Epidemiology of drugs and HIV sex risk among Latino migrants

拉丁裔移民中毒品流行病学和艾滋病毒性风险

• 批准号: 7689644
• 负责人: Patricia J Kissinger
• 金额: $ 23.55万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-15 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7689644
• 关键词: Acculturation; Address; Adult; Affect; American; Area; Attitude; Centers for Disease Control and Prevention (U.S.); Central America; Central American; Cities; Data; Destinations; Disasters; Drug usage; Emigrations; Environment; Epidemiology; Etiology; Event; Evolution; Explosion; Exposure to; Family; Funding; Future; Goals; HIV; Health; Hispanics; Hurricane; Individual; Interview; Intramural Research; Laboratories; Latino; Methods; Mexican; Mexico; Migrant Workers; Modeling; Nomads; Pattern; Pharmaceutical Preparations; Police; Policies; Population; Prevalence; Prevention; Probability Samples; Prostitution; Public Health; Research; Research Personnel; Respondent; Risk; Risk Behaviors; Risk Factors; Sampling; Seeds; Sentinel; Services; Stress; Surveys; Sweat; Sweating; Time; Toxic Environmental Substances; Work; cohort; experience; follow-up; high risk; high risk behavior; instrumentation; men; migration; public health relevance; sex; sex risk; theories

DESCRIPTION (provided by applicant): After the Hurricane Katrina disaster in August, 2005 a massive influx of Latinos from Mexico and Central America, mostly men, undocumented and unaccompanied by their families, came seeking construction work. Post-disaster New Orleans is not only a new receiving area for Latino migrants, but an extremely high risk environment given its sex and drugs tourism which makes it a natural laboratory for the exploration of factors that promote drug use and HIV sexual risk among migrants. In October 2007, our research team assembled a cohort of 125 newly arrived Latino migrant workers (LMW) using respondent driven sampling, and followed them every 3 months to examine HIV risk. Over 9 months of follow-up, we discovered high rates of drug use ranging from 19% to 29% and 12 men who initiated drug use while in New Orleans and follow-up rates of 90%. From our preliminary data we know the "what", but we do not know the "why" and "how", which are the focus of this exploratory research. The overall goal of this research is to identify and explore factors affecting drug use and drug-related HIV sexual risk behaviors among Latino migrant workers who have migrated to a new receiving environment known for its sex and drugs tourism. The specific aims are: 1) To describe the patterns of drug use prospectively in a quasi-probability sample of 125 Latino workers migrating to a new high-risk U.S. receiving environment, 2) To explore the superstructural, structural, environmental, individual and cultural factors affecting initiation and continuation of drug use among Latino migrant workers using mixed methods and applying Sweat and Dennison's model of HIV causation and Handwerker's theory of culture as guides, 3) To describe the influence of drug use on HIV sexual risk behavior among Latino migrant workers, 4) To refine instrumentation and the theoretic framework to be used in further research on the relationship of drug use, migration, acculturation and HIV sexual risk behaviors. To achieve these aims, a multi-disciplinary team will employ mixed methods and continue to follow the cohort for an additional 18 months (for 30 months of total follow-up). Simultaneous qualitative and quantitative methods will be used to refine instrumentation and the theoretic framework and to explore factors associated with drug use and drug- related HIV sexual risk for a future R01 application. This is the only documented cohort to describe the evolution of drug use and HIV risk among migrant workers in a U.S. post-disaster setting where there are essentially no prevention or treatment services available. PUBLIC HEALTH RELEVANCE: Central America and Mexico, once thought to be areas with little drug use and low HIV prevalence, have seen a steady rise in rates. In these areas, the prevalence of HIV is higher in regions with significant emigration to the U.S. and there has been an explosion of migration to the U.S. by Mexicans and Central Americans. Close to 4 million Latin American migrants entered the U.S. between 1990 and 2000, doubling the number of foreign born Latinos in just a decade. Between 1990 and 2000, the number of Latinos in selected southern states that had no or small Latino populations in 1990 increased by more than 300% on average. New destinations are important because precipitators of acculturation-stress are likely to be greater than in more established areas. While many studies have described high rates of HIV risk behavior, far fewer have examined the broader context of this risk. This study will address this gap, as well as providing data from a high-risk behavior receiving environment in which the influence of extremes of drug use and sexual risk can help to illustrate factors affecting initiation, use patterns and drug-related sexual risk.

描述（由申请人提供）：2005年8月卡特里娜飓风灾难发生后，来自墨西哥和中美洲的大量拉丁美洲人涌入，其中大多数是男性，无证且无家人陪同，前来寻求建筑工作。灾后的新奥尔良不仅是拉丁美洲移民的新接收区，而且由于其性和毒品旅游业，它是一个极高风险的环境，这使其成为探索促进移民吸毒和艾滋病毒性风险因素的天然实验室。在2007年10月，我们的研究小组聚集了一个队列的125个新来的拉丁美洲移民工人（LMW）采用受访者驱动的抽样，并跟踪他们每3个月检查艾滋病毒的风险。在9个月的随访中，我们发现药物使用率很高，从19%到29%不等，12名男性在新奥尔良开始使用药物，随访率为90%。从我们的初步数据中，我们知道“是什么”，但我们不知道“为什么”和“如何”，这是本探索性研究的重点。本研究的总体目标是确定和探索影响拉丁美洲移民工人中药物使用和与药物相关的艾滋病毒性风险行为的因素，这些移民工人已经迁移到一个以性和毒品旅游而闻名的新的接收环境。具体目标是：1）在125名迁移到新的高风险美国接收环境的拉丁裔工人的准概率样本中前瞻性地描述药物使用模式，2）探索上层建筑，结构，环境，使用混合方法并应用Sweat和Dennison的艾滋病毒因果关系模型和Handwerker的理论，研究影响拉丁美洲移徙工人开始和继续使用毒品的个人和文化因素3）描述药物使用对拉丁美洲移民工人艾滋病性风险行为的影响; 4）完善工具和理论框架，用于进一步研究药物使用、移民、文化适应与艾滋病性风险行为的关系。为了实现这些目标，一个多学科团队将采用混合方法，并继续随访队列18个月（总随访时间为30个月）。同时使用定性和定量方法来完善仪器和理论框架，并探索与药物使用和药物相关的艾滋病毒性风险相关的因素，以供未来的R 01应用。这是唯一一个描述美国灾后环境中移民工人吸毒和艾滋病毒风险演变的记录队列，那里基本上没有预防或治疗服务。 公共卫生关系：中美洲和墨西哥曾被认为是吸毒少和艾滋病毒流行率低的地区，但吸毒率稳步上升。在这些地区，艾滋病毒的流行率在大量移民到美国的地区更高，墨西哥人和中美洲人移民到美国的人数激增。1990年至2000年间，近400万拉丁美洲移民进入美国，在短短十年内，外国出生的拉丁美洲人数量翻了一番。在1990年至2000年期间，在1990年没有拉丁裔人口或拉丁裔人口较少的南部各州，拉丁裔人口平均增加了300%以上。新的目的地很重要，因为文化适应压力的沉淀物可能比更成熟的地区更大。虽然许多研究都描述了艾滋病毒风险行为的高发生率，但很少有人研究这种风险的更广泛背景。这项研究将解决这一差距，以及提供数据，从高风险行为接收环境中的影响，极端的药物使用和性风险，可以帮助说明影响因素的启动，使用模式和与药物有关的性风险。