Structural Behavioral HIV Prevention for Male Sex Workers in Peru

秘鲁男性性工作者的结构性行为艾滋病毒预防

• 批准号: 8436816
• 负责人: ANGELA M BAYER
• 金额: $ 13.53万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-20 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8436816
• 关键词: AIDS prevention; Academic Training; Affect; Award; Behavior Therapy; Behavioral; California; Characteristics; Client; Cognitive; Communities; Country; Data; Data Analyses; Development; Diagnostic tests; Dimensions; Effectiveness; Environment; Epidemic; Epidemiologic Studies; Epidemiology; Ethnography; Funding; Future; Goals; HIV; HIV Seroprevalence; High Prevalence; Home environment; Human Resources; Incidence; Income; Infection; Infection prevention; International; Intervention; Interview; Laboratories; Latin America; Learning; Life; Link; Location; Los Angeles; Low income; Maps; Maternal and Child Health; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Outcome; Participant; Peer Review; Peru; Population; Positioning Attribute; Postdoctoral Fellow; Prevention Research; Preventive Intervention; Public Health Schools; Publishing; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Research Infrastructure; Research Personnel; Research Support; Sampling; Scientist; Sexual Health; Sexually Transmitted Diseases; South American; Subgroup; Surveys; Syphilis; Techniques; Time; Training; United States National Institutes of Health; Universities; Weight; Work; base; career; cohort; comparison group; data management; design; global health; group intervention; high risk; innovation; interest; intervention program; knowledge base; male sex worker; meetings; men; men who have sex with men; prevent; professor; programs; public health research; responsible research conduct; satisfaction; sex; skills; social; time use; transmission process

DESCRIPTION (provided by applicant): Candidate's Background. As a global health researcher who specializes in the sociocultural dimensions of sexual health in Latin America, is fully bilingual and has lived and worked in Peru for the past eight years, I am in a unique position to make significant contributions to the prevention of HIV and other sexually transmitted infections (STIs) in Peru and in the region. I am currently a Postdoctoral Fellow in Global AIDS Prevention Research at the University of California, Los Angeles Program in Global Health, based in its Peru office. I have a strong interest in how to combine research and public health interventions to prevent HIV/STIs. However, I need additional training and mentorship to strengthen my skills in the development and assessment of global HIV/STI prevention interventions. The International Research Scientist Development K01 Award (IRSDA) would enable me to obtain this training and carry out mentored research to implement and assess a pilot HIV/STI prevention intervention with male sex workers or fletes in Peru. 2. Career Goals and Objectives. My long-term objective is to become a successful independent investigator who makes significant contributions to research and public health by developing, implementing and assessing rigorously evaluated, innovative HIV/STI prevention interventions in Peru and Latin America. I will achieve this objective by meeting these goals during the award period: 1. Complete academic training in: (1) key issues in HIV/STIs and global health; (2) social and cultural forces around sex work; (3) sampling methods with hidden populations; (4) design, implementation and assessment of biomedical, behavioral, and combination trials for HIV/STI prevention; (5) analysis of multi- component HIV/STI prevention trials; and (6) responsible conduct of research. 2. Complete the proposed Research Plan, described in the last section below (section 5). 3. Present the results from my IRSDA research at international scientific meetings. 4. Publish at least 6 peer-reviewed articles from my IRSDA research. 5. Develop and submit an NIH R01 proposal to implement a randomized controlled trial of a comprehensive intervention for fletes in Peru, to be developed based on the findings from this IRSDA proposal. 