HIV Risk & Migration -Young Yi Minority - Sichuan China

描述(申请人提供)：东南亚和中亚正在见证全球市场经济的快速渗透。与经济转型并行的城市化带来了传染病传播的增加，通常是在公共卫生资源有限的地区。流动人口参与城市非正规劳动力部门的扩大尤其令人担忧，因为城市中心和偏远农村地区之间的流动可能成为传播行为风险做法和传染病本身的一种机制。彝族长期处于社会和经济的边缘地位，对进城务工劳动力的依赖程度越来越高，是中国南部一个特别脆弱的民族。由于普遍缺乏对该区域艾滋病毒和性传播疾病传播的了解，这种社会经济脆弱性可能会加剧。作为一项使用R21机制的探索性试点研究，本申请提出了一套有针对性的人种学方法，用来详细说明我们对外来劳工如何以及为什么可能带来独特的健康风险，特别是接触毒品和性风险做法的高风险的理解。我们建议将重点放在年轻的彝族人身上，因为我们的初步工作表明，许多彝族人在成年后很早就开始从事外来务工，而且接触毒品和性风险也发生得很早。由于我们的试点工作表明，性别对男性和女性在移民劳动力中所扮演的经济角色具有重要影响，我们建议同时研究男性和女性。根据既定的人种学研究设计，这项研究将从一系列形成性研究活动开始，这些活动将有助于为进行研究的当地社区的研究团队定位。此外，将招募一小群关键参与者进行一系列人种学访谈，其中将包括关于生活史和生命历程事件、家庭经历、教育和技能获得、生存和创收战略、关于艾滋病毒/性传播疾病的知识和信念、启动毒品和性风险活动以及耻辱经历等问题(N=60)。访谈将提供一些信息，使我们能够初步构建药物和性风险做法是如何启动的流行病学轨迹，以及行为风险早期过程的关键特征，这将需要在未来的研究和预防活动中进行预测。

DESCRIPTION (provided by applicant): Southeast and central Asia are witnessing rapid penetration by the global market economy. The urbanization that has paralleled this economic transformation has brought with it an increased spread of communicable diseases, often in areas with limited public health resources. Expansions in migrants' involvement in the urban-based informal labor sector is of particular concern because movement between urban centers and remote rural regions may serve as a mechanism for diffusing both behavioral risk practices as well as infectious diseases themselves. With a long history of social and economic marginalization, and increasing dependence on urban-based migrant labor, the Yi minorities are an especially vulnerable ethnic group in southern China. This socio-economic vulnerability may be exacerbated by the general lack of knowledge about transmission of HIV and STD's in the region. Developed as an exploratory pilot study using the R21 mechanism, this application proposes a targeted set of ethnographic methods with which to elaborate our understanding of how and why migrant labor may confer unique health risks, notably high risk for exposure to drug and sexual risk practices. We propose to focus on young adult Yi because our preliminary work suggests that many Yi become involved in migrant labor early in their adult lives and that exposure to drug and sexual risk also occur early. Since our pilot work suggests that gender is an important influence on the economic roles that men and women occupy in migrant labor, we propose to study both men and women. Based on an established ethnographic research design, the study will begin with a set of formative research activities that will serve to orient the research team in the local communities where the study will be conducted. Additionally, a small group of key participants will be recruited for a series of ethnographic interviews that will include questions about life history and life course events, family experience, education and skills acquisition, subsistence and income generating strategies, knowledge and beliefs about HIV/STD's, initiation of drug and sexual risk activities, and experiences of stigma (N=60). Interviews will yield information that will allow us to construct a preliminary epidemiological trajectory of how drug and sexual risk practices are initiated, and key features of the early course of behavioral risk, that would need to be anticipated in future research and prevention activities.