Migration, Tourism and the HIV-drug use Syndemic in the Dominican Republic

多米尼加共和国的移民、旅游和艾滋病毒吸毒流行病

基本信息

批准号：
8735107
负责人：
MARK B PADILLA
金额：
$ 40.02万
依托单位：
FLORIDA INTERNATIONAL UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-30 至 2018-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8735107
关键词：
AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Affect Africa South of the Sahara Alcohol or Other Drugs use Area Behavior Businesses Caribbean region Centers for Disease Control and Prevention (U.S.)Cocaine Cognitive Communities Country Cross-Sectional Studies Data Data Collection Development Dominican Dominican Republic Drug usage Ecology Educational workshop Environment Epidemic Ethnography Evaluation Evidence based intervention Face Feedback Female Goals Government Growth HIV HIV risk Haiti Health Health Policy Health Promotion Heroin Heterosexuals High Prevalence Illicit Drugs Intervention Interview Investments Island Labor Migrations Link Literature Location Maps Mediation Mediator of activation protein Methods Migrant Workers Nomads Pattern Perception Pharmaceutical Preparations Phase Preparation Prevention Prevention Research Preventive Intervention Procedures Process Prostitution Public Health Recording of previous events Recruitment Activity Research Review Literature Risk Risk Behaviors Route Sales Sampling Self Efficacy Shapes Site Social Environment Social Problems Social isolation Structure Testing Theft Translational Research United States United States National Institutes of Health Work alcohol availability base civil society condoms design drug abuse prevention gang health knowledge high risk high risk behavior high risk sexual behavior interest male men migration peer programs public health relevance public health research rapid growth sex sexual encounter social social stigma trafficking transmission process

项目摘要

DESCRIPTION (provided by applicant): The Caribbean region has the second highest prevalence rates of HIV in the world following sub-Saharan Africa and is one of the region's most affected by illicit drug use and drug trafficking. Focusing on men's changing work, migration, and sexual and drug use behavior in the Dominican Republic, the proposed mixed- methods collaborative study examines how HIV risk and drug use among migrant men are related to (1) patterns of migration and (2) the social environments of tourism areas. We relate contemporary demographic changes to HIV and drug use practices through the notion of tourism ecologies - geographically constrained areas in which five ecological features (social isolation; social stigma; business norms; touristic escapism; and drug and alcohol availability) are hypothesized to contribute to high risk behaviors. Our research relies fundamentally on a long-standing multisectoral Community Advisory Board involving private tourism representatives, government, public health officials, and civil society. Data collection consists o: (1) semi- structured interviews with 36 systematically selected male migrant workers in two coastal tourism areas (two interviews per subject = 72 sessions); (2) ethnographic mapping and spatial analysis using Arc-GIS in two tourism areas; (3) a cross-sectional survey with 400 male migrant workers in two research sites; and (4) the implementation of a pilot intervention with 40 migrant male tourism workers. This study contributes to public health knowledge and health promotion in three key ways. First, it identifies the factors in tourism areas that most contribute to HIV risk and drug use, contributing to the development and piloting of an evidence-based intervention. Second, it draws on an extensive literature to systematically analyze the health effects of tourism environments in high-risk settings for HIV and drug use. Finally, it incorporate a participatory process to research that will strengthen local relevance, research translation, and the impact on health policies and programs.

描述（由申请人提供）：加勒比地区的艾滋病毒率是撒哈拉以南非洲以下的第二高艾滋病毒率，是该地区受非法药物使用和贩毒的影响最大的地区之一。拟议的混合方法协作研究专注于男性不断变化的工作，移民以及性和吸毒行为，研究了移民男人中的艾滋病毒风险和毒品使用与（1）移民模式以及（2）旅游区的社会环境。我们通过旅游生态的概念将当代人口变化与艾滋病毒和毒品使用实践联系起来 - 地理约束的领域，其中五个生态特征（社会隔离；社会污名；商业规范；旅游逃避现实；毒品和酒精的可用性；毒品和酒精的可用性）假设有助于高风险行为。我们的研究从根本上依赖于涉及私人旅游代表，政府，公共卫生官员和公民社会的长期多部门社区顾问委员会。数据收集包括O：（1）在两个沿海旅游区的36个系统选择的男性移民工人的半结构化访谈（每个受试者进行两次访谈= 72次会议）；（2）在两个旅游区使用ARC-GIS的人种学映射和空间分析；（3）在两个研究地点与400名男性移民工人进行横断面调查；（4）实施与40名移民男性旅游工人的飞行员干预。这项研究以三种关键方式为公共卫生知识和健康促进做出了贡献。首先，它确定了最大贡献的旅游区域的因素为了艾滋病毒的风险和吸毒，有助于基于证据的干预的开发和驾驶。其次，它借鉴了广泛的文献，可以系统地分析高风险环境中旅游环境的健康影响，以供艾滋病毒和吸毒。最后，它结合了一个参与过程的研究，该过程将加强当地相关性，研究翻译和对健康政策和计划的影响。