3. Mentoring Team. My mentors and co-mentors are leaders in the field of HIV/STI prevention and will provide intensive guidance during the IRSDA period. Dr.Thomas Coates, Professor and Director of the Program in Global Health (PGH) at the University of California, Los Angeles (UCLA), is my U.S.-based mentor. Dr. Patricia Garcia, Professor at the Universidad Peruana Cayetano Heredia (UPCH) School of Public Health, is my Peru- based mentor. Dr. Martin Iguchi from Georgetown University, Dr. Pamina Gorbach from UCLA, and Dr. Deanna Kerrigan from the Johns Hopkins Bloomberg School of Public Health will serve as co-mentors. 4. Institutional Environments. UCLA is home to global HIV-related research centers including the PGH, directed by Dr. Coates. PGH has conducted several global HIV prevention projects that include Comunidades Positivas, an ongoing community-level HIV/STI prevention trial in low-income, urban Peru where communities are randomized to a behavioral intervention, a biomedical intervention, or both. PGH has an office in Peru to support investigators working in Latin America. UPCH has an impressive track record in internationally-funded research, including in HIV/STIs. The Unit of Epidemiology, STDs and HIV, directed by Dr. Garcia, has full-time research and support staff, office space, a Data Management and Analysis Center, and an STI Laboratory. The Unit has carried out several large studies on HIV/STI prevention in Peru and is currently implementing Brighter Futures, to develop and apply diagnostic tests - including for STIs - for maternal and child health. My K01 will benefit from the infrastructure and lessons learned during Dr. Coates' and Dr. Garcia's studies. 5. Research Plan. The overall aim of the proposed study is to implement and assess a pilot Skill-building Program intervention that will provide fletes with vocational training and HIV/STI prevention skill-building within a supportive environment in order to prevent HIV/STIs in this group. Studies demonstrate that HIV/STIs disproportionately affect men who have sex with men (MSM) in Peru, with HIV seroprevalences among MSM ranging from 17.8-22.3% and recent syphilis infection of 10.5% among men who have sex with only men. Dr. Coates, Dr. Garcia and I carried out formative research, which demonstrated that fletes are a critical component of the Peruvian HIV epidemic, with high prevalence of both HIV (23%) and syphilis (22%). Therefore, this proposal aims to implement and assess a pilot Skill-building Program to prevent HIV/STIs among fletes. The Specific Aims are as follows: (1) To develop an ethnographic map of flete-related sex work venues and enumerate the fletes present in each venue; (2) To develop the assessment survey for the Skill- building Program intervention; and (3) To estimate the effectiveness of the pilot Skill-building Program for reducing (a) the proportion of fletes' income that is derived from sex work, (b) the proportion of fletes who report unprotected intercourse with clients, and (3) incidence of HIV and syphilis among fletes. PUBLIC HEALTH RELEVANCE: As a global health researcher who specializes in the sociocultural dimensions of sexual health in Latin America, is fully bilingual and has lived and worked in Peru for the past eight years, I am in a unique position to make significant contributions to the prevention of HIV and other sexually transmitted infections (STIs) in Peru and other countries in the region. However, I need additional training and mentorship to strengthen my skills in the development, implementation and assessment of global HIV/STI prevention interventions. The International Research Scientist Development K01 Award would enable me: to pursue systematic training on key issues related to global health, the design and assessment of HIV/STI prevention interventions, and the responsible conduct of research; and to carry out research to implement and assess a pilot HIV/STI prevention intervention with male sex workers in Peru, which will be guided by mentors from the U.S. and Peru who are leaders in the field of HIV/STI prevention and supported by the HIV-related research infrastructure of both the University of California, Los Angeles and the Universidad Peruana Cayetano Heredia.

