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

描述(申请人提供)：这个为期5年的职业发展奖将为候选人提供混合研究方法及其应用方面的培训，以了解物质使用和移民对少数族裔和弱势群体中艾滋病毒和血液传播感染(BBI)的影响。新的定性和混合方法培训，再加上公共卫生博士学位和以前的卫生服务研究，将使候选人为在少数群体和弱势社区预防艾滋病毒方面的复杂社会和移徙因素进行独立的、面向政策的研究做好准备。拟议的职业和培训目标采用授课和有指导的学习，以：(1)彻底了解促成物质使用的社会和环境因素，并促进BBIS在移徙者中的传播；(2)获得制定和实施混合方法方案(即定性和定量方法)的专门知识，以研究物质使用问题；(3)获得研究道德行为方面的持续培训，特别是针对弱势群体；(4)发展成功的学术研究事业所需的技能(例如，发表同行评审的论文、在专业会议上发表报告、提供资助)；以及(5)深入了解可减少外来注射吸毒者中BBI传播的基于理论的干预措施。这项培训的一个关键方面是调查移民对蒂华纳(美墨边境城市)注射毒品的外来女性性工作者(FSW-IDU)危险物质使用和性行为的影响。暗娼中HIV感染率为12.3%本研究采用混合方法(1)描述蒂华纳暗娼过去和未来的迁移决策和资源；(2)描述社区和家庭迁移经历对暗娼从事性工作和吸毒行为决策的影响；(3)考察迁徙因素与参与危险性行为和吸毒行为的关系。这项研究产生的数据将被申请者用来开发R01或R34，目标是美国-墨西哥边境地区的移民FSW-IDU和艾滋病毒风险。相关性：这项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可能通过FSW-IDU及其客户对居住在美墨边境地区的其他人口以及前往该地区的游客的危险性行为和药物使用行为而变得普遍。

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.