Training in Drug Abuse & HIV Prevention for Female & Transgender Sex Workers

药物滥用培训

• 批准号: 8790248
• 负责人: Jeffrey Allen Wickersham
• 金额: $ 16.76万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8790248
• 关键词: AIDS prevention; Accounting; Address; Adopted; Adult; Age; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Amphetamines; Area; Asia; Asians; Behavioral; Career Choice; Client; Complex; Conduct Clinical Trials; Country; Data; Destinations; Discrimination; Drug abuse; Drug usage; Drug user; Enrollment; Ensure; Epidemic; Evidence based intervention; Face; Female; Funding; Future; Gender; General Population; Goals; HIV; HIV Infections; HIV diagnosis; HIV risk; Health; Health Services Accessibility; Healthcare; Heroin; Illicit Drugs; Incidence; Income; Individual; Infection; Infection prevention; International Agencies; Interpersonal Violence; Intervention; Knowledge; Lead; Malaysia; Malaysian; Mediation; Mentors; Mentorship; Meta-Analysis; Pattern; Pharmaceutical Preparations; Population; Prevalence; Prevention strategy; Preventive Intervention; Probability; Productivity; Prophylactic treatment; Public Health; Recommendation; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Research Project Grants; Respondent; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Role; Sampling; Science; Services; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Smoking; Social Network; Southeastern Asia; Substance abuse problem; Surveys; Target Populations; Techniques; Testing; Training; Woman; Women' s Health; Work; biobehavior; career; comparative effectiveness; condoms; design; effectiveness trial; evidence base; experience; improved; innovation; male; men; novel strategies; patient oriented research; prevent; reproductive; research study; self esteem; sex; sexual violence; skills; substance abuse epidemiology; substance abuse prevention; substance use prevention; systematic review; therapy development; transgender; transmission process; uptake

DESCRIPTION (provided by applicant): Malaysia's HIV epidemic, historically driven by male people who inject drugs (PWIDs), has transitioned over the last two decades to a generalized epidemic with bridges between substance abuse and sexual transmission. During this period, females have accounted for a growing proportion of new HIV infections (from 1% in 1990 to 25% in 2011), which are overwhelmingly attributed to sexual transmission. Transgender women have also faced a growing HIV burden in the region, with recent evidence suggesting they are one of the highest at-risk subpopulations globally. Sex work and the frequent co-occurrence of substance abuse is a major risk factor for both females and transgender women, especially in Malaysia, which has become a major destination for sex tourism. Despite recommendations by international agencies (WHO, UNODC, UNAIDS) to implement innovative, combination approaches to HIV and substance abuse prevention, especially among women, uptake in Malaysia, and Southeast Asia generally, has been woefully inadequate. Novel approaches to addressing the complex syndemic of sex work and substance abuse among female and transgender sex workers (F/TGSWs) are in demand. The mentored projects proposed here address this need through the conduct of two formative research studies. The first will estimate the prevalence of HIV and STIs among F/TGSWs in Malaysia's Klang Valley, assess sexual and drug risk behaviors, and determine feasibility of behavioral and biomedical approaches to HIV and substance use prevention. The second study will build on the first by adapting behavioral and biomedical interventions to address co-occurring sexual and drug risk behaviors among F/TGSWs in the region. Findings from these projects will contribute to a greater understanding of HIV and substance abuse risk behaviors among the target population and establish the knowledge necessary to develop innovative approaches to addressing them. The candidate, Dr. Wickersham, is uniquely poised to perform this work because of his strong background in gender and women's studies, his research productivity in the area of public health, and his experience with research in the Malaysian context. Over the five years of this proposal, he will achieve his career goals and professional objectives to: 1) develop expertise in research methods necessary to design, perform, and adapt HIV risk reduction interventions and eventually conduct clinical trials relating to HIV and STI prevention among TGW and FSWs in Malaysia; 2) gain experience in intervention development, adaptation, testing, implementation, and dissemination that will address gender-specific barriers to HIV prevention and treatment services; and 3) develop an independent career path in patient-oriented research focused on the interface between HIV, women's health, gender, and substance abuse and prevention. To achieve these goals, Dr. Wickersham has assembled a team of outstanding leaders in the fields of HIV, substance abuse, epidemiology, and behavioral and biomedical intervention science. Under their guidance, he will complete relevant coursework, attend seminars, and conduct research to apply the skills necessary to become an independent investigator in HIV and substance abuse prevention among female and transgender women sex workers in the Malaysian context.

描述（由申请人提供）：马来西亚的艾滋病毒流行历史上是由注射毒品的男性（PWIDs）推动的，在过去二十年中已经转变为一种普遍的流行病，在药物滥用和性传播之间架起了桥梁。在此期间，女性在新发艾滋病毒感染中所占的比例越来越大（从1990年的1%增加到2011年的25%），其中绝大多数是性传播。跨性别妇女在该地区也面临着日益增长的艾滋病毒负担，最近的证据表明，她们是全球风险最高的亚群体之一。性工作和经常同时发生的药物滥用是女性和变性女性的主要危险因素，特别是在马来西亚，它已成为性旅游的主要目的地。尽管国际机构（世卫组织、毒品和犯罪问题办公室、联合国艾滋病规划署）建议对预防艾滋病毒和药物滥用，特别是在妇女中，实施创新的综合方法，但马来西亚和整个东南亚的采用情况严重不足。需要新的方法来解决女性和变性性工作者（F/TGSWs）中复杂的性工作和药物滥用问题。这里提出的指导项目通过进行两项形成性研究来解决这一需求。第一个项目将估计马来西亚巴生谷F/TGSWs中艾滋病毒和性传播感染的流行情况，评估性和药物风险行为，并确定行为和生物医学方法预防艾滋病毒和药物使用的可行性。第二项研究将以第一项研究为基础，调整行为和生物医学干预措施，以解决该区域F/TGSWs中同时发生的性行为和药物风险行为。这些项目的研究结果将有助于更好地了解目标人群中的艾滋病毒和药物滥用风险行为，并建立必要的知识，以制定解决这些问题的创新方法。候选人Wickersham博士因其在性别和妇女研究方面的强大背景、在公共卫生领域的研究生产力以及在马来西亚背景下的研究经验，在开展这项工作方面具有独特的优势。在该计划的五年中，他将实现他的职业目标和专业目标：1)在设计，执行和适应艾滋病毒风险降低干预措施所需的研究方法方面发展专业知识，并最终在马来西亚的TGW和fsw中进行有关艾滋病毒和性传播感染预防的临床试验；2)在干预措施的制定、适应、测试、实施和传播方面积累经验，以解决艾滋病毒预防和治疗服务的性别障碍；3)在以患者为导向的研究领域开辟一条独立的职业道路，重点研究艾滋病毒、妇女健康、性别和药物滥用与预防之间的关系。为了实现这些目标，Wickersham博士在艾滋病毒，药物滥用，流行病学以及行为和生物医学干预科学领域组建了一支杰出的领导者团队。在他们的指导下，他将完成相关课程，参加研讨会，并进行研究，以应用必要的技能，成为马来西亚女性和变性女性性工作者中艾滋病毒和药物滥用预防的独立调查员。