描述（由申请人提供）：候选人背景。作为一名专门研究拉丁美洲性健康的社会文化层面的全球健康研究人员，我精通两种语言，过去八年一直在秘鲁生活和工作，我处于一个独特的位置，可以为秘鲁和该地区预防艾滋病毒和其他性传播感染（sti）做出重大贡献。我目前是加州大学洛杉矶分校全球健康项目全球艾滋病预防研究的博士后，该项目位于秘鲁办事处。我对如何结合研究和公共卫生干预措施来预防艾滋病毒/性传播感染有浓厚的兴趣。然而，我需要额外的培训和指导，以加强我在制定和评估全球艾滋病毒/性传播感染预防干预措施方面的技能。国际研究科学家发展K01奖（IRSDA）将使我能够获得这一培训，并开展指导研究，以实施和评估秘鲁男性性工作者或妓女的艾滋病毒/性传播感染预防干预试点。职业目标和目的。我的长期目标是成为一名成功的独立调查员，通过在秘鲁和拉丁美洲制定、实施和评估经过严格评估的创新性艾滋病毒/性传播感染预防干预措施，为研究和公共卫生作出重大贡献。我将在奖励期内通过实现以下目标来实现这一目标：完成以下方面的学术培训：(1)艾滋病毒/性传播感染和全球健康的关键问题；(2)围绕性工作的社会文化力量；(3)隐总体抽样方法；(4)设计、实施和评估艾滋病毒/性传播感染预防的生物医学、行为和联合试验；(5)多组分HIV/STI预防试验分析；(6)负责任的研究行为。2. 完成下面最后一节（第5节）中描述的拟议研究计划。在国际科学会议上展示我的IRSDA研究结果。4. 从我的IRSDA研究中发表至少6篇同行评审的文章。5. 根据IRSDA提案的结果，制定并提交NIH R01提案，在秘鲁实施一项综合干预措施的随机对照试验。3. 指导团队。我的导师和共同导师是HIV/STI预防领域的领导者，他们将在IRSDA期间提供密集的指导。加州大学洛杉矶分校（UCLA）全球健康项目（PGH）教授兼主任托马斯·科茨博士是我在美国的导师。帕特里夏·加西亚博士，秘鲁大学卡耶塔诺·埃雷迪亚（UPCH）公共卫生学院教授，是我在秘鲁的导师。乔治城大学的Martin Iguchi博士、加州大学洛杉矶分校的Pamina Gorbach博士和约翰霍普金斯大学彭博公共卫生学院的Deanna Kerrigan博士将担任共同导师。4. 制度环境。加州大学洛杉矶分校是全球艾滋病相关研究中心的所在地，包括由科茨博士领导的PGH。PGH开展了几个全球艾滋病毒预防项目，其中包括comidades Positivas，这是一项正在进行的社区一级艾滋病毒/性传播感染预防试验，在秘鲁的低收入城市，社区被随机分配到行为干预、生物医学干预或两者同时进行。PGH在秘鲁设有办事处，支持在拉丁美洲工作的调查人员。UPCH在包括艾滋病毒/性传播感染在内的国际资助研究方面有着令人印象深刻的记录。流行病学、性传播疾病和艾滋病毒部门由加西亚博士领导，拥有全职研究和支持人员、办公场所、数据管理和分析中心以及性传播疾病实验室。该股在秘鲁开展了几项关于预防艾滋病毒/性传播感染的大型研究，目前正在实施“更光明的未来”，为孕产妇和儿童健康开发和应用诊断测试——包括性传播感染测试。我的K01将受益于科茨博士和加西亚博士研究期间的基础设施和经验教训。5. 研究计划。拟议研究的总体目标是实施和评估一项试点技能建设计划干预措施，该干预措施将在一个支持性环境中为飞行员提供职业培训和艾滋病毒/性传播感染预防技能建设，以便在这一群体中预防艾滋病毒/性传播感染。研究表明，艾滋病毒/性传播感染对秘鲁男男性行为者（MSM）的影响尤为严重，男男性行为者的艾滋病毒血清患病率为17.8-22.3%，而最近仅与男性发生性行为的男性中梅毒感染率为10.5%。科茨博士、加西亚博士和我进行了形成性研究，结果表明，跳蚤是秘鲁艾滋病毒流行的一个重要组成部分，艾滋病毒（23%）和梅毒（22%）的流行率都很高。因此，本提案旨在实施和评估一项试点技能建设计划，以在船队中预防艾滋病毒/性传播感染。具体目标如下：(1)编制与船队有关的性工作场所人种志地图，并列举每个场所的船队；(2)制定技能培养计划干预措施的评估调查；(3)评估试点技能建设计划的有效性，以降低(a)妓女收入中来自性工作的比例，(b)报告与客户发生无保护性交的妓女比例，以及(3)妓女中艾滋病毒和梅毒的发病率。