High Risk Crack Use Settings and HIV in El Salvador

萨尔瓦多的高风险快克使用环境和艾滋病毒

• 批准号: 7434407
• 负责人: Julia B Dickson-Gomez
• 金额: $ 27.56万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-20 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7434407
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Affect; Area; Central America; Class; Collaborations; Communities; Community Psychology; Condition; Country; Crack Cocaine; Crime; Data; Depth; Developed Countries; Developing Countries; Development; Drug Addiction; Drug usage; Drug user; Early Intervention; Economics; Effectiveness; El Salvador; Elderly; Epidemic; Ethnography; Evaluation; Focus Groups; Government; HIV; Healthcare; Housing; Individual; Institutes; Institution; International; Intervention; Interview; Joints; Latin America; Lead; Literature; Longitudinal Studies; Low income; Measures; Methods; National Institute of Drug Abuse; Neighborhoods; Nomads; Numbers; Participant; Patients; Pharmaceutical Preparations; Phase; Police; Policies; Populations at Risk; Prevalence; Prevention; Prevention intervention; Preventive; Provider; Purpose; Range; Recording of previous events; Reporting; Research; Research Design; Research Infrastructure; Research Methodology; Research Personnel; Resources; Risk; Risk Behaviors; Risk-Taking; Role; Running; Salvadoran; Services; Sex Behavior; Site; Smoker; Social Characteristics; Social Environment; Social Network; Squatter; Substance abuse problem; Surveys; System; Testing; Training; United States; Universities; Violence; Work; World Bank; base; design; drug distribution; follow-up; gang; member; metropolitan; prevent; programs; sex; social; statistics; therapy development; transmission process

DESCRIPTION (provided by applicant): The purpose of this 4-year project entitled "High Risk Crack Use Settings and HIV in El Salvador" is to conduct formative research on the social context of crack use and sexual risk-taking in targeted communities in the San Salvador metropolitan area. The study has the following aims: 1) To identify and describe structural differences within and across three types of low-income communities in the San Salvador metropolitan area that affect the social context of crack use and HIV risk; 2) To document the range of variability in drug use sites, drug users' personal risk networks, and drug distribution systems across the three types of community; 3) To examine the relationship between drug distribution systems, drug use settings and drug user networks and HIV risk; 4) To estimate HIV prevalence among crack users in the San Salvador metropolitan area. Results from this study will be used to develop and explore the feasibility and acceptability of an HIV prevention intervention in collaboration with community partners that will address both community structural factors and the micro-social context of crack use and risky sex. An additional aim of the project is to increase the capacity of collaborating Salvadoran researchers to integrate qualitative, survey and network data in the conduct of research and intervention development. The proposed study will combine qualitative and quantitative research methods. In the first phase of the study we will conduct formative ethnographic research (community observations, focus groups and in-depth interviews) in nine communities (three of each type) in order to examine structural differences among the communities that may result in differences in the sites where crack is consumed and risky sex occurs, drug user roles in the drug distribution system, and drug user networks. We will use the formative ethnographic research to develop and pilot a survey instrument to measure macro-social characteristics of communities, the micro-social context of drug use, and individual-level drug use and HIV risky behaviors. In the second phase of the project we will conduct a survey with 540 crack smokers to explore variability in the micro-social context of drug use and HIV risk within and among the three community types, and to test the relationship between micro-social context of drug use and HIV risk. Additionally, we will conduct an abbreviated follow-up interview at 6 months with all survey participants in order to assess the effectiveness of different methods for tracking and retaining participants for follow-up interviews in the Salvadoran context, and demonstrate the feasibility of longitudinal research designs necessary for the rigorous evaluation of an HIV prevention intervention. In the final phase of the project, we will present the findings of the study to key stakeholders in the nine communities in order to develop a multi-level HIV prevention intervention. We will then explore the acceptability and feasibility of the intervention through focus group interviews with community leaders and crack users.

描述(由申请人提供)：这一为期四年的项目题为“萨尔瓦多的高风险吸毒环境和艾滋病毒”，目的是对圣萨尔瓦多大都市区目标社区吸毒和性行为风险的社会背景进行形成性研究。这项研究的目的如下：1)确定和描述圣萨尔瓦多大都市区三类低收入社区内部和之间影响吸毒和艾滋病毒风险的社会背景的结构性差异；2)记录毒品使用地点、吸毒者的个人风险网络和三类社区的毒品分配系统的变异性范围；3)检查毒品分配系统、吸毒环境和吸毒者网络与艾滋病毒风险之间的关系；4)估计圣萨尔瓦多大都市区吸毒人员中艾滋病毒的流行率。这项研究的结果将用于开发和探索与社区合作伙伴合作的艾滋病毒预防干预措施的可行性和可接受性，该干预措施将解决社区结构因素和吸毒和危险性行为的微观社会背景。该项目的另一个目的是提高合作的萨尔瓦多研究人员的能力，以便在开展研究和制定干预措施时整合定性、调查和网络数据。本研究将采用定性与定量相结合的研究方法。在研究的第一阶段，我们将在九个社区(每种类型三个)进行形成性民族志研究(社区观察、焦点小组和深入访谈)，以检查社区之间的结构差异，这些差异可能导致吸食毒品和发生危险性行为的地点、毒品分配系统中的吸毒者角色和吸毒者网络的不同。我们将利用形成性民族志研究开发和试点调查工具，以衡量社区的宏观社会特征、吸毒的微观社会背景以及个人层面的吸毒和艾滋病毒危险行为。在项目的第二阶段，我们将对540名吸烟者进行调查，以探索在三种社区类型内和之间吸毒和艾滋病毒风险的微观社会背景的变异性，并测试吸毒的微观社会背景与艾滋病毒风险之间的关系。此外，我们将在6个月后对所有调查参与者进行一次简短的后续访谈，以评估在萨尔瓦多情况下跟踪和留住参与者进行后续访谈的不同方法的有效性，并论证严格评估艾滋病毒预防干预措施所需的纵向研究设计的可行性。在项目的最后阶段，我们将向九个社区的主要利益攸关方介绍研究结果，以制定多层次的艾滋病毒预防干预措施。然后，我们将通过对社区领袖和吸毒者的焦点小组访谈，探索干预的可接受性和可行性。