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

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.

描述（由申请人提供）：拟议论文研究项目（R36）的总体目标是对性伴侣并发性（即重叠性伴侣）进行横断面混合方法研究，这是艾滋病毒和艾滋病流行病学的一个重要因素。其他性传播感染 (STI)，存在于美墨边境高风险、吸毒女性性工作者 (FSW) 及其非商业性亲密男性伴侣之间 地区。药物滥用、性工作和人口流动是该地区的特点，在包括 FSW 和注射吸毒者 (IDU) 在内的高危人群中，艾滋病毒/性传播感染呈动态流行。尽管迄今为止，这些艾滋病毒/性传播感染仍然集中流行，但 FSW 与亲密伴侣二人组之间的并发可以迅速促进艾滋病毒/性传播感染与普通人群的“桥梁”。尽管有大量关于并发的文献，但人们对西半球资源贫乏地区边缘化吸毒二人组中并发的动机和背景知之甚少。拟议的论文研究旨在描述高风险二人组并发的社会背景（目标 1），并确定高风险 FSW（目标 2）及其亲密男性伴侣（目标 3）中并发的性别特定患病率和相关性在美国和墨西哥边境地区。为了实现这些目标，我们将在 Proyecto Parejas（R01-DA02772；PI：S. Strathdee）中使用定性和定量方法实施横断面混合方法设计，Proyecto Parejas 是一个由 200 名高风险吸毒 FSW 组成的现有队列以及他们在蒂华纳和CD的亲密男性伴侣。华雷斯（N = 总共 400 名受试者）。为了实现目标 1，我们将有目的地抽样约 20 名女性和约 20 名男性 (N=40)，报告现有基线定量调查中最近（过去一年）的并发性，这些调查使用联合国艾滋病规划署推荐的性伴侣历史模块来衡量并发性。我们将对这个子样本进行半结构化访谈，这将不同于母研究的数据收集，以定性探索并发的含义和动机，包括可能促进或阻止并发行为的社会和环境因素。然后，我们将利用新出现的定性发现来制定概念框架和具体假设来指导定量分析。为了实现目标 2 和 3，我们将使用来自 200 个二人组 (N=400) 的整个队列的现有定量基线数据。我们将确定并发流行率并应用多级（即二元）逻辑回归来确定 FSW（目标 2）及其亲密男性伴侣（目标 3）的并发性的个体和关系级相关性。我们的二元混合方法研究设计将首次对以毒品泛滥、商业性行为和人口流动为特征的地区的并发性进行深入调查。它还将使 PI 成为药物滥用研究领域具有竞争力的新调查员。研究结果对于制定基于证据的、针对性别的干预措施至关重要，以降低吸毒的女性工作者及其亲密男性伴侣的艾滋病毒/性传播感染风险。