BEHAVIORAL DYNAMICS OF HIV/AIDS IN UTTAR PRADESH, INDIA

本研究的总体目标是描述艾滋病毒/艾滋病在印度北方邦（UP）的北方州的传播潜力。 北方邦是印度人口最多的邦，其特点是加剧了其他地方艾滋病流行的条件：社会经济发展水平低，特别是妇女的健康状况差，性别分层高。 该研究的两个连续阶段将解决四个具体目标：第一阶段：定性方法将用于：1）开发一套解释性模型，以阐明将城市UP男性置于从事性桥接行为风险的因素组合; 2）告知第二阶段男性调查工具的开发，并帮助解释第二阶段的结果。 从事搭桥行为的男性将从第二阶段人口调查选择的同一城市的女性性工作者和性病患者的客户中确定。 对这些男子的深入访谈将侧重于生活史、同龄人群体、性关系网、伴侣史、安全套使用模式、艾滋病毒/性病相关知识和其他因素。 定性分析将查明与使男子有感染和传播艾滋病毒风险的行为有关的影响因素和途径。第二阶段：在北方邦育龄夫妇中进行一项横断面的、基于人口的调查，目的是：3）调查艾滋病毒/性病相关知识的模式和决定因素，以及对风险的看法，以及使他们处于这些感染风险的相关行为，4）确定并比较已婚妇女和男子寻求性传播疾病症状的健康行为的决定因素。 将在组成UP的五个地理区域中的每一个区域的两个最大城市和一个农村地区抽取3 000对夫妇的概率样本。 符合资格的妇女年龄在14- 49岁之间，已婚，在面试时与丈夫住在一起。 符合条件的男子将是符合条件的妇女确定的配偶。 将把妻子和丈夫提供的数据联系起来，用于多变量分析，以调查配偶之间在感兴趣的结果的模式和决定因素方面的差异，特别侧重于妇女的自主权和男子对其妻子的社会支持的影响。

The overall objective of the present study is to describe the potential for the spread of HIV/AIDS in the northern state of Uttar Pradesh, India (UP). UP, the most populous state of India, is characterized by conditions that have exacerbated the AIDS epidemic elsewhere: low socio-economic development, poor health outcomes particularly for women, and high gender stratification. The study's two consecutive phases will address the four specific aims: Phase I: Qualitative methods will be used to: 1) Develop a set of explanatory models to elucidate the combination of factors that place men in urban UP at risk for engaging in sexual bridging behavior; 2) inform the development of the male survey instrument for Phase II and aid the interpretation of Phase II results. Men who engage in bridging behavior will be identified from among clients of female sex workers and STD patients in the same cities selected for the Phase II population-based survey. In-depth, interviews with these men will focus on life history, peer groups, sexual networking, partner history, patterns of condom use, HIV/STD-related knowledge, and other factors. Qualitative analyses will identify factors and pathways of influence associated with behavior that places men at risk for becoming infected with and transmitting HIV infection. Phase II: A cross-sectional, population-based survey among couples of reproductive age in UP will be conducted to: 3) Investigate the patterns and determinants of HIV/STD-related knowledge, and perceptions of risk, and of related behavior that places them at risk for these infections, 4) identify and compare the determinants of married women's and men's health seeking behavior for symptoms of sexually transmitted diseases. A probability sample of 3,000 couples living in the two largest cities and a rural area in each of the five geographical regions that comprise UP will be drawn. Eligible women will be aged 14- 49, married, and residing with their husbands at the time of interview. Eligible men will be the spouses identified by eligible women. Data provided by wives and husbands will be linked and used in multivariate analyses to investigate the differentials between spouses in the patterns and determinants of the outcomes of interest, with a particular focus on the effects of women's autonomy and men's social support for their wives.