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Epidemiologic Study on Changing HIV Risks Among FSW-IDUs on the Mexico-US Border

墨西哥-美国边境 FSW-IDU 人群 HIV 风险变化的流行病学研究

基本信息

批准号：
7790838
负责人：
STEFFANIE A. STRATHDEE
金额：
$ 7.98万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-02-01 至 2013-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7790838
关键词：
Accounting Adult Age Alcohol or Other Drugs use Anal Sex Animal Welfare Attitude Bacterial Vaginosis Behavior Behavior Therapy Bibliography Birth Place Budgets California Characteristics Child Chlamydia Cities Client Clinic Communities Congenital Syphilis Consult Consumption Country Data Collection Drug usage Education Environment Environmental Impact Epidemic Epidemiologic Studies Epidemiology Equipment Expectancy Female Feminine Fluorescent Dyes Foundations General Population Goals Gonorrhea Government HIV HIV Seropositivity HIV/STD Herpes zoster disease Hygiene IACUC Incentives Infant Food Injection of therapeutic agent International Intervention Intervention Studies Joints Knowledge Laboratories Light Maps Marketing Methods Mexican Mexico Modeling Needle Sharing Needle-Exchange Programs Needles Outcome Pattern Pharmaceutical Preparations Pilot Projects Play Population Prevalence Prevention Principal Investigator Publishing Randomized Recommendation Recruitment Activity Reporting Research Research Ethics Committees Research Personnel Resources Risk Risk Reduction Role Route Secure Self Efficacy Sex Behavior Sex Education Shares syringes Shipping Ships Side Sister Site Soaps Source Specimen Subgroup Suggestion Syphilis Syringes Testing Time Toy Translating Trichomonas Infections Upper arm Vagina Vertebrates Visit Water Woman Work abstracting aged base condoms contextual factors cost depressive symptoms design efficacy testing experience expiration family structure follow-up group intervention high risk high risk behavior human subject improved intervention effect intimate partner violence male meetings motivational enhancement therapy peer pleasure policy implication primary outcome programs response safer sex self esteem sex social trafficking voucher

项目摘要

Globally, FSWs who inject drugs (FSW-IDUs) are important `bridge' populations that can transmit HIV/STIs to the general population; however, interventions to reduce both their injection and sexual risks are lacking. The overall goal of this epidemiologic study is to simultaneously reduce high risk sexual and injection behaviors among FSW-IDUs in two Mexico-U.S. border cities, among whom HIV prevalence has recently increased from 2% to 14%; 46% had at least one active STI. Our specific aims are: Aim 1) To evaluate the efficacy of a behavioral intervention to decrease sharing of syringes and injection paraphernalia among FSW-IDUs. We hypothesize that FSW-IDUs in the active experimental injection risk eduction ondition will report: (a) less receptive and distributive needle sharing; (b) less sharing of injection paraphernalia; (c) obtaining syringes and injection paraphernalia from safer sources. Aim 2) To valuate efficacy of a behavioral intervention to increase condom use among FSW-IDUs in the context of ongoing drug use. We hypothesize that FSW-IDUs in the active experimental sexual risk reduction condition will: (a) report less unprotected vaginal and anal sex; (b) have fewer incident cases of specific STIs. Aim 3) To evaluate the joint effects of these two behavioral interventions o increase condom use and reduce sharing of needles/injection paraphernalia among FSW- IDUs. We hypothesize that the joint effect of these interventions will generate greater risk reductions compared to either intervention alone. Aim 4) To determine the extent to which theoretically-important components of our interventions (i.e., self-efficacy, outcome expectancies, attitudes, intentions) represent underlying mechanisms of change in primary outcomes (i.e., sexual and injection-related risk reductions). Aim 5) To explore subgroup differences in the efficacy of a) the sexual risk reduction intervention and b) the injection risk reduction intervention based on background characteristics, contextual factors, social factors and intrapersonal factors. To meet these aims, we will recruit 600 HIV-negative FSW-IDUs (300 each in Tijuana and Cd. Juarez) and randomize women to one of three time-equivalent groups (Group 1: injection risk intervention and didactic safer sex education; Group 2: sexual risk intervention and didactic safer injection education; Group 3: Both active injection and sexual interventions). In each city, cluster randomization will be used to minimize contamination. All women receive free STI treatment and will be followed-up at 4, 8 and 12 months. Our design allows us to ‘ unpack' the intervention to determine whether its components are just as effective in reducing injection and/or sexual risks, or if the more intensive conditions are needed to alter the epidemiology of HIV/STIs, thus having direct, tangible policy implications for Mexico and the US. Interventions that reduce HIV risks among FSW-IDUs may curtail the burgeoning HIV epidemic in the U.S-Mexico border region, and have applicability to other resource-poor countries.

在全球范围内，注射毒品的妇女是可以将艾滋病毒/性传播感染传播给一般人群的重要“桥梁”人群；然而，缺乏减少注射和性行为风险的干预措施。本流行病学研究的总体目标是同时降低墨西哥-美国两个地区FSW-IDUs吸毒者的高危性行为和注射行为。这些城市的艾滋病毒感染率最近有所上升