Concurrent Partnerships Among High-Risk Couples in the U.S.-Mexico Border Region

美国-墨西哥边境地区高风险夫妇的同时伴侣关系

• 批准号: 8311620
• 负责人: Angela Robertson Bazzi
• 金额: $ 5.29万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-15 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8311620
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Africa South of the Sahara; Behavior; Behavior Therapy; California; Chlamydia; Cities; Client; Control Groups; Couples; Data; Data Collection; Developed Countries; Development; Drug abuse; Drug usage; Enrollment; Environmental Risk Factor; Epidemic; Epidemiology; Female; Gender; General Population; Goals; Gonorrhea; HIV; Incidence; Individual; Infection prevention; Injecting drug user; Intervention; Intervention Studies; Interview; Investigation; Literature; Logistic Regressions; Measures; Methods; Mexico; Motivation; Nature; Parents; Persons; Pharmaceutical Preparations; Population; Positioning Attribute; Prevalence; Preventive Intervention; Prostitution; Qualitative Methods; Qualitative Research; Recording of previous events; Regression Analysis; Reporting; Research; Research Design; Research Methodology; Research Personnel; Research Project Grants; Resources; Risk; Risk Behaviors; Role; Sampling; Sex Behavior; Sex Characteristics; Sexual Partners; Sexual abuse; Sexually Transmitted Diseases; Social Environment; Spouses; Structure; Substance abuse problem; Surveys; Syphilis; Testing; Time; Trust; United States National Institutes of Health; Unsafe Sex; Urban Population; Woman; Work; cohort; condoms; demographics; design; evidence base; high risk; high risk behavior; insight; male; meetings; men; men who have sex with men; sex; social; transmission process; AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Africa South of the Sahara; Behavior; Behavior Therapy; California; Chlamydia; Cities; Client; Control Groups; Couples; Data; Data Collection; Developed Countries; Development; Drug abuse; Drug usage; Enrollment; Environmental Risk Factor; Epidemic; Epidemiology; Female; Gender; General Population; Goals; Gonorrhea; HIV; Incidence; Individual; Infection prevention; Injecting drug user; Intervention; Intervention Studies; Interview; Investigation; Literature; Logistic Regressions; Measures; Methods; Mexico; Motivation; Nature; Parents; Persons; Pharmaceutical Preparations; Population; Positioning Attribute; Prevalence; Preventive Intervention; Prostitution; Qualitative Methods; Qualitative Research; Recording of previous events; Regression Analysis; Reporting; Research; Research Design; Research Methodology; Research Personnel; Research Project Grants; Resources; Risk; Risk Behaviors; Role; Sampling; Sex Behavior; Sex Characteristics; Sexual Partners; Sexual abuse; Sexually Transmitted Diseases; Social Environment; Spouses; Structure; Substance abuse problem; Surveys; Syphilis; Testing; Time; Trust; United States National Institutes of Health; Unsafe Sex; Urban Population; Woman; Work; cohort; condoms; demographics; design; evidence base; high risk; high risk behavior; insight; male; meetings; men; men who have sex with men; sex; social; transmission process

