Migration to Urban Slums, Sexual Networks, and HIV in Ghana

加纳向城市贫民窟的移民、性网络和艾滋病毒

• 批准号: 7531983
• 负责人: SUSAN LYNN CASSELS
• 金额: $ 8.76万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7531983
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; African; Age; Behavior; Behavior Therapy; Behavioral; Biological; Biological Markers; Characteristics; Cities; Communicable Diseases; Complex; Country; Couples; Data; Data Collection; Discipline; Ego; Empirical Research; Ensure; Epidemic; Epidemiology; Equilibrium; Exhibits; Future; Ghana; Grant; HIV; HIV Infections; Health; Helping Behavior; High Prevalence; Home environment; Immigration; Individual; International; Intervention; Knowledge; Lead; Left; Life; Link; Measures; Methods; Modeling; Network-based; Nomads; Pattern; Phase; Pilot Projects; Play; Policies; Population; Prevalence; Prevention; Prevention intervention; Public Health Education; Questionnaire Designs; Rate; Recording of previous events; Research; Research Personnel; Research Project Grants; Research Training; Review Literature; Risk; Risk Behaviors; Role; Rural; Sampling; Sex Behavior; Shapes; Slum; Social Network; South Africa; Standards of Weights and Measures; Structure; Surveys; System; Testing; Thinking; Time; Training; Travel; Viral Load result; Vulnerable Populations; Work; antiretroviral therapy; base; career; design; experience; high risk sexual behavior; human migration; infectious disease model; life history; mathematical model; migration; pathogen; population migration; prevent; programs; residence; retinal rods; sex; success; theories; transmission process; trend; urban area

DESCRIPTION (provided by applicant): The long-term objective of this research is to use dynamic network-based mathematical models of human migration and HIV transmission dynamics for designing and evaluating HIV prevention interventions, such as the message of concurrency. There are three specific aims of this research project. The first aim is to review existing data on migration and HIV in Ghana. This literature review and empirical research will 1) highlight migration patterns and HIV disparities in Ghana 2) emphasize gaps in our knowledge of the complex association between migration and HIV transmission, and 3) reveal the limitations of standard cross- sectional data collection. Thus the second aim of this research is to design and implement a small-scale pilot survey of sexual networks, migration history, and HIV sexual risk behaviors. The PI will also determine the feasibility of collecting HIV biomarkers for HIV for future cross-discipline work. The third aim is to develop a mathematical model based on the network sample in order to quantify the impact of migration on the spread of HIV. This pilot modeling work will be the basis of an R01 application toward the end of the K99/R00 grant cycle. The support of a K99/R00 will enable the PI to engage in substantial public health training (MPH in epidemiology) as well as formal training in infectious disease modeling and social network theory and analysis. The PI has plans for an academic career in global health; therefore, this additional training and experience conducting research in an international setting will help ensure success in this endeavor. Past work has suggested that migrants exhibit riskier sexual behavior than non-migrants and have a higher risk of acquiring HIV; nonetheless, the mechanism in which migration may enhance HIV spread is unclear. This work hypothesizes that migration may significantly enhance HIV transmission because 1) migration changes the timing and sequence of partnership formation and duration which promotes concurrency, and 2) concurrency links individuals together to create large connected "components" in a network that allow a pathogen to travel rapidly and efficiently. Restricting people from moving is not a viable HIV prevention intervention, but messages of behavioral change (i.e. one partner at a time) and earlier antiretroviral therapy (ART) to reduce infectiousness for migrants are practical policies to prevent additional HIV infections.

描述（由申请人提供）：本研究的长期目标是使用基于动态网络的人类迁移和艾滋病毒传播动态数学模型来设计和评估艾滋病毒预防干预措施，例如并发消息。本研究项目有三个具体目标。第一个目标是审查加纳关于移徙和艾滋病毒的现有数据。本文献综述和实证研究将：1）突出加纳的移民模式和艾滋病毒差异; 2）强调我们对移民与艾滋病毒传播之间复杂联系的认识存在差距; 3）揭示标准横截面数据收集的局限性。因此，本研究的第二个目的是设计和实施一个小规模的试点调查的性网络，移民史，艾滋病毒的性危险行为。PI还将确定收集HIV生物标志物的可行性，用于未来的跨学科工作。第三个目标是根据网络样本建立一个数学模型，以量化移徙对艾滋病毒传播的影响。这项试点建模工作将成为K99/R 00资助周期结束时R 01申请的基础。K99/R 00的支持将使PI能够参与大量的公共卫生培训（流行病学硕士）以及传染病建模和社会网络理论与分析的正式培训。PI计划在全球卫生领域开展学术生涯;因此，在国际环境中进行研究的额外培训和经验将有助于确保这一奋进取得成功。过去的研究表明，移民比非移民表现出更危险的性行为，感染艾滋病毒的风险更高;然而，移民可能增加艾滋病毒传播的机制尚不清楚。这项工作假设，迁移可能会显着增强艾滋病毒的传播，因为1）迁移改变了伙伴关系的形成和持续时间的时间和顺序，促进了并发性，2）并发性将个人联系在一起，在网络中创建大型连接的“组件”，使病原体能够快速有效地传播。限制人们流动并不是一个可行的艾滋病毒预防干预措施，但改变行为的信息（即一次一个伴侣）和早期抗逆转录病毒治疗以减少移民的传染性是预防更多艾滋病毒感染的实际政策。