A Mixed-Method Study of Injection Drug Use Settings Among FSWs in Tijuana

描述（由申请人提供）：这个指导研究科学家发展奖（K 01）的目的是三重。该奖项将使我能够：1）学习三种新的技能：地理空间分析;将地理空间技术与定性方法相结合;以及使用视觉/摄影方法作为定性研究的辅助手段; 2）在新的文化和环境背景下扩大我对吸毒者中艾滋病毒社会流行病学的理解（美国/墨西哥边境）; 3）促进我成为加州圣地亚哥大学的一名富有成效的NIH资助的独立调查员。培训目标将通过具体讲习班和课程、实践研究项目以及与培训委员会的一对一辅导来实现，培训委员会由以下领域的专家组成：弱势群体中的艾滋病毒预防研究、地理信息系统和地理空间分析、混合方法研究、地理空间和定性方法的整合、照片人种学、道德、国际背景下的艾滋病毒社会流行病学研究（特别是美国/墨西哥边境地区）。研究目标将通过对注射环境的态度和在特定环境中使用药物的社会结构背景进行混合方法研究来实现，其中60名女性性工作者（FSW）在墨西哥蒂华纳注射药物。该研究项目将作为现有NIH/NIDA资助的R 01，DA 028692 -01（“墨西哥/美国边境FSW不断演变的艾滋病毒/性传播感染风险环境”，又名Proyecto Mapa Salud，PI Kimberly Brouwer）的独立附属项目进行，以利用该项目所代表的基础设施和专业知识。美国/墨西哥边境正在经历一场迅速发展的艾滋病毒流行病，集中在吸毒者和FSW等高危人群中。 多年来，地理空间和定性方法已被用于探索与高危人群中的HIV传播相关的因素，然而，新兴的方法，联合收割机两者尚未被应用于HIV传播的研究。了解物理空间在增加或减少与注射吸毒有关的风险方面的作用，并了解导致高风险个人在特定类型的地点消费毒品的社会因素，对于改进旨在减少传染病在边境地区传播的个人和社区一级干预措施至关重要。拟议的研究将使我能够应用新获得的地理空间分析技能，并将地理空间技术与定性方法相结合，以探索FSW注射者在注射环境中认为哪些因素是“可取的”和“不可取的”，以及他们生活中的哪些社会因素导致他们从公共卫生的角度在“更安全”或“不安全”的环境中注射。这项工作将在特别高风险的人群中进行（在蒂华纳，注射毒品者中的艾滋病毒感染率为：男性4%，女性10%，同时从事性工作的女性12%）。从拟议的研究结果将是至关重要的发展量身定制的干预措施，为个人在艾滋病毒的风险，通过在边境地区的药物使用，并为未来的研究发展到艾滋病毒风险的“空间”的作用。此外，发展地理空间，视觉和混合地理空间/定性方法的技能将使我成为药物滥用领域少数几个拥有这种技能的混合方法研究人员之一，也是加州圣地亚哥大学全球公共卫生部唯一的一个。

DESCRIPTION (provided by applicant): The purpose of this Mentored Research Scientist Development Award (K01) is threefold. This award will allow me to: 1) learn three new skill sets: geospatial analysis; integrating geospatial techniques with qualitative methodologies; and the use of visual/photographic methods as an adjunct to qualitative research; 2) broaden my understanding of the social epidemiology of HIV among drug users in a new cultural and environmental context (the US/Mexico border); and 3) facilitate my transition to becoming a productive NIH-funded independent investigator at the University of California San Diego. The training aims will be accomplished through a combination of specific workshops and coursework, a hands-on research project, and one-on-one mentoring with a Training Committee comprised of experts in the areas of HIV prevention research among vulnerable populations, GIS and geospatial analysis, mixed methods research, the integration of geospatial and qualitative methodologies, photo-ethnography, ethics, and HIV social epidemiology research in international contexts (and specifically the US/Mexico border region). The research aims will be accomplished by conducting a mixed-methods study of attitudes toward injecting environments and the sociostructural contexts of the use of drugs in particular environments among 60 female sex workers (FSWs) who inject drugs in Tijuana, Mexico. The research project will be conducted as an independent adjunct to an existing NIH/NIDA-funded R01, DA028692-01 ("Evolving HIV/STI risk environments of FSWs on the Mexico/US border" aka Proyecto Mapa Salud, PI Kimberly Brouwer), in order to capitalize on the infrastructure and expertise represented by that project. The US/Mexico border is experiencing a burgeoning HIV epidemic, concentrated among high-risk groups such as drug users and FSWs. Geospatial and qualitative methods have been used for many years to explore factors associated with the spread of HIV among high risk populations, however emergent methodologies which combine the two have yet to be applied to the study of HIV transmission. Understanding the role of physical space in increasing or decreasing risk associated with injecting drug use, and understanding the social factors which lead already high risk individuals to consume drugs in specific types of location, are critical to improving both individual and community level interventions designed to reduce the spread of infectious disease in border regions. The proposed research will allow me to apply newly acquired skills in geospatial analysis and integrating geospatial techniques with qualitative methods to explore which factors FSW injectors see as 'desirable' and 'undesirable' in an injecting environment, and what social factors in their lives lead them to inject in 'safer' or 'les safe' environments from a public health perspective. This work will be conducted in a particularly high-risk population (in Tijuana, HIV prevalence among those who inject drugs is 4% for men, 10% for women, and 12% for women who also participate in sex work). Findings from the proposed research will be critical for developing tailored interventions for individuals at risk fo HIV via drug use in border regions, and for the development of future research into the role of 'space' in HIV risk. Further, developing skills in geospatial, visual, and mixed geospatial/qualitative methods will uniquely position me as one of only a handful of mixed-methods researchers in the field of drug abuse possessing such skills, and the only one in the Division of Global Public Health at the University of California San Diego.