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: 8549331
• 负责人: ANGELA M BAYER
• 金额: $ 13.69万
• 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/8549331
• 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.

描述（由申请人提供）：候选人的背景。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员，我完全掌握两种语言，过去八年来一直在秘鲁生活和工作，我处于一个独特的地位，能够为秘鲁和该区域预防艾滋病毒和其他性传播感染作出重大贡献。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研究员，该项目设在秘鲁办事处。我对如何将联合收割机研究和公共卫生干预措施结合起来预防艾滋病毒/性传播感染有着浓厚的兴趣。然而，我需要更多的培训和指导，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K 01奖（IRSDA）将使我能够获得这一培训，并进行指导研究，以实施和评估秘鲁男性性工作者或飞行员的艾滋病毒/性传播感染预防干预试点。2.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开发、实施和评估经过严格评估的创新艾滋病毒/性传播感染预防干预措施，为研究和公共卫生做出重大贡献。我将通过在获奖期间实现这些目标来实现这一目标：1。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）围绕性工作的社会和文化力量;（3）对隐藏人群的抽样方法;（4）设计、实施和评估预防艾滋病毒/性传播感染的生物医学、行为和组合试验;（5）分析多组分艾滋病毒/性传播感染预防试验;（6）负责任地开展研究。2.完成下面最后一节（第5节）中描述的拟议研究计划。3.在国际科学会议上展示我的IRSDA研究成果。4.发表至少6篇来自我的IRSDA研究的同行评审文章。5.制定并提交一份NIH R 01提案，以在秘鲁实施一项综合干预的随机对照试验，该试验将根据本IRSDA提案的结果进行开发。3.指导团队。我的导师和共同导师是艾滋病毒/性传播感染预防领域的领导者，将在IRSDA期间提供密集指导。洛杉矶加州（UCLA）全球健康项目（PGH）教授兼主任托马斯科茨博士是我的美国-基于Mentor帕特里夏·加西亚博士是秘鲁大学卡耶塔诺·埃雷迪亚公共卫生学院的教授，是我在秘鲁的导师。乔治敦大学的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彭博公共卫生学院的Deanna Kerrigan博士将担任共同导师。4.体制环境。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Comunidades Positivas，这是一项正在低收入城市秘鲁进行的社区一级艾滋病毒/性传播感染预防试验，社区被随机分配到行为干预，生物医学干预或两者兼而有之。PGH在秘鲁设有办事处，以支持在拉丁美洲工作的调查人员。UPCH在国际资助的研究，包括艾滋病毒/性传播感染研究方面有着令人印象深刻的记录。加西亚博士领导的流行病学、性病和艾滋病毒股有全职研究和支助人员、办公场所、数据管理和分析中心以及性病实验室。该股在秘鲁开展了几项关于艾滋病毒/性传播感染预防的大型研究，目前正在实施“更光明的未来”，以开发和应用诊断测试，包括性传播感染测试，促进孕产妇和儿童健康。我的K 01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方案干预措施，该方案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，以预防这一群体的艾滋病毒/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的影响不成比例，男男性行为者中艾滋病毒血清阳性率为17.8-22.3%，在只与男性发生性关系的男子中，最近感染梅毒的比例为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，跳蚤是秘鲁艾滋病流行的关键组成部分，艾滋病（23%）和梅毒（22%）的患病率都很高。因此，该提案旨在实施和评估一项技能建设试点方案，以预防船队中的艾滋病毒/性传播感染。具体目标如下：（1）绘制与卖淫有关的性工作场所的人种学地图，并对每个场所的卖淫者进行计数;（2）为技能建设方案的干预制定评估调查;以及（3）评估技能建设试点方案在降低（a）来自性工作的收入占女性收入的比例，（B）报告与嫖客发生无保护性交的妓女比例;（3）妓女中艾滋病毒和梅毒的发病率。