Sex/Drug Tourism at the US/Mexico Border: Social Network Influences on HIV Risk.

描述（由申请人提供）：本指导研究科学家发展奖（K01）的目的是三重的。这个奖项将使我能够：1)学习一套新的技能（社会网络分析；SNA）， 2)在新的文化和环境背景下（美国/墨西哥边境）扩大我对吸毒者中艾滋病毒社会流行病学的理解，以及3)促进我成为加州大学圣地亚哥分校一名富有成效的美国国立卫生研究院资助的独立调查员。培训目标将通过具体的讲习班和课程、实践实习以及由弱势群体艾滋病毒预防研究、行为干预设计、社会网络分析和国际背景下（特别是美国/墨西哥边境地区）艾滋病毒社会流行病学研究等领域专家组成的培训委员会的一对一指导来实现。研究目的将通过对墨西哥蒂华纳200名女性性工作者（FSWs）的吸毒男性客户进行与HIV风险行为相关的社会网络因素的横断面研究来实现。美国/墨西哥边境正在经历一场迅速蔓延的艾滋病毒疫情，集中在吸毒者和外籍女工等高风险群体中。社会网络分析（Social network analysis， SNA）在美国已经使用多年，以了解吸毒者社交网络在区域HIV传播中的作用，但很少在区域之间或跨国界之间使用，其特点是高水平的跨境流动。了解社会网络在高度流动的“桥接”人口中的作用，对于更细致和根据具体情况了解边境地区的传染病传播至关重要。拟议的研究将使我能够应用SNA中新获得的技能来评估社会网络的结构、组成和影响，以及一个特别高风险群体的药物、性和社会网络之间的相互作用程度：美国和蒂华纳的fsw吸毒男性客户。这一人群的药物使用率很高（25%报告曾经注射过毒品，高达88%报告终生使用可卡因、海洛因或甲基苯丙胺），而且与女妓女和其他伴侣都有相当大的性风险行为（其中66%报告同时发生性行为和药物使用）。拟议研究的结果对于为边境地区因性行为和吸毒而有感染艾滋病毒风险的个人制定量身定制的干预措施，以及对流动性-艾滋病毒风险途径的未来研究的发展至关重要。此外，开发社交网络分析技能将使我成为在药物滥用领域拥有这种技能的少数混合方法研究人员之一，也是加州大学圣地亚哥分校全球公共卫生部门唯一的研究人员。

DESCRIPTION (provided by applicant): The purpose of this Mentored Research Scientist Development Award (K01) is threefold. This award will allow me to: 1) learn a new skill set (social network analysis; SNA), 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 practicum, and one-on-one mentoring with a Training Committee comprised of experts in the areas of HIV prevention research among vulnerable populations, behavioral intervention design, social network analysis, and HIV social epidemiology research in international contexts (and specifically the US/Mexico border region). The research aims will be accomplished by conducting a cross-sectional study of the social network factors associated with HIV risk behavior among 200 drug-using male clients of female sex workers (FSWs) in Tijuana, Mexico. The US/Mexico border is experiencing a burgeoning HIV epidemic, concentrated among high-risk groups such as drug users and FSWs. Social network analysis (SNA) has been used for many years in the US to understand the role of drug user social networks in regional HIV transmission, but rarely has it been used between regions or across international borders, which are characterized by high levels of cross-border mobility. Understanding the role of social networks in highly mobile "bridging" populations is critical to a more nuanced and contextualized understanding of infectious disease transmission in border regions. The proposed research will allow me to apply newly acquired skills in SNA to evaluate the structure, composition, and influence of social networks, and the degree of interaction among drug, sex, and social networks of a particularly high-risk group: US and Tijuana-based drug-using male clients of FSWs. This population exhibits high rates of drug use (25% report ever injecting drugs, and up to 88% report lifetime use of cocaine, heroin, or methamphetamine) and considerable sexual risk behavior with both FSWs and other partners (including 66% who report concurrent sex and drug use). Findings from the proposed research will be critical for developing tailored interventions for individuals at risk for HIV via sex and drug use in border regions, and for the development of future research into the mobility-HIV risk pathway. Further, developing skills in social network analysis 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. PUBLIC HEALTH RELEVANCE: The US/Mexico border is home to an evolving HIV epidemic among vulnerable groups such as drug users, including female sex workers (FSWs) and their clients, but little social epidemiological research has assessed the role of social networks in influencing transmission of HIV in this region. Findings from the proposed research will be critical to bi-national efforts to develop tailored interventions for drug users at risk for HIV, and for the development of future long-term research into the influence of social networks on HIV risk among mobile "bridging" populations who have the potential to connect higher- and lower-risk groups. Further, developing skills in social network analysis will uniquely position the candidate 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.