人基线时以及干预后 3、6、9 和 12 个月时的男性社交网络成员。我们将进行使用具有随机人截距的混合效应模型重复测量线性和逻辑回归测试：(1) HIV 危险行为、预防自我效能和行为规范是否发生较大变化 MASLIHAT 参与者（同伴教育者）与对照参与者相比，以及 (2) HIV 变化是否更大同伴教育者网络成员中出现风险行为、预防自我效能和行为规范与对照组网络成员相比。通过改变自己的风险行为并鼓励他人移民同伴教育者也可以冒着这样做的风险，在个人和社会方面发起积极的变革。他们在东道国以及回国后的祖国的网络水平。的影响拟议的研究在于开发一种急需的、经过科学测试的干预措施，以减少艾滋病毒境内和跨国注射毒品的移民之间的传播。