MINORITY PREDOCTORAL FELLOWSHIP

描述(申请人提供)：泰国男性性工作者(MSW)中的艾滋病毒流行尚未得到充分研究，估计发病率在过去几年中有所上升。此外，大多数城市生活垃圾是没有证件的少数民族，生活贫困，受教育程度低；这使他们特别容易感染艾滋病毒。MSW的流动性也很强；他们在主要旅游城市工作几个月，挣钱，然后离开；因此，准确衡量艾滋病毒和性传播感染的流行和发病率极其困难。我的假设是，在清迈，MSW的特征与女性性工作者(FSW)明显不同，MSW中艾滋病毒和性传播感染的发病率是FSW或普通人群的数倍。与泰国公共卫生部(MOPH)合作，这项拟议的研究将是一项对泰国清迈男性和女性性工作者进行的开放式前瞻性队列研究。这项研究的主要目的是通过亲和力指数的计算，描述和比较清迈男女性工作者中艾滋病毒和性传播感染的流行病学，特别是近期和长期感染艾滋病毒的情况。次要目标是确定该人群中艾滋病毒和性传播感染的社会和行为风险因素。研究结果将有助于为泰国城市生活垃圾形成有针对性和文化敏感性的公共卫生干预措施，并为政策决策提供参考，特别是为这一弱势群体分配预算。此外，测试使用亲和力指数计算来估计这一高度流动人口的发病率的可行性，将有助于在资源有限的情况下对艾滋病毒和性传播感染监测采取成本效益办法。

DESCRIPTION (provided by applicant): The HIV epidemic among male sex workers (MSW) in Thailand is understudied and incidence was estimated to have increased over the past few years. Furthermore, most MSW are undocumented ethnic minorities, are impoverished, and have low levels of education; making them particularly vulnerable to HIV infections. MSW are also highly mobile; they work in major tourist cities for few months, earn money, and then leave; thus making it extremely difficult to accurately measure HIV and STI prevalence and incidence. My hypothesis is that the characteristics of MSW are markedly different from female sex workers (FSW) in Chiang Mai, and that HIV and STI incidence is many times higher among MSW than FSW or the general population. In collaboration with the Thai Ministry of Public Health (MOPH), the proposed research will be an open prospective cohort study of male and female sex workers in Chiang Mai, Thailand. The primary goal of the < study is to describe and compare the epidemiology of HIV and STI among male and female sex workers in Chiang Mai, particularly recent versus longer-term HIV infections by use of the avidity index calculation. The Secondary goal is to determine HIV and STI social and behavioral risk factors among this population. Study findings will aid in forming targeted and culturally sensitive public health interventions for MSW in Thailand, and inform policy decisions; particularly budget allocations to this vulnerable population. Moreover, testing the feasibility of using the avidity index calculation to estimate incidence in this highly mobile population will contribute to a cost-benefit approach to HIV and STI surveillance in resource-limited settings.