Migrancy, Masculinity, and Preventing HIV in Tajik Male Migrant Workers

描述（由申请人提供）：本申请解决了中亚男性劳工移民中艾滋病毒预防的主要全球健康问题。这项研究的重点是在莫斯科工作的塔吉克斯坦已婚男子，以及他们通过与女性性工作者发生性关系然后将感染传染给妻子或女性性伴侣而感染艾滋病毒的风险。这项为期五年的定量和定性研究收集了来自莫斯科的移民、塔吉克斯坦的移民家庭、莫斯科的女性伴侣和性工作者以及这两个地方与移民有关的组织的数据。它发展了以下方面的背景知识：（1）社会、文化和心理因素塑造男性气质的过程;（2）男性规范如何影响男性移民的艾滋病毒风险和预防行为;以及（3）如何通过在移民生活的真实的世界背景和与他们合作的组织中处理男性规范来提高艾滋病毒预防技能。这些目标的重点是建立形成性知识和制定创新的干预战略，为艾滋病毒预防提供信息。本研究的具体目的是：1）描述在极端条件下已婚男性的劳动力迁移如何塑造男性规范和图式以及艾滋病风险和预防行为; 2）描述女性如何塑造男性规范和图式以及艾滋病风险和预防行为。（妻子、固定伴侣、性工作者）及其对艾滋病毒的看法、女性特征和男性特征影响男性流动人口的艾滋病毒风险和预防行为; 3）评估与已婚男性移民有关的组织在应对艾滋病毒和减轻影响男性性行为的男性规范方面的当前和潜在作用;四、在已婚男性移民中建立一个基于经验的预防艾滋病毒模式，这将有助于制定侧重于以下方面的方案和政策：异性恋男性和男性规范。这些目标将通过以下方式实现：对莫斯科的塔吉克已婚男性移民（n=400）进行调查，对莫斯科的塔吉克移民（n=40）、他们在塔吉克斯坦（n=40）和莫斯科（n=~30）的妻子/固定女性伴侣、莫斯科的性工作者（n=30）进行人种学访谈和观察，在塔吉克斯坦和莫斯科从事移徙者工作的组织中的服务提供者（n=40）。这项研究的意义在于通过关注男性气质和移民在塑造艾滋病毒风险和预防行为中的作用，解决男性劳动力移民艾滋病毒风险带来的重大全球健康问题。 公共卫生相关性：这项研究解决了中亚已婚男性劳工移民中艾滋病毒预防的主要全球健康问题和塔吉克斯坦艾滋病流行的公共卫生风险。它建立了关于男子气概作为男性移民性行为和艾滋病毒风险的决定因素的作用的知识。它制定了创新的模式和战略，如何男性规范可能实际解决，将告知设计，实施和评估艾滋病毒预防干预男性劳动力移民。

DESCRIPTION (provided by applicant): This application addresses the major global health problem of HIV prevention amongst male labor migrants in Central Asia. The study focuses on married men from Tajikistan working in Moscow and their risks for acquiring HIV through having sex with female sex workers and then transmitting the infection to their wives or female sexual partners. This five-year quantitative and qualitative study gathers data from migrants in Moscow, sending families in Tajikistan, female partners and sex workers in Moscow, and organizations involved with migrants in both locations. It develops contextual knowledge on: 1) the processes through which social, cultural, and psychological factors shape masculinity; 2) how masculine norms impact male migrants' HIV risk and preventive behaviors; and 3) how to enhance HIV prevention skills through addressing masculine norms in the real world contexts of migrants' lives and the organizations working with them. The goals are focused both on building formative knowledge and on developing innovative intervention strategies to inform HIV prevention. The specific aims of this study are: 1) To characterize how labor migration of married men under extreme conditions shapes masculine norms and schemas and HIV risk and preventive behaviors; 2) To characterize how women (wives, regular partners, sex workers) and their perceptions of HIV, femininity, and masculinity impact male migrants' HIV risk and preventive behaviors; 3) To assess the current and potential roles of the organizations involved with married male migrants in responding to HIV and in mitigating masculine norms impacting men's sexual behavior; 4) To build an empirically based model for preventing HIV amongst married male migrants that will help to develop programs and policies focused on heterosexual men and masculine norms. These aims will be accomplished by a survey of Tajik married male migrants in Moscow (n=400), ethnographic interviews and observations of the Tajik migrants in Moscow (n=40), their wives/regular female partners in Tajikistan (n=40) and Moscow (n=~30), sex workers in Moscow (n=30), and service providers (n=40) in organizations that are involved with migrants in Tajikistan and Moscow. This study's significance lies in addressing the major global health problems posed by male labor migrants' HIV risks through focusing on the roles of masculinity and migrancy in shaping HIV risk and preventive behaviors. PUBLIC HEALTH RELEVANCE: This research addresses the major global health problem of HIV prevention amongst married male labor migrants in Central Asia and the public health risk for an AIDS epidemic in Tajikistan. It builds knowledge on the role of masculinity as a determinant of male migrants' sexual behavior and HIV risk. It develops innovative models and strategies for how masculine norms may be practically addressed that will inform the design, implementation, and evaluation of HIV preventive interventions for male labor migrants.