Microbicide/Female Condom Acceptability for Sex Workers

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DESCRIPTION (provided by applicant): We seek AIDS-FIRCA funds to supplement the Microbicide Acceptability to Prevent HIV in High-risk Women (R01 MH63631). This supplemental study will be conducted by an international research team from the Institute for Community Research in Hartford, CT, in collaboration with Dr. Susu Liao from the Department of Epidemiology, Peking Union Medical College (PUMC), in Beijing, China, to work in three mid-sized towns in Hainan and Guangxi Provinces, targeting female sex workers at high risk of HIV/STDs. It will examine their level of preparedness for using microbicide products and the female condom for HIV/STD prevention, the factors that affect their willingness to try or adopt such methods, and their reasons for choosing among alternative approaches to reducing STDs including HIV. This study will: 1) examine readiness for and acceptability of microbicide prevention methods and the female condom among Chinese female sex workers at high risk of contracting or transmitting HIV through unprotected sex in three southern Chinese rural and semi-urban towns; 2) identify contextual factors in the southern Chinese setting that affect acceptability of microbicides/female condoms, including ethnic/cultural beliefs, peer norms, personal risk context (prostitution, migration, abusive partners), economic conditions, social settings, partners and partner relationships, and concern for reproduction; 3) assess conditions under which high-risk Chinese female sex workers will be willing and/or able to use a vaginal microbicide (in a gel form) for HIV prevention during their regular sexual activity with their primary, casual, and/or paying sex partners; 4) assess conditions under which high-risk Chinese female sex workers will be willing and/or able to use a female condom for HIV prevention during their regular sexual activity with their primary, casual, and/or paying sex partners; and 5) establish an international research collaboration, infrastructure, and foundation for conducting a larger study of microbicide and female condom acceptability and adoption for HIV/STD prevention among female sex workers in these three towns in southern China. The target population will include 300 female sex workers (100 from each of three study sites), and will be approximately 80% Han Chinese and 20% minority ethnic groups (especially Li). We will use a combination of qualitative (elicitation techniques, semi-structured interviews) and quantitative (pile sorting, ranking, survey) methods to assess microbicide/female condom readiness and acceptability in the target populations. In the first 3 months, we will visit and review the three study sites and meet local collaborators. The rest of Year 1 will focus on research in Site 1; developing instruments, materials, and protocols; training local staff in sample recruitment, research methods, and data analysis; and collecting and analyzing data. In year 2, we will work in Site 2 and in Year 3, in Site 3 to replicate the work conducted in Site 1. In the last 6 months of the project we will finalize data analyses and an intervention program to promote the female condom and/or microbicides for a subsequent study.