HIV Risk and Access to Health Care Among Mexican Migrants

墨西哥移民的艾滋病毒风险和获得医疗保健的机会

• 批准号: 8495781
• 负责人: Ana P Martinez-Donate
• 金额: $ 39.16万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-13 至 2015-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8495781
• 关键词: AIDS prevention; AIDS/HIV problem; Acculturation; Anal Sex; Area; Behavior; Behavioral; Biological; California; Cities; Collaborations; Communities; Country; Data; Development; Disease Outbreaks; Economics; Effectiveness; Environment; Environmental Risk Factor; Epidemic; Epidemiology; Exposure to; Face; Family; Future; Gender; HIV; HIV Infections; HIV risk; Health; Health Services; Health Services Accessibility; Healthcare; Immigrant; Improve Access; Individual; Infection; International; Joints; Lead; Learning; Legal; Light; Maintenance; Measures; Methodology; Methods; Mexican; Mexico; Modeling; Monitor; Needle Sharing; Nomads; Pattern; Policies; Population; Poverty; Prevalence; Prevention strategy; Probability; Probability Samples; Process; Psychosocial Factor; Public Health; Reporting; Research; Research Personnel; Resources; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Role; Rural; Sampling; Seroprevalences; Services; Sexual Partners; Sexually Transmitted Diseases; Site; Social isolation; Societies; Source; Staging; Surveillance Modeling; Survey Methodology; Surveys; System; Testing; Time; Travel; Vagina; alcohol and other drug; base; disorder risk; experience; health disparity; high risk; improved; migration; operation; prevent; programs; role model; sex; social; socioeconomics; study characteristics; transmission process; treatment strategy; vector transmission

DESCRIPTION (provided by applicant): Studies suggest that Mexican migrants and immigrants (MMIs) in the US are at increased risk for HIV infection and face important barriers to access health care services. Studies have estimated that HIV infection is over 10 times more prevalent among MMIs compared to the overall Mexican and US population and suggested that MMIs serve as transmission vectors for increasing rates of HIV/AIDS in rural Mexico. Most research on this topic has been limited by methodological difficulties to reach this mobile, geographically widespread, and often undocumented population. Few conclusive data exist regarding the true prevalence of HIV infection, related risk practices, and determinants of HIV risk among MMIs, including the role of exposure to US society and limited health care access. This binational study will investigate the prevalence, patterning, and determinants of HIV infection and related risk practices among a representative sample of the MMI population who travels through the San Diego - Tijuana border region. This region concentrates about 37% of the migrant flow traveling through the US-Mexico border and represents the natural crossing port between Mexico and California. Survey methods that have been successfully applied to characterize the socio-demographic, labor, and geographic patterns of the MMI population in the North border of Mexico for over 13 years by Mexican investigators at El Colegio de la Frontera Norte (COLEF) will be used. A cross-sectional, multi-stage probability survey on HIV and migration will be conducted at key migrant crossing sites in the border city of Tijuana (Baja California, Mexico). MMIs (N=3,800) representing four distinct subpopulations at different stages of the migration experience will be tested for HIV infection and surveyed on HIV-related practices and theoretical determinants. The sample will include MMIs (a) returning voluntarily from the US to Mexico; (b) returned from the US to Mexico by the US Border Patrol; (c) arriving at Tijuana from other Mexican border regions; and (d) traveling North from other Mexican regions. Following the Behavioral Ecological Model, the role of demographic, geographic, economic, social, and psychosocial factors on HIV risk practices in these four subpopulations and the changes in these factors associated with different contexts and stages of the migration process will be examined. In addition, a pilot survey (N=300) on health care access and utilization will be conducted to test the feasibility of applying the proposed survey methods to the study of this and other migrant health areas. Results from this study will advance behavioral epidemiology and may lead to actions in Mexico and the US to reduce HIV infection and improve health care access among MMIs. This study may also set the basis for binational collaboration in the monitoring of migrants' health and provide baseline data to evaluate the effectiveness of future policies aimed at reducing HIV risk and health disparities in both countries.

描述（由申请人提供）：研究表明，在美国的墨西哥移民和移民（MMI）感染艾滋病毒的风险增加，并面临获得医疗保健服务的重要障碍。研究估计，与墨西哥和美国总人口相比，MMI中的艾滋病毒感染率高出10倍以上，并表明MMI是墨西哥农村艾滋病毒/艾滋病发病率上升的传播媒介。关于这一专题的大多数研究都受到方法上的困难的限制，难以接触到这一移动的、地理上分布广泛而且往往没有证件的人口。关于艾滋病毒感染的真实流行率，相关的风险实践和MMI中艾滋病毒风险的决定因素，包括暴露于美国社会和有限的医疗保健的作用，几乎没有结论性的数据。这项两国研究将调查流行率，模式和艾滋病毒感染的决定因素和相关的风险做法之间的代表性样本的MMI人口谁旅行通过圣地亚哥-蒂华纳边境地区。该地区集中了约37%的通过美墨边境的移民流，是墨西哥和加州之间的天然过境口岸。将使用墨西哥北部边境研究人员在El Colegio de la Frontera Norte（COLEF）成功应用于描述墨西哥北部边境MMI人口的社会人口统计学，劳动力和地理模式的调查方法。将在边境城市蒂华纳（下加利福尼亚，墨西哥）的主要移民过境点进行关于艾滋病毒和移民的跨部门、多阶段概率调查。代表四个不同的亚群在不同阶段的移徙经验的MMI（N= 3 800）将进行艾滋病毒感染检测和调查艾滋病毒相关的做法和理论决定因素。样本将包括（a）自愿从美国返回墨西哥的MMI;（B）由美国边境巡逻队从美国返回墨西哥的MMI;（c）从墨西哥其他边境地区抵达蒂华纳的MMI;以及（d）从墨西哥其他地区向北旅行的MMI。根据行为生态模型，人口，地理，经济，社会和心理社会因素对艾滋病毒风险的做法，在这四个亚群的作用和这些因素的变化与不同的背景和阶段的移民过程将进行审查。此外，试点调查（N=300）的卫生保健的获得和利用将进行测试的可行性，适用于本研究和其他移民健康领域的拟议的调查方法。这项研究的结果将推动行为流行病学的发展，并可能导致墨西哥和美国采取行动，减少艾滋病毒感染，改善医疗保健服务。这项研究还可以为两国在监测移徙者健康方面的合作奠定基础，并提供基线数据，以评估两国未来旨在减少艾滋病毒风险和健康差距的政策的有效性。