Behavioral and institutional barriers to HIV prevention among migrant women

描述（由申请人提供）：本申请为合作的美国-俄罗斯关于在俄罗斯联邦移民妇女中预防艾滋病毒的研究报告连同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并提交给了国家卫生研究院。它建立在国际团队在俄罗斯完成的和目前由NIH支持的试点工作以及美国研究人员对移民和艾滋病毒的广泛跨国研究的基础上。它提出了一个新的人口层面的定量和定性分析与分析机构动态相结合，以描述来自三个中亚国家-吉尔吉斯斯坦，塔吉克斯坦和乌兹别克斯坦的非正常女性移民的艾滋病毒风险，并确定艾滋病毒预防和缓解这一弱势群体面临的挑战和障碍。具体而言，该研究将收集关于俄罗斯两个城市中来自中亚的移民妇女的统计代表性调查数据，这些数据是通过答卷人驱动的抽样和来自这些妇女及其性伴侣的子样本的定性信息招募的。此外，机构人种志，包括与服务提供者的访谈， 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开展对提供者与客户互动情况的观察。分析将侧重于：妇女与其性伙伴就减少艾滋病毒风险进行谈判;妇女利用其个人网络获得有关艾滋病毒风险和预防的信息，评估其风险，并采取旨在减少这些风险的行动;妇女与正规保健部门的互动以及这些互动中的提供者-客户差距和脱节。这项探索性研究的结果将为随后设计和测试基于文化、对性别问题有敏感认识、可在全国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.