Substance Abuse and Health Vulnerability: Colombian Refugees in Ecuador

描述（由申请人提供）：本申请是研究者发起的探索性/发展性研究资助（R21）。它提议成立一个两国和多学科小组进行一项探索性研究，以确定采用尼加拉瓜和纽约西班牙裔移民社区的类似研究中使用的研究战略和工具的可行性和所需的修改，以探索厄瓜多尔境内哥伦比亚难民的吸毒和性传播感染/艾滋病毒风险。(4)研究目的包括：1)确定最近在厄瓜多尔的哥伦比亚难民的社会人口特征、移民/难民轨迹和健康风险特征；2)探索影响性传播感染/艾滋病毒风险的环境和行为因素；3)查明难民社区使用的预防和护理资源，以及已经/正在解决结构性暴力（例如耻辱、歧视）和社区认为的健康风险的社区/社会行动；4)发展非政府组织部门在厄瓜多尔进行移民健康研究的机构能力，重点关注吸毒和性传播感染/艾滋病毒风险。这些目标反映了迫切需要关于厄瓜多尔境内数量庞大且不断增长的哥伦比亚难民人口的描述性数据，特别是影响易感染艾滋病毒/艾滋病和其他性传播感染的环境和行为风险因素。制定有效的预防方案和公共卫生干预措施需要更全面地了解移民过程和移民/难民的脆弱性，因为他们跨越国际边界，特别是研究不足的南美和中美洲边界。这些目标还反映了在国际上，特别是在厄瓜多尔，当地非政府组织对移民健康研究能力建设的需要作出的反应，因为它们最有能力向这些人口提供有效的干预措施。这些发现将为未来的研究提供信息，这些研究对于制定更有效的移民和难民人口预防和控制计划至关重要。公共卫生相关性：这项研究反映了对大量和不断增长的难民人口的描述性数据的迫切需要，特别是影响感染艾滋病毒/艾滋病和其他性传播感染脆弱性的环境和行为风险因素。制定有效的预防方案和公共卫生干预措施需要对移民过程和移民/难民跨越国际边界时的脆弱性有更全面的了解。这项研究的目的还反映了对国际上移民健康研究能力建设需求的响应，特别是当地非政府组织的响应，因为它们最有能力向这些人口提供有效的干预措施。

DESCRIPTION (provided by applicant): This application is an investigator-initiated Exploratory/Developmental Research Grant (R21). It proposes a bi-national and multidisciplinary team to conduct an exploratory study to establish the feasibility and modifications needed for employing research strategies and instruments utilized in similar research in Nicaragua and among Hispanic immigrant communities of New York to explore drug use and STI/HIV risk among Colombian refugees in Ecuador. The (4)study aims include: 1) Identification of the sociodemographic characteristics, migratory/refugee trajectories, and health risk characteristics of recent Colombian refugees in Ecuador; 2)exploration of the contextual and behavioral factors influencing STI/HIV risk; 3) identification of prevention and care resources utilized by the refugee community, as well as community/social action which has/is addressing structural violence (e.g. stigma, discrimination) and community- perceived health risks; and 4) development of institutional capacity in the NGO sector for immigrant health research in Ecuador, focusing on drug use and STI/HIV risk. These aims reflect the urgent need for descriptive data on the large and growing Colombian refugee population in Ecuador, specifically the contextual and behavioral risk factors that influence vulnerability for contracting HIV/AIDS and other sexually transmitted infections. The development of effective prevention programs and public health interventions require a more complete understanding of the migration process and vulnerabilities of immigrants/refugees as they cross international borders, especially the understudied South and Central American borders. The aims also reflect a response to the need for capacity building in immigrant health research internationally, and in Ecuador, specifically, by local non-governmental organizations who are the most able to reach these populations with effective interventions. The findings will be used to inform future studies that are essential in the development of more effective prevention and control programs for immigrant and refugee populations. PUBLIC HEALTH RELEVANCE: This study reflects the urgent need for descriptive data on large and growing refugee populations, specifically the contextual and behavioral risk factors that influence vulnerability for contracting HIV/AIDS and other sexually transmitted infections. The development of effective prevention programs and public health interventions require a more complete understanding of the migration process and vulnerabilities of immigrants/refugees as they cross international borders. The study aims also reflect a response to the need for capacity building in immigrant health research internationally, specifically by local non-governmental organizations who are the most able to reach these populations with effective interventions.