Identifying Opportunities for HIV Prevention Among Female Migrants in Kenya

寻找肯尼亚女性移民预防艾滋病毒的机会

• 批准号: 8400900
• 负责人: Carol Suzanne Camlin
• 金额: $ 17.14万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-02-15 至 2015-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8400900
• 关键词: AIDS prevention; AIDS/HIV problem; Academic Training; Acquired Immunodeficiency Syndrome; Address; Africa; Africa South of the Sahara; Award; Behavior Therapy; Behavioral; Blood specimen; Communities; Complex; Data; Data Analyses; Data Sources; Decision Making; Demographic Survey; Destinations; Educational workshop; Emerging Communicable Diseases; Employee Strikes; Epidemic; Ethnography; Evaluation; Exercise; Female; Funding; Future; HIV; HIV Infections; HIV risk; Health; Immigration; Infection; Internal Migrations; Intervention; Intervention Trial; Interview; Investigation; Kenya; Knowledge; Measures; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; National Institute of Mental Health; Nomads; Participant; Pattern; Phase; Play; Population; Prevalence; Prevention Research; Preventive Intervention; Province; Psychological Theory; Public Health; Qualitative Research; Randomized; Research; Research Methodology; Research Project Grants; Risk; Role; Serological; Site; Source; South Africa; Surveys; Training; United States National Institutes of Health; Woman; Women' s Role; Work; design; experience; high risk; high risk behavior; high risk sexual behavior; improved; male; meetings; men; migration; migratory population; neglect; pandemic disease; population based; population movement; programs; psychologic; research study; rural area; sex; social; urban area

DESCRIPTION (provided by applicant): This mentored research project will investigate an under-researched aspect of HIV in Africa: the HIV prevention needs of female migrants. Migration and HIV research has almost exclusively focused on HIV risks to male migrants, often failing to measure the risks to women via their involvement in migration. Yet across the region, women's levels of participation in migration have met or exceeded those of men. Moreover, the few studies which have examined HIV risks to female migrants found higher risk behavior and HIV prevalence in migrant compared to non-migrant women. My dissertation study found that migration was associated with a higher risk of HIV infection in women than in men in South Africa. The finding warrants confirmation in East Africa, where HIV/AIDS is devastating communities and the sex disparity in infection risk is striking. HIV prevalence levels in Nyanza Province, Kenya are among the highest in Africa. Previous studies have found high levels of participation in migration by both men and women in Kenya and higher sexual risk behaviors among migrants than non-migrants. However, little is known about the mechanisms through which participation in migration leads to higher risk behavior in women. My proposed plan will address this gap. It is comprised of two phases: a secondary data analysis, and an in-depth qualitative study in Kenya. These two 'modules' will address the following aims: (1) Assess the degree to which HIV infection in women in Kenya is influenced by their participation in migration, and identify explanatory mechanisms by which women's migration may increase their HIV risks. I will use secondary data from Kenya Demographic and Health and AIDS Indicator Surveys and demographic surveillance field sites to carry out analyses to achieve this aim. Using 'HIV Triangulation', I will evaluate these findings along with information from other sources in participatory workshops with local stakeholders in Kenya. This exercise will inform the design of the qualitative study to be carried out in Aim 2: (2) Characterize social and psychological aspects of women's migration experience in Nyanza Province, Kenya which facilitate their risks of acquiring and transmitting HIV infection. I will use participant observation and in-depth interviews to characterize the spatial and social features of the common destinations of female migrants, and identify the structural and psychological aspects of women's migration that influence their HIV infection risks. These antecedents to HIV infection in female migrants serve as potential points of HIV prevention intervention, thus laying the groundwork for Aim 3: (3) Develop a preliminary plan for a multi-level HIV prevention intervention with female migrants in Nyanza. In participatory workshops with local stakeholders, I will critically evaluate the cumulative findings of this research, identify potential points of intervention with female migrants, assess acceptability of various options, and develop a preliminary intervention plan. At the start of year 4 I will submit an R34 application to the NIMH for a formative study to develop and assess the feasibility and acceptability of the intervention.

描述(由申请者提供)：这个有指导的研究项目将调查非洲艾滋病毒研究不足的一个方面：女性移民的艾滋病毒预防需求。移民和艾滋病毒研究几乎完全集中在男性移民面临的艾滋病毒风险上，往往没有衡量妇女参与移民给她们带来的风险。然而，在整个区域，妇女参与移徙的程度已经达到或超过了男子。此外，研究女性移民感染艾滋病毒风险的少数几项研究发现，与非移民女性相比，移民女性的危险行为和艾滋病毒流行率更高。我的论文研究发现，在南非，移民与女性感染艾滋病毒的风险高于男性。这一发现值得在东非证实，那里的艾滋病毒/艾滋病是毁灭性的社区，感染风险的性别差异令人震惊。肯尼亚Nyanza省的艾滋病毒流行水平是非洲最高的之一。以前的研究发现，肯尼亚男性和女性参与移民的程度很高，移民的性行为风险比非移民高。然而，人们对参与移徙导致妇女更高风险行为的机制知之甚少。我提出的计划将解决这一差距。它由两个阶段组成：二级数据分析和在肯尼亚的深入定性研究。这两个“单元”将解决以下目标：(1)评估肯尼亚妇女的艾滋病毒感染受其参与移徙影响的程度，并确定妇女移徙可能增加其艾滋病毒风险的解释机制。我将利用肯尼亚人口与健康和艾滋病指标调查以及人口监测实地地点的二手数据进行分析，以实现这一目标。利用“艾滋病毒三角测量”，我将在肯尼亚与当地利益攸关方共同举办的参与性研讨会上，评估这些发现以及来自其他来源的信息。这项工作将为将在目标2中进行的定性研究的设计提供参考：(2)描述肯尼亚尼安萨省妇女移徙经历的社会和心理方面，这有助于她们感染和传播艾滋病毒感染的风险。我将利用参与者观察和深入访谈来描述女性移民共同目的地的空间和社会特征，并确定影响其艾滋病毒感染风险的女性移民的结构和心理方面。这些女性移民感染艾滋病毒的先兆因素是艾滋病毒预防干预的潜在要点，从而为目标3奠定了基础：(3)制定一项初步计划，在Nyanza对女性移民进行多层次的艾滋病毒预防干预。在与当地利益攸关方的参与性研讨会上，我将对这项研究的累积结果进行批判性评估，确定女性移民的潜在干预点，评估各种选择的可接受性，并制定初步干预计划。在第四年开始时，我将向NIMH提交一份R34申请，以进行一项形成性研究，以制定和评估干预措施的可行性和可接受性。