DESCRIPTION (provided by applicant): The overall goal of the proposed dissertation research project (R36) is to conduct a cross-sectional mixed methods study of sexual partner concurrency (i.e., overlapping sexual partnerships), an important factor in the epidemiology of HIV and other sexually transmitted infections (STIs), among dyads of high-risk, drug using female sex workers (FSWs) and their non-commercial, intimate male partners in the U.S.-Mexico border region. Substance abuse, sex work, and population mobility are features of the region, where a dynamic epidemic of HIV/STIs has emerged in high-risk populations including FSWs and injection drug users (IDUs). Although to date these HIV/STI epidemics remain concentrated, concurrency among FSW-intimate partner dyads could rapidly promote the "bridging" of HIV/STIs to the general population. Despite the vast literature on concurrency, little is known about the motivations for and contexts surrounding concurrency among marginalized, drug-using dyads in resource-poor settings in the Western Hemisphere. The proposed dissertation study seeks to characterize the social context of concurrency for high-risk dyads (Aim 1) and determine the gender-specific prevalence and correlates of concurrency among high-risk FSWs (Aim 2) and their intimate male partners (Aim 3) in the U.S.-Mexico border region. To meet these aims, we will implement a cross-sectional mixed methods design using qualitative and quantitative methods within Proyecto Parejas (R01-DA02772; PI: S. Strathdee), an existing cohort of 200 dyads of high-risk, drug-using FSWs and their intimate male partners in Tijuana and Cd. Juarez (N=400 subjects total). To meet Aim 1, we will purposively sample ~20 women and ~20 men (N=40) reporting recent (past year) concurrency in existing baseline quantitative surveys that measured concurrency using a UNAIDS-recommended sexual partner history module. We will conduct semi-structured interviews with this subsample, which will be distinct from data collection of the parent study, to qualitatively explore the meanings of and motivations for concurrency including social and environmental factors that may promote or discourage concurrency behaviors. We will then use emergent qualitative findings to develop a conceptual framework and specific hypotheses to guide quantitative analyses. To meet Aims 2 and 3, we will use existing quantitative baseline data from the entire cohort of 200 dyads (N=400). We will determine concurrency prevalence and apply multilevel (i.e., dyadic) logistic regression to identify individual- and relationship-level correlates of concurrency for FSWs (Aim 2) and their intimate male partners (Aim 3). Our dyadic, mixed methods study design will provide the first in-depth investigation of concurrency in a region characterized by prevalent drug use, commercial sex, and population mobility. It will also position the PI as a competitive new investigator in drug abuse research. Findings will be critical to the development of evidence-based, gender-specific interventions to reduce HIV/STI risk among drug-using FSWs and their intimate male partners.

DESCRIPTION (provided by applicant): The overall goal of the proposed dissertation research project (R36) is to conduct a cross-sectional mixed methods study of sexual partner concurrency (i.e., overlapping sexual partnerships), an important factor in the epidemiology of HIV and other sexually transmitted infections (STIs), among dyads of high-risk, drug using female sex workers (FSWs) and their non-commercial, intimate male partners在美墨边境地区。药物滥用，性工作和人口流动性是该地区的特征，在该地区，包括FSW和注射吸毒者（IDU）在内的高风险人群中出现了艾滋病毒/性传播感染的动态流行。尽管迄今这些HIV/STI流行病仍然集中，但FSW领域伴侣二元组之间的并发可能会迅速促进HIV/STI的“桥接”向普通人群。尽管有关于并发的大量文献，但对西半球的资源贫乏环境中边缘化的，吸毒的二元组的动机和背景知之甚少。拟议的论文研究旨在表征高风险二元组并发的社会背景（AIM 1），并确定高风险FSW（AIM 2）及其亲密男性伴侣（AIM 3）在美墨边境地区的性别特异性流行和并发的相关性。为了满足这些目标，我们将使用Proyecto Parejas（R01-DA02772; PI：S。Strathdee）内的定性和定量方法实施横截面混合方法设计，这是200个高风险，吸毒的FSW及其在Tijuaana和CD中的高风险，吸毒的FSW及其亲密男性伴侣的同类。 Juarez（n = 400名受试者）。为了满足AIM 1，我们将有目的地采样约20名女性和约20名男性（n = 40）报告的（过去一年）在现有的基线定量调查中并发，这些调查使用UNAIDS-RECROMPORNTed性伴侣历史模块来测量并发。我们将对此子样本进行半结构化访谈，这将与父母研究的数据收集不同，以定性地探索并发的含义和动机，包括可能促进或劝阻并发行为的社会和环境因素。然后，我们将使用新兴的定性发现来开发概念框架和特定假设，以指导定量分析。为了满足目标2和3，我们将使用来自200个二元组的整个队列中现有的定量基线数据（n = 400）。我们将确定并发率的流行，并应用多级（即二元）逻辑回归，以识别FSWS（AIM 2）及其亲密男性伴侣（AIM 3）并发的个体和关系级相关。我们的二元，混合方法研究设计将对以普遍使用药物使用，商业性和人口流动性为特征的区域进行首次对并发性的深入研究。它还将将PI定位为药物滥用研究领域的竞争新研究者。调查结果对于开发基于证据的，特定性别的干预措施至关重要，以降低吸毒的FSW及其亲密男性伴侣的艾滋病毒/性传播感染风险。