The HIV risk environment of high-risk women: Interaction with public safety

高危女性的艾滋病毒风险环境：与公共安全的互动

• 批准号: 8845848
• 负责人: Susan G. Sherman
• 金额: $ 64万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-02-01 至 2018-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8845848
• 关键词: Alcohol or Other Drugs use; Area; Attitude; Baltimore; Behavior; Businesses; Chlamydia; Cities; Communities; Community Workers; Crime; Criminal Law; Cross-Sectional Studies; Data; Data Analyses; Decision Making; Drug usage; Drug user; Employee Strikes; Enrollment; Environment; Environmental Risk Factor; Epidemic; Ethnography; Etiology; Female; Foundations; Frequencies; Future; Goals; Gonorrhea; HIV; HIV risk; HIV/STD; Health; Health Promotion; High Risk Woman; Hot Spot; Incidence; Infection; Injection of therapeutic agent; Intervention; Interview; Law Enforcement; Leadership; Legal; Letters; Maps; Maryland; Measures; Methods; Organizational Culture; Outcome; Participant; Pharmaceutical Preparations; Police; Police officer; Policies; Prevalence; Prostitution; Public Health; Recruitment Activity; Reporting; Research; Research Design; Risk; Risk Behaviors; Risk Reduction; Role; Safety; Sampling; Seizures; Series; Severities; Sex Behavior; Sexual Harassment; Sustainable Development; Syringes; System; Testing; Time; Unsafe Sex; Validity of Self Report; Visit; Vulnerable Populations; Walking; Work; base; biological research; cohort; condoms; evidence base; experience; follow-up; informant; injection drug use; innovation; meetings; prospective; public health research; response; sex; stem

DESCRIPTION: Despite many shared goals, public health and public safety systems often do not collaborate and therefore may end up working at cross purposes. Their divergent responses to sex work are particularly striking, with public health focusing on health promotion and risk reduction in contrast to public safety's focus on criminalization of both sex work and the substance use that so often accompanies it. The need to better understand and align these approaches is evident when one considers female sex workers' (FSWs) HIV risk. To fill this gap, study aims are to: 1) to explore police culture, attitudes of, and experiences with FSWs among Baltimore city police leadership (N=15) and street-level police (N=30) working in high crime areas in Baltimore City; 2) to examine the association between the FSWs' HIV risk behaviors (e.g., unprotected sex, unsafe injection practices use, crack use) with police encounters the frequency and type (i.e., verbal and sexual harassment, sexual exploitation, condom and syringe confiscation) of police encounters, among a cohort of FSWs (N=250) over a 12-month period of time; and 3) to examine the association between HIV/STIs incidence and prevalence with the frequency and type of police encounters among a cohort of FSWs (N=250) over a 12-month period of time. In meeting Aim 1, we will conduct organizational ethnography, a multi-method approach, which will allow for an in-depth examination of police culture, police policies, as well as attitudes and experience of leadership and patrol police in their own words. Through Aim 2, we will enroll and follow a cohort of FSWs (N=250) through targeted sampling, at street-based venues that will be identified through secondary data analysis, street key informant interviews, and ethnographic mapping. Through these data, we will examine associations between risky drug and sexual behaviors (i.e., unprotected sex, injection drug use) with police encounters over time. Data will be collected at baseline, 3-, 6-, 9-, and 12-months. The proposal is innovative in responding to an emerging, global evidence base illustrating the centrality of police in FSWs' HIV/STI risk behaviors and infection.1,2,9,19,20 The study blends organizational ethnography, prospective quantitative research, and biological outcomes and represents the first US-based effort to better understand how and why police function as a structural HIV/STI driver among FSWs, and in turn lay the foundation for future interventions. The study will be guided by a multi-sectorial community advisory board (CAB) comprised of police, legal, public health, FSW, and community stakeholders. The CAB and support of the Police Commissioner will be central to the development of sustainable and realistic interventions stemming from this work.

描述：尽管有许多共同的目标，但公共卫生和公共安全系统通常不会合作，因此最终可能会出于交叉目的而工作。他们对性工作的不同反应尤其引人注目，与公共安全的关注对性工作的犯罪和经常伴随的物质使用相比，公共卫生的重点是促进健康和降低风险。当人们考虑女性性工作者（FSW）艾滋病毒风险时，需要更好地理解和调整这些方法的需求是显而易见的。为了填补这一空白，研究的目标是：1）在巴尔的摩市警察领导层（n = 15）和巴尔的摩市高犯罪地区工作的街头警察领导和街头级警察（n = 30）中，探索警察文化，对FSW的态度和经验； 2）检查FSW的HIV风险行为（例如，不受保护的性行为，不安全的注射习惯，使用，破解使用）与警察遇到的频率和类型（即，口语和性骚扰，性剥削，避孕套，避孕套和注射案）在警察遭遇中，在警察遭遇中的频率（n = 250）之间的频率和指标。 3）检查艾滋病毒/性传播疾病的发生率与患病率与警察在12个月内的FSW（n = 250）之间的频率和类型之间的关联。在会议目标1中，我们将进行组织民族志，一种多方法方法，该方法将允许对警察文化，警察政策以及对领导和巡逻警察的态度和经验进行深入研究。通过AIM 2，我们将通过有针对性的采样来注册并遵循FSW的队列（n = 250），在基于街头的场地，通过二级数据分析，街头关键信息告知者访谈和人种志映射将确定，这些场所将确定。通过这些数据，我们将随着时间的推移，我们将研究风险的药物和性行为（即无保护的性行为，注射药物使用）之间的关联。数据将在基线，3-，6-，9-和12个月时收集。该提案在回应新出现的全球证据基础方面具有创新性，该证据说明了警察在FSW的HIV/STI风险行为和感染中的中心地位。1,2,9,19,20该研究融合了组织人种志，前瞻性定量研究，以及为了更好地理解HIV和STE的驾驶员的局部努力，并代表了off of fureding of fureding and of struction and Iver/sT的驾驶员，并代表了off of furets of stud and of struction/steT of struptir and sTINGIS/steT IV，IV级的驾驶员IV级的驾驶效果，这是该驾驶员的效果。干预措施。该研究将由由警察，法律，公共卫生，FSW和社区利益相关者组成的多部门社区顾问委员会（CAB）指导。警察专员的驾驶室和支持将是这项工作所产生的可持续和现实干预措施的核心。