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

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。这个奖项将使我：1）学习一套新的技能（社会网络分析; SNA），2）扩大我对吸毒者中艾滋病毒的社会流行病学在新的文化和环境背景下（美国/墨西哥边境）的理解，和3）促进我的过渡，成为一个富有成效的NIH资助的独立调查员在加州圣地亚哥大学。培训目标将通过具体的研讨会和课程，实践实习，一对一的指导与培训委员会组成的艾滋病毒预防研究领域的专家在脆弱人群，行为干预设计，社会网络分析和艾滋病毒社会流行病学研究在国际环境（特别是美国/墨西哥边境地区）相结合来实现。研究目的将通过在墨西哥蒂亚戈州的200名女性性工作者（FSW）的吸毒男性客户中进行与艾滋病毒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发展的艾滋病毒流行病，集中在吸毒者和FSW等高危人群中。社会网络分析（SNA）已在美国使用多年，以了解吸毒者社交网络在区域艾滋病毒传播中的作用，但很少用于区域之间或跨越国际边界，其特点是高水平的跨境流动性。了解社交网络在高度移动的“桥接”人群中的作用，对于更加细致入微和情境化地了解边境地区的传染病传播至关重要。拟议中的研究将使我能够应用新获得的技能在SNA中评估的结构，组成，和影响的社交网络，以及药物之间的相互作用的程度，性，和社交网络的一个特别高风险的群体：美国和蒂华纳的吸毒男性客户的FSW。这一人群表现出较高的吸毒率（25%的人报告曾经注射毒品，高达88%的人报告终生使用可卡因，海洛因或甲基苯丙胺）以及与FSW和其他伴侣的相当大的性风险行为（包括66%的人报告同时性和毒品使用）。拟议研究的结果对于为边境地区因性行为和吸毒而面临艾滋病毒风险的个人制定量身定制的干预措施以及未来对流动性-艾滋病毒风险途径的研究至关重要。此外，发展社交网络分析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。 公共卫生相关性：美国/墨西哥边境是一个不断发展的艾滋病毒流行病的脆弱群体，如吸毒者，包括女性性工作者（FSW）和他们的客户，但很少有社会流行病学研究评估的作用，社交网络在影响艾滋病毒在该地区的传播。拟议研究的结果将对两国努力为有艾滋病毒风险的吸毒者制定有针对性的干预措施至关重要，并对今后开展社交网络对移动的“桥接”人群中艾滋病毒风险的影响的长期研究至关重要，这些人群有可能将高风险群体和低风险群体联系起来。此外，发展社交网络分析技能将使候选人成为少数几个拥有此类技能的药物滥用领域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的唯一一位。

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.