Community Mobilization and HIV/STI Epidemiology of Female Sex Workers in Mexico

描述（由申请人提供）：这项指导研究科学家发展奖（K 01）将使我能够1）获得针对使用药物的女性性工作者（FSW）的结构性艾滋病毒预防干预措施的研究方法的专业知识; 2）增加药物滥用流行病学，评估和预防的知识; 3）在新的国际环境下，在涉及行为和生物艾滋病毒/性传播感染数据收集、暴力测量和结构性干预的研究中，获得文化上胜任的道德行为方面的额外培训; 4）学习如何设计干预措施的随机对照试验，并进行相关的纵向数据分析（GLMM）; 5）磨练成功的学术生涯所需的技能，研究药物使用，艾滋病毒/性传播感染的获得，以及高风险人群中的结构性风险和保护因素，包括在国内和国际上传播科学研究成果。我的职业发展计划将包括教学课程、研讨会、实践现场研究经验和指导的独立研究，这将为我提供干预评估方法、药物使用流行病学和临床生物标志物方面的培训。例如，我将参加纵向数据分析课程（例如事件历史和生存，以及成本效益分析）。我将与一个世界知名的指导团队和一个已经在墨西哥建立的基础设施合作，目的是将我学到的知识应用到其他国家的环境中。我将接受干预适应培训，同时在现有数据上实践严格的RCT评估方法（广义线性混合模型（GLMM）），目标是成为全球FSW的少数结构性HIV预防干预研究人员之一。我提出的K 01项目“妇女联合会”（妇女联合会）将嵌入NIDA资助的家长赠款“Proyecto Mapa de Salud”（R 01 DA 028692 -01，PI：Brouwer），该项目探讨了墨西哥/美国边境沿着的FSW和其他弱势人群中的艾滋病毒/STI传播。在墨西哥蒂华纳，妇女联合会将：1）就社区动员和药物使用的作用对FSW（30人）和FSW倡导者/组织者（20人）进行定性访谈; 2）通过对FSW（n=10）进行认知测试，使社区动员措施适应天津的环境，以确保可读性和可接受性，和3）确定社区动员参与的普遍程度及其与物质使用的关系，通过在父母补助金的12个月随访调查中增加适应措施，调查FSW中的艾滋病毒/性传播感染流行率和性风险行为（N=300名FSW）。研究结果将为未来的R34赠款申请提供试点数据，以试点/可行性测试适应性预防干预措施， 吸毒和艾滋病毒感染的获得。

DESCRIPTION (provided by applicant): This Mentored Research Scientist Development Award (K01) will enable me to 1) acquire expertise in the research methods of developing structural HIV prevention interventions targeting substance using female sex workers (FSWs); 2) increase knowledge of substance abuse epidemiology, assessment and prevention; 3) obtain additional training in the culturally competent ethical conduct of research involving behavioral and biological HIV/STI data collection, violence measurement, and structural interventions in a new international setting; 4) learn how to design RCTs of interventions and conduct related longitudinal data analyses (GLMM); 5) hone skills needed for a successful academic career studying the intersection of substance use, HIV/STI acquisition, and structural risk and protective factors among high risk populations, including grantsmanship and disseminating scientific research findings nationally and internationally. My career development plan will include a mixture of didactic courses, seminars, hands-on field research experience, and mentored independent studies which will provide me with training in intervention evaluation methodologies, substance use epidemiology, and clinical biomarkers. For example, I will take courses in longitudinal data analyses (e.g. event history and survival, and cost-benefit analyses). I will work with a world-renowned mentoring team and an infrastructure already in place in Mexico, with the goal of applying what I learn to other national contexts as well. I will train in intervention adaptation while simultaneously practicing rigorous RCT evaluation methodologies (Generalized Linear Mixed Modeling (GLMM)) on existing data, with the goal of becoming one of a few structural HIV prevention intervention researchers for FSWs worldwide. My proposed K01 project "Mujeres Unidas" (Women United) will be embedded in the NIDA funded parent grant, "Proyecto Mapa de Salud" (R01DA028692-01, PI: Brouwer), which explores HIV/STI transmission among FSWs and other vulnerable populations along the Mexico/U.S. border. In Tijuana, Mexico, Mujeres Unidas will 1) qualitatively interview FSWs (N=30) and FSW advocates/organizers (N=20) about community mobilization and the role of substance use; 2) adapt measures of community mobilization to the Tijuana context through cognitive testing with FSWs (n=10) to ensure readability and acceptability, and 3) determine the prevalence of community mobilization participation and its association with substance use, HIV/STI prevalence and sexual risk behaviors among FSWs by adding adapted measures to the parent grant's 12- month follow up surveys (N=300 FSWs). Results will generate pilot data for a future R34 grant application to pilot/feasibility test an adapted preventive intervention targeting drug use and HIV infection acquisition.