Intersectional Stigma Reduction for Tajik Migrants Who Inject Drugs

项目摘要 劳动力流动是助长全球艾滋病流行和艾滋病毒流动的主要因素 跨越国界和人口。在东道国注射毒品的移民尤其 风险很高。中亚小国塔吉克斯坦输出100多万临时劳工移民 每年，其中许多人注射毒品。这些移民非常容易受到跨部门移民的负面影响 俄罗斯文化和社会经济环境中的耻辱，因为既是移民工人又是 注射毒品者(PWID)。此外，他们还受到广泛的谴责和边缘化。 他们在他们居住的紧密的散居社区中的非吸毒者塔吉克同龄人，特别是如果他们 感染艾滋病病毒。污名化对那些经历过污名化的人的不利影响是有据可查的。这个 作为移民和注射毒品者(PWID)的污名身份与污名的交集 与艾滋病毒感染有关，导致艾滋病毒危险行为，对获得艾滋病毒检测和 其他预防/治疗服务，并导致艾滋病毒携带者的健康结果较差。 这项拟议的研究将调查莫斯科塔吉克移民社区的污名特征， 以及多种交叉形式的耻辱对塔吉克劳工移民健康和福祉的影响 在莫斯科居住期间注射毒品(目标1)。我们将使用通过这个形成法获得的洞察力和发现 研究开发一种创新的干预措施，专门用于对抗药物的负面影响- 塔吉克移民社区内可能影响塔吉克人艾滋病毒危险行为和预防的相关污名 在莫斯科注射毒品的移民(目标2)。通过领导减少污名的干预方法 散居海外(SRI-AVLOD)干预将利用#年关系密切的塔吉克散居社区的优势 哪些新的规范和行为可以在流动人口社会内部和之间有效地传播和推广 网络如果得到他们信任的领导人的支持。SRI-AVLOD旨在招募和培训散居国外的塔吉克人 社区领袖作为变革的推动者，在莫斯科塔吉克社区内开启关于 毒品和艾滋病毒相关污名的影响，以减少对艾滋病毒产生负面影响的污名化信念和行动 社区注射吸毒者危险行为及预防。在制定了一项工作后 原型，我们将向塔吉克移民社区领导人的小团体提供干预，以评估其 可行性和可接受性，以及进一步修改的必要性(目标3)。 在未来的工作中，我们将交付并测试SRI-AVLOD模型在改变与药物相关的 污名化和污名化所有级别的信仰、行为和后果(社区、领导层、PWID) 在塔吉克侨民社区内及其在减少艾滋病毒危险行为和增加 在注射毒品的塔吉克成员中采用艾滋病毒预防方法和服务。

Project Summary Labor migration is a major contributor to fueling the global AIDS epidemic and also the movement of HIV across country borders and populations. Migrants who inject drugs while in a host country are at especially high risk. Tajikistan, a small country in Central Asia, exports more than a million temporary labor migrants annually, many of whom inject drugs. These migrants are highly subject to the negative effects of intersectional stigma within Russia's cultural and socio-economic environment due to being both a migrant worker and a person who injects drugs (PWID). In addition, they are subject to extensive censure and marginalization from their non-drug-using Tajik peers in the close-knit diaspora communities in which they reside, especially if they acquire HIV. The adverse effects of stigmatization on those who experience it are well documented. The intersection of stigmatized identities as migrants and people who inject drugs (PWID), along with stigma associated with HIV infection, contributes to HIV risk behavior, poses as a barrier to accessing HIV testing and other prevention/treatment services, and results in poorer health outcomes for those living with HIV. The proposed study will investigate the character of stigma in the Moscow Tajik migrant community, and the effects of multiple intersecting forms of stigma on the health and well-being of Tajik labor migrants who inject drugs while living in Moscow (Aim 1). We will use the insight and findings gained through this formative research to develop an innovative intervention specifically designed to counter the negative effects of drug- related stigma within the Tajik migrant community that can affect HIV risk behavior and prevention among Tajik migrants in Moscow who inject drugs (Aim 2). The Stigma Reduction Intervention Approach Via Leaders of Diaspora (SRI-AVLOD) intervention will draw on the strengths of close-knit Tajik diaspora communities in which new norms and behaviors can be effectively diffused and promoted within and across migrant social networks if endorsed by leaders whom they trust. SRI-AVLOD is designed to recruit and train Tajik diaspora community leaders as agents of change and open up conversation within the Moscow Tajik community about the effects of drug and HIV-related stigma, to reduce stigmatizing beliefs and actions that negatively affect HIV risk behavior and prevention among community members who inject drugs. After developing a working prototype, we will deliver the intervention to small groups of Tajik migrant community leaders to assess its feasibility and acceptability, and need for further modifications (Aim 3). In future work we will deliver and test the efficacy of the SRI-AVLOD model in changing drug-related stigma and stigmatizing beliefs, behavior, and consequences at all levels (community, leadership, PWID) within the Tajik diaspora community and its positive effects in reducing HIV risk behavior and increasing the adoption of HIV prevention methods and services among its Tajik members who inject drugs.