Labor Migration and Multilevel HIV Prevention

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DESCRIPTION (provided by applicant): This Mid-Career Investigator Award is designed to support the continued research development and mentoring activities of Stevan Weine MD, Professor of Psychiatry at the University of Illinois at Chicago. Over the past 15 years, Dr. Weine has demonstrated a strong commitment to patient-oriented research and mentoring new investigators. He is a psychiatrist and an established researcher in trauma, migration, and HIV/AIDS impacted families, with continuous federal funding as Principal Investigator since 1998. His overall research mission is to develop, implement, and evaluate psychosocial interventions that are feasible, acceptable, and effective with respect to the complex real-life contexts where migrants and refugees live. Goals for this proposal include: 1) training and mentoring students, trainees, and junior faculty in patient-oriented research generally, and multilevel HIV prevention and refugee and migrant research specifically; 2) receiving consultation from senior researchers regarding mixed methods in preventive intervention development, research collaborations with families and communities, and ethics in HIV/AIDS and migration research; 3) expanding research activities so as to build the intervention content and methodology needed to develop and evaluate multilevel HIV preventive interventions for labor migrants. The mentoring plan incorporates individual mentoring, mentees direct consultation from the senior mentors, formal courses and seminars, training regarding research ethics, and mentees' direct involvement in a research project. There are three proposed studies that build off an ongoing five year NICHD funded study (5R01MH076118-02) being conducted in Tajikistan and Russia that investigates the social, cultural, and psychological constructions of masculinity and their impact on HIV risk and prevention. Study 1 uses mixed methods to build an evidence base for developing multilevel interventions with labor migrants. Study 2 designs a multilevel HIV preventive intervention for Tajik labor migrants through a community-researcher collaborative. Study 3 pilots components of the multilevel intervention, examines engagement, retention, outcomes, and mediators, and estimates parameters for a future large scale R01 investigation. PUBLIC HEALTH RELEVANCE: Impacting billions globally, labor migration adds to family burdens and instability, changes the social landscape, and is associated with increased HIV risk behaviors. In Russia and Central Asia, where AIDS rates are amongst the world's highest, conditions in both sending and receiving countries pose serious obstacles to HIV prevention. Because Tajikistan is so highly impacted by labor migration and is one of the world's poorest countries, it is at substantial risk for an HIV/AIDS epidemic. To build HIV prevention services for migration- impacted populations calls for understanding how to intervene amongst the complex circumstances of labor migration. This five-year K24 program of mentoring, research, and training consultation is designed to improve HIV preventive services for labor migrants and their families. The research draws upon social science and behavioral methods to develop and partially pilot a multilevel HIV preventive intervention for migration- impacted persons in Tajikistan and Russia. There are three studies for this Midcareer Investigator Award. These studies are designed to build the intervention content and methodology needed to develop and evaluate multilevel interventions for labor migrants. They also provide the basis for mentoring junior investigators.