Behavioral and institutional barriers to HIV prevention among migrant women

描述(由申请人提供)：本申请是关于在俄罗斯联邦境内的移民妇女中预防艾滋病毒的美俄合作研究，它与俄罗斯合作者向俄罗斯基础研究基金会提交的一份平行申请一起提交给美国国立卫生研究院。它建立在国际团队完成的和目前由NIH支持的俄罗斯试点工作以及美国调查人员关于移民和艾滋病毒的广泛跨国研究的基础上。它提出了人口一级的定量和定性分析与机构动态分析相结合的新方法，以描述来自吉尔吉斯斯坦、塔吉克斯坦和乌兹别克斯坦这三个中亚国家的非正常女性移民的艾滋病毒风险，并确定这一弱势群体在预防和减轻艾滋病毒方面面临的挑战和障碍。具体地说，这项研究将收集在俄罗斯两个城市通过受访者驱动的抽样招募的中亚移民妇女的统计代表性调查数据，并从这些妇女及其性伴侣的一个子样本中收集定性信息。此外，机构人种学，包括与服务提供商和 将在向移徙妇女提供性健康和生殖健康以及艾滋病毒/性传播感染服务的诊所观察提供者与服务对象之间的互动。这些分析将侧重于：妇女与其性伴侣就减少艾滋病毒风险进行谈判；妇女利用其个人网络获取有关艾滋病毒风险和预防的信息、评估其风险并采取旨在降低这些风险的行动；以及妇女与正规保健部门和服务提供者与服务对象之间的互动，这些互动的特点是差距和脱节。这项探索性研究的结果将为随后设计和测试基于文化的、对性别问题敏感的、可在全国范围内推广的干预措施奠定基础，这些干预措施旨在降低移徙妇女感染艾滋病毒的风险，并改善她们获得艾滋病毒咨询、检测和治疗服务的机会。

DESCRIPTION (provided by applicant): This application for collaborative U.S.-Russia research on HIV prevention among migrant women in the Russian Federation is submitted to the NIH in conjunction with a parallel application submitted by the Russian collaborators to the Russian Foundation for Basic Research. It builds upon the international team's completed and current NIH-supported pilot work in Russia as well as the US investigators' extensive cross-national research on migration and HIV. It proposes a novel combination of population-level quantitative and qualitative analyses with analyses of institutional dynamics to describe HIV risks of irregular female migrants from three Central Asian countries- Kyrgyzstan, Tajikistan, and Uzbekistan and to identify challenges and barriers in HIV prevention and mitigation faced by this vulnerable group. Specifically, the study will collect statistically representative survey data on migrant women from Central Asia in two Russian cities recruited through respondent driven sampling and qualitative information from a subsample of those women and their sexual partners. In addition, institutional ethnographies, including interviews with service providers and observations of provider-client interactions, will be carried out at clinics offering sexual and reproductive health and HIV/STI services to migrant women. The analyses will focus on: women's negotiation of HIV risk reduction with their sexual partners; women's use of their personal networks to obtain information about HIV risks and prevention, to evaluate their risks, and to take actions aimed at reducing those risks; and women's interactions with the formal health care sector and the provider- client gaps and disconnects that characterize those interactions. The results of this exploratory study will lay the foundation for subsequent design and testing of culturally-grounded, gender-sensitive, nationally-scalable interventions aimed at reducing the risks of HIV infection among migrant women and improving their access to HIV counseling, testing, and treatment services.