ATS Use & HIV Among Young Female Sex and Entertainment Workers in Cambodia

苯丙胺类兴奋剂的使用

• 批准号: 7546955
• 负责人: Kimberly Page
• 金额: $ 12.86万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7546955
• 关键词: AIDS prevention; Adherence; Alcohol consumption; Alcohol or Other Drugs use; Amphetamines; Anti-Retroviral Agents; Asia; Cambodia; Caring; Clinical; Cohort Studies; Communities; Data; Data Reporting; Depth; Development; Disease Outcome; Drug Interactions; Drug usage; Epidemic; Evaluation; Female; Focus Groups; Forensic Medicine; Future; HIV; HIV Antibodies; HIV Infections; HIV Seropositivity; Health Care Seeking Behavior; Hepatotoxicity; High Risk Woman; Human immunodeficiency virus test; Ice; Incidence; Industry; Interview; Knowledge; Locales; Measures; Medical Surveillance; Numbers; Outcome; Patient Self-Report; Patients; Pharmaceutical Preparations; Play; Population; Preparation; Prevalence; Provider; Qualifying; Rate; Recommendation; Recruitment Activity; Relative (related person); Reporting; Research; Resistance; Risk; Risk Behaviors; Role; Screening procedure; Serologic tests; Services; Sexual Partners; Smoke; Source; Southeastern Asia; Surveys; Target Populations; Testing; Therapeutic; Toxic effect; Toxicology; Treatment Failure; Treatment outcome; Urine; Woman; Women' s Health; Work; Working Women; antiretroviral therapy; base; caspase-3; cohort; condoms; disorder risk; follow-up; health care service utilization; information gathering; pill; sex

DESCRIPTION (provided by applicant): We propose an exploratory developmental study investigating amphetamine-type substance (ATS) use among young women working in the entertainment and female sex work (FSW) industries in Phnom Penh, Cambodia. ATS use has increased tremendously in Cambodia, and although acknowledged to be a significant potential problem, little is known about ATS use among women. We will research current drugs being used, assess and develop measures of ATS use, and investigate associations between ATS with HIV infection, sexual risk behavior, and access to HIV care in HIV negative and positive women working in the entertainment/FSW industry. In recent work we conducted in Cambodia, 42.5% of entertainment/FSWs reported using ATS, including yama (40%) and,or crystal (23%). No studies have been conducted to qualify the various substances used, to quantify its use, or ATS' impact on sexual risk and health-seeking behaviors among this population. ATS use has been shown to be associated with elevated risk of HIV infection in many groups and locales; thus we hypothesize the same will be true among women in Cambodia. We also hypothesize that ATS use may be associated with negative outcomes relative to HIV care: HIV positive ATS users may access HIV care, and initiate antiretroviral therapy (ART) at lower rates than their non-ATS using counterparts due to poor patient follow up or provider bias. ATS may increase risk of medication related toxicities, for instance hepatotoxicities, poor adherence, contributing to sub-therapeutic drug levels and resistance. The proposed study will be conducted within the framework of an pilot cohort of HIV-negative and positive young entertainment/ FSWs: the Young Women's Health Study (YWHS), affording us an extraordinary opportunity to better understand the entwined epidemics of ATS use and HIV infection in a high-risk population To explore ATS use and assess associations between ATS use and HIV, sexual risk, and utilization of HIV care/treatment, we will collect both qualitative and quantitative data. In depth interviews and focus groups will be conducted initially, to explore ATS issues, views, and knowledge among the target population and to inform a quantitative survey. We will recruit 100 women from the YWHS cohort, to participate in a survey and HIV testing. We will measure ATS use, and other risk exposures by self-report and urine-based toxicology testing. HIV antibody status will be determined by serologic testing. Associations between ATS use and sexual risk (principally condom use, and number and type of sex partners) will be assessed for both HIV-positive and negative women, and access to HIV care including initiation of anti-retroviral therapy (ART) use) will be evaluated among those who are HIV-positive. Finally, we will gather information from governmental, clinical and other (NGO) sources in Cambodia regarding known pharmacological and forensic data, to inform an evaluation of potential interactions between ATS and antiretroviral treatment. The results of this study will be used to lay the groundwork for a future R01 proposal examining ATS substances in more detail, and ART use, including potential drug-drug interactions, and will guide recommendations for the provision of HIV prevention and care services among ATS-using women in Cambodia and Southeast Asia. Project Narrative We propose to conduct an exploratory developmental study investigating amphetamine-type substance (ATS) use among young women working in the entertainment and female sex work (FSW) industries in Phnom Penh, Cambodia. ATS use has increased tremendously in Cambodia, and although acknowledged to be a significant potential problem, little is known about ATS use and HIV among young high risk women. We will research which current drugs are being used, assess and develop measures of ATS use, and investigate associations between ATS with HIV infection, sexual risk behavior, and access to HIV care and treatment in HIV negative and positive women working in the entertainment/FSW industry. The research will be conducted by a multi-disciplinary collaborative research group that includes academic, governmental and community partners.

