Context & Correlates of Health Behaviors in South India

描述（申请人提供）：据估计，印度有510万艾滋病毒感染者，仅次于南非。Tripathi最近的一项定性研究发现，酒精消费在几个艾滋病毒高危人群中很常见。 深入访谈表明，这些群体的成员可能会喝酒，以科普压力，以提高快乐和性能，他们的酒精使用可能与艾滋病毒的风险。我们对孟买男性性病患者的定量研究表明，在酒精影响下与女性性工作者发生性关系的男性也更有可能与这些伴侣发生无保护措施的性行为。然而，没有获得关于酒精或药物使用模式、酒精或药物使用背景或预期的数据。因此，虽然酒精和艾滋病毒风险之间的联系已经在一些印度人口群体和环境中得到证明，但对这种关系的性质知之甚少。本研究旨在满足这一需求。它利用健康行为的信息-动机-行为（1 MB）模型，结合性别和赋权理论的结构，指导研究措施的选择和试点干预措施的设计。这项研究将Tripathi的工作扩展到印度南部的男性移民工人和女性性工作者。拟议的研究还将通过让YRG Care的两个南印度非政府组织扩大合作伙伴参与，建立印度科学家和工作人员的研究能力; YRG Care是泰米尔纳德邦钦奈的一个艾滋病研究组织。具体而言，我们建议在奇拉拉、安得拉邦和卡利卡特、喀拉拉邦招募参与者： 1.定性检查：a）饮酒的模式和背景; B）性风险承担模式; c）文化和人口特定因素; d）动机、饮酒、饮酒的社会背景和这些环境中MMW和FSW的性行为之间的关系。 2.制定和管理一项理论驱动的定量调查，以衡量a）性风险行为和饮酒的普遍性和模式; B）性风险行为模式; c）特定模式变量; d）目标人群中性风险行为、饮酒类型和背景与其他动机、人际、社会文化和背景变量之间的关系。 3.与我们的印度伙伴以及当地和区域酒精问题研究人员、保健提供者、公共卫生官员和非政府组织代表合作，制定、实施和试点测试一项针对特定文化、有理论指导和以实践为基础的减少风险干预措施，以减少南印度性工作者和移徙工人在饮酒情况下的艾滋病毒风险。

DESCRIPTION (provided by applicant): India is estimated to have 5.1 million people living with HIV infection, making it second only to South Africa. A recent qualitative study by Tripathi found that alcohol consumption is common in several subpopulations who are also at high risk for HIV. In-depth interviews suggest that members of these groups may drink to cope with stress, to enhance pleasure and performance, and that their alcohol use may be related to HIV risk taking. Our quantitative research with male STD patients in Mumbai showed that men who reported sex with female sex workers under the influence of alcohol were also more likely to report unprotected sex with these partners. However, no data were obtained on alcohol or drug use patterns, the context of alcohol or substance use, or on expectancies. Thus, although the link between alcohol and HIV risk taking has been demonstrated in some Indian population groups and settings, very little is known about the nature of this relationship. The current study has been designed to meet this need. It utilizes the Information-Motivation-Behavior (1MB) model of health behavior, incorporating constructs from gender and empowerment theory, to guide the selection of study measures and the design of a pilot intervention. The study extends Tripathi's work to male migrant workers (MMW) and female sex workers (FSW) in South India. The proposed study will also build research capacity of Indian scientists and staff by involving two South Indian NGO scale-up partners of YRG Care; an established AIDS research organization in Chennai, Tamil Nadu. Specifically, we propose to recruit participants in Chirala, Andhra Pradesh and Calicut, Kerala to: 1. Examine qualitatively: a) patterns and contexts of alcohol consumption; b) sexual risk taking patterns; c) culturally- and population-specific factors; and d) the relationship between motivation, alcohol consumption, its social context and sexual behaviors among MMWs and FSWs in these settings. 2. Develop and administer a theory-driven, quantitative survey to measure a) the prevalence and patterns of sexual risk taking and alcohol consumption; b) sexual risk taking patterns, c) model-specific variables; and d) the relationship between sexual risk taking, type and context of alcohol consumption and other motivational, interpersonal, sociocultural and contextual variables in the target populations. 3. Develop, implement and pilot test a culturally-specific, theoretically-guided and empirically-based risk reduction intervention in collaboration with our Indian partners as well as with local and regional alcohol researchers, health care providers, public health officials and NGO representatives to reduce HIV risk taking in the context of alcohol use among South Indian sex workers and migrant workers.