Mexican Female Migration, Substance Use, Sex Work, and HIV Risks in Tijuana

描述（由申请人提供）：这项为期5年的职业发展奖励将为候选人提供混合研究方法及其应用的培训，以了解少数民族和弱势群体中药物使用和迁移对艾滋病毒和血源性感染（BBIs）的影响。新的定性和混合方法培训与公共卫生和先前卫生服务研究博士学位相结合，将为候选人做好准备，对少数民族和弱势社区预防艾滋病毒的复杂社会和移民因素进行独立的、面向政策的研究。拟议的职业和培训目标采用说教式和指导性学习：(1)深入了解导致移民物质使用和促进bbi传播的社会和环境因素；(2)获得制定和执行混合方法协议（即定性和定量方法）以研究物质使用问题的专门知识；(3)在研究中，特别是针对弱势群体的研究中，不断接受道德行为方面的培训；(4)培养成功的学术研究生涯所需的技能（例如，发表同行评议论文，在专业会议上演讲，获得资助）；(5)深入了解基于理论的干预措施可能会减少流动注射吸毒者（IDUs）中bbi的传播。这项培训的一个关键方面是调查移民对在美墨边境城市提华纳注射毒品的移徙女性性工作者（FSW-IDUs）使用危险物质和性行为的影响。该研究使用混合方法来(1)描述提华纳FSW-IDUs之前和未来的迁移决策和资源；(2)描述社区和家庭迁移经历对FSW-IDUs从事性工作和物质使用行为决定的影响；(3)检验迁移因素与从事危险性行为和物质使用行为之间的关系。该研究产生的数据将由申请人用于制定R01或R34，目标是美国-墨西哥边境地区移民FSW-IDUs和艾滋病毒风险。相关性（见注射）：本研究的公共卫生相关性在于研究人群作为桥梁人群的作用，这意味着性传播感染或其他bbi可能会通过FSw-IDUs及其客户参与危险性行为和物质使用行为而传播给居住在美墨边境地区的其他人群以及该地区的游客。

DESCRIPTION (provided by applicant): This 5 year career development award will provide the candidate with training in mixed research methods and their applications to understanding substance use and migration impacts on HIV and blood borne infections (BBIs) in minority and vulnerable populations. The new qualitative and mixed-methods training coupled with a Ph.D. in public health and prior health services research will prepare the candidate for independent, policy oriented research on complex social and migration factors in HIV prevention in minority and disadvantaged communities. The proposed career and training goals employ didactic and mentored learning to: (1) Develop a thorough understanding of social and environmental factors that contribute to substance use and facilitate transmission of BBIs in migrants; (2) Acquire expertise in developing and implementing mixed-methods protocols (i.e., qualitative and quantitative methods) to study substance use issues; (3) Obtain ongoing training in the ethical conduct in research, especially vis-¿-vis vulnerable populations; (4) Develop the skills necessary for a successful academic research career (e.g., publishing peer reviewed papers, presenting at professional meetings, grantsmanship); and (5) Acquire an in-depth understanding of theory-based interventions that may reduce transmission of BBIs among migrant injection drug users (IDUs). A key aspect of this training involves investigating the influence of migration on risky substance use and sexual behaviors among migrant female sex workers who inject drugs (FSW-IDUs) in Tijuana, a city on the U.S.-Mexico border. The prevalence of HIV in FSW-IDUs is 12.3% This study uses a mixed-methods approach to (1) characterize prior and future migration decisions and resources of FSW- IDUs in Tijuana; (2) Describe the influence of community and family migration experiences on FSW-IDUs' decisions to engage in sex work and substance use behaviors, and (3) Examine the relationship between migration factors and engagement in risky sex and substance use behaviors. Data generated from this study will be used by the applicant to develop an R01 or R34 targeting migrant FSW-IDUs and HIV risks in the U.S.-Mexico border region. RELEVANCE (See instnjections): The public health relevance of this study lies in the study population's role as a bridge population, meaning that sexually transmitted infections or other BBIs may become generalized through engagement in risky sex and substance use behaviors by FSw-IDUs and their clients to other populations residing in the U.S.-Mexico border region as well as tourists to the region.