Epidemiology of Sex Trafficking, Drug Use and HIV at the U.S.-Mexico Border

美国-墨西哥边境性贩运、吸毒和艾滋病毒的流行病学

• 批准号: 8330121
• 负责人: Jay G Silverman
• 金额: $ 34.88万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8330121
• 关键词: Address; Affect; Age; Asia; Central America; Cities; Client; Consultations; Costs and Benefits; Crime; Data; Data Collection; Development; Direct Costs; Drug usage; Ensure; Epidemiology; Exposure to; Frequencies; HIV; HIV Infections; HIV/STD; Health Services; Health Services Accessibility; Human Resources; Human Rights; Human immunodeficiency virus test; Illicit Drugs; Information Systems; Injection of therapeutic agent; Intervention; Interview; Laboratories; Latin America; Location; Methods; Mexican; Mexico; Minor; Nature; Needle Sharing; Patient Self-Report; Pharmaceutical Preparations; Phase; Police; Reporting; Research; Research Infrastructure; Risk; Role; Sampling; Screening procedure; South America; Southeastern Asia; Structure; Surveys; System; Testing; Time; United Nations; Unsafe Sex; Violence; Woman; Work; base; design; experience; girls; informant; migration; prevent; sex; sex trafficking; trafficking

DESCRIPTION (provided by applicant): Across Latin America, virtually no empirical data exist on the subject of sex trafficking, defined by the United Nations as "forced, coerced, fraudulent or deceitful entry in to sex work, entry by abduction, or entry into such work under age 18." Recent media reports support that trafficking of women and girls into sex work, and drug cartel involvement in this form of sexual exploitation, is on the rise in the U.S. Mexico border region, constituting a major human rights crisis. Further, previous research by the PI in South and Southeast Asia has established that entry into sex work via trafficking confers elevated HIV/STI risk. Although the nature and context of sex trafficking in the US-Mexico border region likely differ significantly from that of Asia (e.g., the likely role of illicit drugs), research of our binational research team has found that factors often associated with trafficking among FSWs (e.g., young age, violence) relate to increased HIV risk, illicit drug use and forced injection drug use in Tijuana and Ciudad Juarez, suggesting that sex trafficking may be promoting vulnerability to HIV in this region. To both prevent sex trafficking and reduce risk for HIV among women and girls who have been trafficked, data is required a) on how sex trafficking is occurring and what structures facilitate this crime, and b) on whether and how victims, once trafficked, are made vulnerable to HIV. Despite the clear and urgent need in the region, no study of these issues has been conducted to date. The proposed study aims to describe the nature of sex trafficking in two major border cities (Tijuana and Ciudad Juarez) including major structural factors (e.g., those related to drug cartel activities, police violence, northward migration, access to health services) that may affect both sex trafficking and HIV risk among trafficking victims. To accomplish this, we propose to conduct a mixed-methods study of 800 FSWs from Tijuana and Ciudad Juarez in consultation with multiple national and state-level systems key informants (SKI) to inform the content, ensure the relevance, and maximize the acceptability and dissemination of our work. As an estimated 70% of FSWs in these cities originate from other Mexican states or Central and South America, these locations offer an unparalleled opportunity within Latin America to study these concerns, as well as to inform the development of much- needed interventions. In-depth interviews will be conducted with 30 FSWs (15 per city) screening positive for sex trafficking (minor or forced/coerced sex work entry). Data will be collected from 800 FSWs (400 per city) identified using venue-based sampling, via self-report survey and biologic HIV/STI testing. Based on interview, survey and laboratory data and SKI consultation, targets will be identified and prioritized for region-specific, structural interventins (i.e., those focused structural factors found to be associated with sex trafficking and HIV risk among trafficked FSWs) to prevent sex trafficking and reduce coincident HIV risk along the US.- Mexico border. Development and piloting of indicated structural interventions will be proposed within a subsequent R34 application. PUBLIC HEALTH RELEVANCE: The proposed study aims to describe the nature of sex trafficking in two major U.S.-Mexico border cities (Tijuana and Ciudad Juarez) including major structural factors (e.g., those related to drug cartel activities) that may affect both sex trafficing and HIV risk among trafficking victims. To accomplish this, we propose to conduct a mixed-methods study of 800 FSWs from Tijuana and Ciudad Juarez in consultation with multiple national and state-level systems key informants (SKI) to inform the content, ensure the relevance, and maximize the acceptability and dissemination of our work. Methods include a) in-depth interviews with 30 FSWs (15 per city) screening positive for sex trafficking (minor or forced/coerced sex work entry); b) survey and HIV testing of 800 FSWs (400 per city) identified via venue-based sampling; and c) identification and prioritization of targets for region-specific, structural interventions.

