Economic Debt, Drug Use, and HIV Risk among Sex Workers in Tijuana, Mexico

墨西哥蒂华纳性工作者的经济债务、吸毒和艾滋病毒风险

• 批准号: 8926376
• 负责人: Elizabeth Ann Reed
• 金额: $ 15.27万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-15 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8926376
• 关键词: AIDS prevention; Address; Affect; Asia; Biological; Child; Cities; Client; Data; Data Collection; Development; Drug abuse; Drug usage; Economic Factors; Economics; Female; Food; Gender; Goals; HIV; HIV risk; HIV/STD; Health; Housing; India; Industry; Influentials; Interview; Investigation; Longitudinal Studies; Measurement; Mediation; Methods; Mexican; Mexico; Nature; Needle Sharing; Needles; Outcome; Parents; Patient Self-Report; Personal Satisfaction; Pharmaceutical Preparations; Police; Population; Prevalence; Prevention program; Prevention strategy; Reporting; Research; Risk; Risk Behaviors; Risk Factors; Safety; Sampling; Secure; Services; Social Change; Source; Structure; Surveys; System; Testing; Unsafe Sex; Victimization; Violence; Woman; Work; Working Women; base; condoms; cost; high risk; life history; male; migration; non-drug; sex; sexual violence; social; socioeconomics

DESCRIPTION: High rates of sex trade and drug use, and the intersection of these, exacerbate the spread of HIV in Tijuana, the largest Mexican city bordering the US. Poor socioeconomic conditions are the primary driver of sex work initiation in Tijuana, as well as elsewhere. Previous research by the PI in South Asia has established that economic debt is not only significant in terms of women's initiating sex trade, but is also associated with elevated HIV/STI risk among FSW. Her work indicated that the vast majority of FSW reported informal types of debt (80%) and that this debt reduced women's condom negotiating power with clients, increasing HIV risk. The nature of debt in the US-Mexico border region likely differs significantly from that of South Asia. In Tijuana, high levels of migration as well as widespread drug use likely have an influence on the types of debts women have that may be most influential in increasing HIV risk. Debt may affect women's drug-related HIV risk as well. Based on preliminary interviews with FSW in Tijuana, debts among FSW have been reported in the form of service obligation (e.g. referred to more formally as debt-bondage in other contexts), where women are expected to work in sex work as a way to repay someone who has provided them with money, drugs, or other needs (e.g. costs associated with migration, provision of housing and food). We hypothesize that these informal types of debts and obligation in Tijuana deplete women's agency in sex work, decreasing negotiating power with managers and clients, reducing condom use, increasing GBV victimization and reducing negotiating power during drug use. More work is needed to define the multiple types of debts among FSW in this context and the extent to which these influence HIV risk behaviors. Thus, the proposed study aims: 1) to identify and define the multiple types of debt (including service obligations), and 2) to examine the interrelations between debt, drug use, sex trade, and HIV risk among FSW in Tijuana. To accomplish this, we propose to conduct a mixed-methods study of 400 FSW in Tijuana. Life history interviews with FSW in debt who report drug use (n=25) and non-drug use (n=25) will provide descriptive scenarios related to debt, drug use, and sex work involvement, as well as the implications of these on HIV risk. Quantitative data will also be collected from 400 FSW identified using venue-based sampling, via self-report survey and biologic HIV/STI testing. Findings will inform longitudinal studies to better understand the temporal and interrelated dynamics of debt, drug use, and sex work - and contribution of these to HIV risk among FSW. Findings will also be critical to provide initial direction on debt reduction strategies (e.g. reducing monetary debt as well as to change the social structures that promote debts) to reduce HIV risk among FSW in this region. Such investigation is especially important, given increasing data indicating that promoting economic well-being is an effective HIV prevention strategy among high-risk populations of women globally.

产品说明：性交易和吸毒的高比率，以及这些因素的交叉，加剧了艾滋病毒在蒂华纳的传播，蒂华纳是墨西哥最大的城市，与美国接壤。贫困的社会经济条件是蒂华纳以及其他地方开始从事性工作的主要驱动力。先前 公共政策研究所在南亚的研究表明，经济债务不仅在妇女开始性交易方面很重要，而且还与性工作者中艾滋病毒/性传播感染风险的增加有关。她的工作表明，绝大多数家庭工作者都报告了非正式类型的债务（80%），这种债务降低了妇女与客户就避孕套进行谈判的能力，增加了艾滋病毒风险。美墨边境地区的债务性质可能与南亚地区有很大不同。在蒂华纳，大量移民和广泛使用毒品可能对妇女的债务类型产生影响，而这些债务可能对增加艾滋病毒风险影响最大。债务也可能影响妇女与毒品有关的艾滋病毒风险。根据在蒂华纳与家庭社会工作者协会的初步访谈，据报告，家庭社会工作者协会中的债务是以服务义务的形式存在的（例如，在其他情况下，更正式地称为债役），妇女被要求从事性工作，以此来偿还向她们提供金钱、毒品或其他需要（例如，与移徙、提供住房和食物有关的费用）的人。我们假设，这些非正式类型的债务和义务，在蒂华纳耗尽妇女的机构在性工作，减少与管理人员和客户的谈判能力，减少安全套的使用，增加GBV的受害者和减少谈判能力在药物使用。需要做更多的工作来确定在这种情况下，FSW之间的多种类型的债务，以及这些债务对艾滋病毒风险行为的影响程度。因此，拟议的研究的目的是：1）确定和定义多种类型的债务（包括服务义务），和2）审查债务之间的相互关系，吸毒，性交易，艾滋病毒风险在蒂华纳的FSW。为了实现这一点，我们建议进行一项混合方法的研究，400搅拌摩擦焊在天津。生活史访谈FSW债务谁报告吸毒（n=25）和非吸毒（n=25）将提供描述性的情况下，债务，吸毒，性工作的参与，以及这些对艾滋病毒的风险的影响。还将通过自我报告调查和生物艾滋病毒/性传播感染检测，从400名使用基于场所的抽样确定的FSW中收集定量数据。调查结果将告知纵向研究，以更好地了解债务，吸毒和性工作的时间和相互关联的动态-这些FSW之间的艾滋病毒风险的贡献。调查结果也将是至关重要的，以提供债务减免战略的初步方向（例如，减少货币债务以及改变社会结构，促进债务），以减少艾滋病毒的风险之间的FSW在该地区。这种调查特别重要，因为越来越多的数据表明，促进经济福祉是全球高风险妇女群体预防艾滋病毒的有效战略。

项目成果

Non-barrier contraceptive use and relation to condom use behaviour by partner type among female sex workers in Andhra Pradesh, India.

印度安得拉邦女性性工作者按伴侣类型划分的无障碍避孕药具使用情况以及与安全套使用行为的关系。

• DOI: 10.1136/jfprhc-2014-100918
• 发表时间: 2017
• 期刊: The journal of family planning and reproductive health care
• 作者: Reed,Elizabeth;Erausquin,JenniferToller;Biradavolu,Monica;Servin,ArgentinaE;Blankenship,KimM
• 通讯作者: Blankenship,KimM

Social Network Clustering of Sexual Violence Experienced by Adolescent Girls.

青春期女孩遭受性暴力的社交网络聚集。

• DOI: 10.1093/aje/kwx154
• 发表时间: 2017
• 期刊: American journal of epidemiology
• 影响因子: 5
• 作者: Shakya,HollyB;Fariss,ChristopherJ;Ojeda,Christopher;Raj,Anita;Reed,Elizabeth
• 通讯作者: Reed,Elizabeth