描述(由申请人提供)：我们建议进行一项探索性发展研究，调查柬埔寨金边娱乐业和女性性工作(FSW)行业年轻女性中苯丙胺类物质(ATS)的使用情况。在柬埔寨，安非他明类兴奋剂的使用大幅增加，尽管人们承认这是一个重大的潜在问题，但人们对女性使用安非他明类兴奋剂的情况知之甚少。我们将研究目前正在使用的药物，评估和开发安非他明类药物的使用指标，并调查在娱乐/FSW行业工作的艾滋病毒阴性和阳性女性中，安非他明类药物与艾滋病毒感染、性行为和获得艾滋病毒护理之间的关联。在我们最近在柬埔寨开展的工作中，42.5%的娱乐/FSWs报告使用了安非他明类兴奋剂，其中包括Yama(40%)和/或Crystal(23%)。还没有进行研究来鉴定所使用的各种物质，量化其使用，或者安非他明类兴奋剂对这一人群中的性风险和寻求健康行为的影响。在许多群体和地区，使用安非他明类兴奋剂已被证明与艾滋病毒感染风险增加有关；因此，我们假设柬埔寨妇女也是如此。我们还假设ATS的使用可能与HIV护理的负面结果相关：HIV阳性的ATS使用者可能会获得HIV护理，并由于患者随访或提供者偏见而以低于使用非ATS的同龄人的比率开始抗逆转录病毒治疗(ART)。ATS可能会增加药物相关毒性的风险，例如肝毒性，依从性差，导致亚治疗药物水平和耐药性。拟议的研究将在艾滋病毒阴性和阳性的年轻娱乐/性服务工作者的试点队列的框架内进行：青年妇女健康研究(YWHS)，为我们提供一个非同寻常的机会，让我们更好地了解在高危人群中ATS使用和艾滋病毒感染的相互交织的流行病，探索ATS使用和评估ATS使用与艾滋病毒、性风险和艾滋病毒护理/治疗利用之间的关系，我们将收集定性和定量数据。最初将进行深入访谈和焦点小组，以探索目标人群中的安非他明类兴奋剂问题、观点和知识，并为量化调查提供信息。我们将从YWHS队列中招募100名妇女参加一项调查和艾滋病毒检测。我们将通过自我报告和尿毒学测试来衡量ATS的使用和其他风险暴露。艾滋病毒抗体状况将通过血清学检测来确定。将对艾滋病毒阳性和阴性妇女评估安非他明类兴奋剂的使用与性风险(主要是避孕套的使用，以及性伴的数量和类型)之间的关系，并将评估艾滋病毒阳性者获得艾滋病毒护理的机会，包括开始使用抗逆转录病毒疗法(ART)。最后，我们将从柬埔寨的政府、临床和其他(非政府组织)来源收集有关已知药理学和法医学数据的信息，以评估ATS和抗逆转录病毒治疗之间的潜在相互作用。这项研究的结果将被用来为未来的R01提案奠定基础，该提案更详细地审查ATS物质和ART的使用，包括潜在的药物-药物相互作用，并将指导柬埔寨和东南亚使用ATS的妇女提供艾滋病毒预防和护理服务的建议。项目简介我们建议进行一项探索性发展研究，调查柬埔寨金边娱乐业和女性性工作(FSW)行业年轻女性中苯丙胺类物质(ATS)的使用情况。在柬埔寨，安非他明类兴奋剂的使用大幅增加，尽管人们承认这是一个重大的潜在问题，但人们对年轻的高危妇女中的安非他明类兴奋剂的使用和艾滋病毒知之甚少。我们将研究目前正在使用哪些药物，评估和开发安非他明类药物的使用指标，并调查在娱乐/FSW行业工作的艾滋病毒阴性和阳性女性中，安非他明类药物与艾滋病毒感染、性行为和获得艾滋病毒护理和治疗的相关性。这项研究将由一个多学科合作研究小组进行，该小组包括学术、政府和社区合作伙伴。