描述（由申请人提供）：在整个拉丁美洲，实际上不存在关于性贩运问题的经验数据，联合国将性贩运定义为“强迫、胁迫、欺诈或 欺骗性从事性工作、绑架或未满 18 岁从事此类工作。” 最近的媒体报道表明，在美墨边境地区，贩卖妇女和女孩从事性工作以及贩毒集团参与这种形式的性剥削的现象呈上升趋势，构成了重大的人权危机。此外，南亚和东南亚的 PI 之前的研究表明，通过贩运从事性工作会导致艾滋病毒/性传播感染的增加 风险。尽管美墨边境地区性贩运的性质和背景可能与亚洲有很大不同（例如，非法药物的可能作用），但我们的两国研究团队的研究发现，与 FSW 贩运相关的因素（例如，年轻、暴力）与蒂华纳和华雷斯城的艾滋病毒风险增加、非法药物使用和强迫注射毒品有关，这表明性贩运 可能会增加该地区感染艾滋病毒的可能性。为了防止性贩运并降低被贩运妇女和女童感染艾滋病毒的风险，需要以下数据：a) 关于性贩运如何发生以及哪些结构助长了这种犯罪；b) 关于受害者一旦被贩运是否以及如何容易感染艾滋病毒。尽管该地区有明确而紧迫的需求，但迄今为止尚未对这些问题进行研究。拟议的研究旨在描述自然 两个主要边境城市（蒂华纳和华雷斯城）的性贩运情况，包括可能影响性贩运和贩运受害者艾滋病毒风险的主要结构性因素（例如，与贩毒集团活动、警察暴力、向北移民、获得医疗服务有关的因素）。为了实现这一目标，我们建议与多个国家的咨询机构协商，对蒂华纳和华雷斯城的 800 名 FSW 进行混合方法研究。 和国家级系统关键信息提供者（SKI），以告知内容，确保相关性，并最大限度地提高我们工作的可接受性和传播度。据估计，这些城市 70% 的 FSW 来自墨西哥其他州或中美洲和南美洲，这些地点为拉丁美洲研究这些问题以及为制定急需的干预措施提供了无与伦比的机会。将对30名FSW进行深度访谈 （每个城市 15 名）筛查性贩运呈阳性（轻微或强迫/胁迫进入性工作）。数据将通过自我报告调查和 HIV/STI 生物检测，从基于场所的抽样确定的 800 名 FSW（每个城市 400 名）中收集。根据访谈、调查和实验室数据以及 SKI 咨询，将确定目标并优先考虑区域特定的结构性干预措施（即那些重点关注的结构性因素） 发现与性贩运和被贩运的 FSW 中的艾滋病毒风险有关），以防止性贩运并减少美国-墨西哥边境沿线的同时发生的艾滋病毒风险。将在随后的 R34 申请中提议开发和试点指定的结构性干预措施。 公共卫生相关性：拟议的研究旨在描述美国-墨西哥边境两个主要城市（蒂华纳和华雷斯城）性贩运的性质，包括可能影响性贩运和贩运受害者艾滋病毒风险的主要结构性因素（例如与贩毒集团活动相关的因素）。为了实现这一目标，我们建议对来自蒂华纳和华雷斯城的 800 名 FSW 进行混合方法研究，并与多个国家和州级系统关键信息提供者 (SKI) 协商，以告知内容、确保相关性并最大限度地提高我们工作的可接受性和传播性。方法包括 a) 深入访谈 30 名性交易筛查呈阳性的 FSW（每个城市 15 名）（轻微或强迫/胁迫从事性工作）； b) 对通过场所抽样确定的 800 名 FSW（每个城市 400 名）进行调查和艾滋病毒检测； c) 确定针对特定区域的结构性干预措施的目标并确定优先顺序。