Proyecto Parejas: HIV/STI Risks among FSWs and their Non-Commercial Partners

Proyecto Parejas：FSW 及其非商业伙伴中的 HIV/STI 风险

基本信息

批准号：
7926479
负责人：
STEFFANIE A. STRATHDEE
金额：
$ 7.14万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-08-01 至 2014-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7926479
关键词：
Acquired Immunodeficiency Syndrome Address Affect Age Back Behavior Behavior Therapy Behavioral Border Crossings Chlamydia Cities Client Clinical Country Couples Data Epidemic Epidemiology Evaluation Female Goals Gonorrhea HIV HIV/STD Hand Home environment Human Herpesvirus 2 Incidence Individual Infection Injecting drug user Internal Migrations Intervention Intervention Trial Interview Knowledge Link Literature Methods Mexico Outcome Pattern Persons Pharmaceutical Preparations Population Positioning Attribute Prevalence Prevention Prevention strategy Recruitment Activity Reporting Research Research Infrastructure Resources Risk Risk Behaviors Running Sexual Partners Social Environment Surveys Syphilis Testing Time Unsafe Sex Woman base condoms consistent condom use follow-up high risk interest intimate partner violence male meetings pill prospective protective behavior public health relevance response sex social therapy design transmission process working men

项目摘要

DESCRIPTION (provided by applicant): The overall goal of this study is to study the context and epidemiology of HIV, STIs and associated risk behaviors among high risk female sex workers (FSWs) and their non-commercial male partners in two Mexico- US border cities. Preliminary data collected by our binational team over the past 5 years suggest that FSWs' non-commercial partners may be significant drivers of HIV/STI acquisition and/or their re-infection, which is supported by literature in other countries. FSWs in our setting are more than twice as likely to engage in unprotected sex with their main non-commercial partner; half of these partners have concurrent partnerships and one third are IDUs. The proposed study of FSW-partner pairs (dyads) builds on our existing research infrastructure in Tijuana and Cd. Juarez to meet the following aims: Aim 1: To examine the a) context and b) patterns of high risk sexual and substance using behaviors among high risk FSWs and their main non- commercial male partners, both within and outside of the partnerships, using a mixed-methods approach; Aim 2: To determine prevalence of HIV and specific STIs (i.e., syphilis, gonorrhea, Chlamydia, HSV-2) and associated correlates at the individual and partner level; Aim 3: To prospectively identify predictors of STI incidence and their attributable risks at the individual and partner level; Aim 4: To determine the feasibility of conducting a behavioral intervention trial among high risk FSWs and their main non-commercial male partner at the a) partner level and b) individual level, using mixed methods. To meet these aims, we will recruit 100 FSW-partner dyads in both Tijuana and Cd. Juarez (i.e., 200 couples), who will undergo interviews and HIV/STI testing at baseline and follow-up for 24 months to address both clinical and behavioral outcomes (Aims 2 and 3). A subset (25 couples per city) will undergo in-depth interviews at baseline and once during follow-up to refine the quantitative survey, and inform a mixed methods analysis to address Aims 1 and 4. Using qualitative and quantitative methods, we will assess each partner's interest in participating in a subsequent intervention, attrition and partnership dissolution, and potential barriers to interventions such as intimate partner violence (Aim 4). To our knowledge, the proposed study is the first prospective evaluation of FSWs and their non-commercial partners. Our binational research team is uniquely positioned to conduct this study, which will inform the response to the growing HIV crisis on the Mexico-US border and efforts to curtail HIV transmission among FSWs and their partners in other resource-constrained settings. PUBLIC HEALTH RELEVANCE: The proposed study of FSW-partner pairs in Tijuana and Ciudad Juarez will meet the following aims: Aim 1: To examine the a) social context and b) patterns of high risk sexual and substance using behaviors among high risk FSWs and their main non-commercial male partners, both within and outside of the partnerships, using a mixed-methods approach; Aim 2: To determine prevalence of HIV and specific STIs (i.e., syphilis, gonorrhea, Chlamydia, HSV-2) and associated correlates at the individual and partner level; Aim 3: To prospectively identify predictors of STI incidence and their attributable risks at the individual and partner level; Aim 4: To determine the feasibility of conducting a behavioral intervention trial among high risk FSWs and their main non-commercial male partner at the a) partner level and b) individual level, using mixed methods.

描述（由申请人提供）：这项研究的总体目标是研究高风险女性性工作者（FSWS）及其在两个墨西哥边境城市中的高风险女性性工作者（FSWS）及其非商业男性伴侣的艾滋病毒，性传播感染和相关风险行为的环境和流行病学。过去5年来，我们的双国团队收集的初步数据表明，FSW的非商业伙伴可能是HIV/STI获取和/或他们的重新感染的重要驱动力，这得到了其他国家的文献支持。在我们的环境中，FSW与主要非商业伙伴进行无保护的性行为的可能性是两倍以上；这些合作伙伴中有一半是同时的合作伙伴关系，三分之一是IDU。提议的FSW-PARTNER PAIRS（DYADS）的研究基于我们在蒂华纳和CD中现有的研究基础设施。 Juarez要满足以下目的：目标1：使用高风险FSW及其主要的非商业男性伴侣在合作伙伴关系内外的高风险FSW中使用行为的高风险性和物质模式，使用混合方法；目的2：确定艾滋病毒和特定性传播感染的患病率（即梅毒，淋病，衣原体，HSV-2）和相关的个人和伴侣级别的相关性；目标3：前瞻性地确定STI发病率的预测因素及其在个人和伴侣层面上的可归因风险；目标4：使用混合方法，使用混合方法来确定高风险FSW及其主要非商业男性伴侣之间进行行为干预试验的可行性。为了实现这些目标，我们将在蒂华纳和CD中招募100个FSW-Partner Dyads。 Juarez（即200对夫妇），他们将在基线进行访谈和艾滋病毒/STI测试，并随访24个月，以解决临床和行为结果（AIMS 2和3）。 A subset (25 couples per city) will undergo in-depth interviews at baseline and once during follow-up to refine the quantitative survey, and inform a mixed methods analysis to address Aims 1 and 4. Using qualitative and quantitative methods, we will assess each partner's interest in participating in a subsequent intervention, attrition and partnership dissolution, and potential barriers to interventions such as intimate partner violence (Aim 4).据我们所知，拟议的研究是对FSW及其非商业伙伴的首次预期评估。我们的双国研究团队在进行这项研究方面具有独特的位置，这将为墨西哥 - 美国边境日益增长的艾滋病毒危机的反应以及在其他资源受限的环境中减少FSW及其合作伙伴之间的HIV传播的努力。公共卫生相关性：拟议中对蒂华纳（Tijuana）和华雷斯（Ciudad Juarez）的FSW-Partner对研究的拟议研究将达到以下目的：目标1：检查a）社会环境和b）使用高风险FSW及其主要的非商业男性伴侣之间的高风险性和物质模式，无论是在使用混合方法的方法内外的非商业男性伴侣）目的2：确定艾滋病毒和特定性传播感染的患病率（即梅毒，淋病，衣原体，HSV-2）和相关的个人和伴侣级别的相关性；目标3：前瞻性地确定STI发病率的预测因素及其在个人和伴侣层面上的可归因风险；目标4：使用混合方法，使用混合方法来确定高风险FSW及其主要非商业男性伴侣之间进行行为干预试验的可行性。