项目成果

Sex work and HIV in Cambodia: trajectories of risk and disease in two cohorts of high-risk young women in Phnom Penh, Cambodia.

• DOI: 10.1136/bmjopen-2013-003095
• 发表时间: 2013-09-10
• 期刊: BMJ open
• 影响因子: 2.9
• 作者: Page K;Stein E;Sansothy N;Evans J;Couture MC;Sichan K;Cockroft M;Mooney-Somers J;Phlong P;Kaldor J;Maher L;Young Women's Health Study Collaborative*
• 通讯作者: Young Women's Health Study Collaborative*

Selling sex in unsafe spaces: sex work risk environments in Phnom Penh, Cambodia.

• DOI: 10.1186/1477-7517-8-30
• 发表时间: 2011-11-20
• 期刊: Harm reduction journal
• 影响因子: 4.4
• 作者: Maher L;Mooney-Somers J;Phlong P;Couture MC;Stein E;Evans J;Cockroft M;Sansothy N;Nemoto T;Page K;Young Women's Health Study Collaborative
• 通讯作者: Young Women's Health Study Collaborative

Cervical human papillomavirus infection among young women engaged in sex work in Phnom Penh, Cambodia: prevalence, genotypes, risk factors and association with HIV infection.

• DOI: 10.1186/1471-2334-12-166
• 发表时间: 2012-07-28
• 期刊: BMC infectious diseases
• 影响因子: 3.7
• 作者: Couture MC;Page K;Stein ES;Sansothy N;Sichan K;Kaldor J;Evans JL;Maher L;Palefsky J
• 通讯作者: Palefsky J

Young women engaged in sex work in Phnom Penh, Cambodia, have high incidence of HIV and sexually transmitted infections, and amphetamine-type stimulant use: new challenges to HIV prevention and risk.

• DOI: 10.1097/olq.0b013e3182000e47
• 发表时间: 2011-01
• 期刊: Sexually transmitted diseases
• 影响因子: 3.1
• 作者: Couture MC;Sansothy N;Sapphon V;Phal S;Sichan K;Stein E;Evans J;Maher L;Kaldor J;Vun MC;Page K
• 通讯作者: Page K

Condom negotiation across different relationship types by young women engaged in sex work in Phnom Penh, Cambodia.

• DOI: 10.1080/17441692.2013.767930
• 发表时间: 2013
• 期刊: Global public health
• 影响因子: 3.3
• 作者: Maher L;Mooney-Somers J;Phlong P;Couture MC;Kien SP;Stein E;Bates AJ;Sansothy N;Page K;Young Women's Health Study Collaborative
• 通讯作者: Young Women's Health Study Collaborative