BEHAVIORAL DYNAMICS OF HIV/AIDS IN UTTAR PRADESH, INDIA

本研究的总体目标是描述印度北方邦（UP）北部地区艾滋病毒/艾滋病传播的可能性。北方邦是印度人口最多的邦，其特点与其他地方的情况一样，加剧了艾滋病的流行：社会经济发展水平低，健康状况差，特别是妇女健康状况差，性别分层程度高。本研究将分为两个连续的阶段，分别针对以下四个具体目标：第一阶段：定性方法将用于：1)建立一套解释模型，以阐明使UP城市男性面临性桥接行为风险的因素组合；2)为第二阶段男性调查仪器的开发提供信息，并协助解释第二阶段的结果。参与桥接行为的男性将从参与第二阶段人口调查的同一城市的女性性工作者和性病患者的客户中确定。对这些男性的深入访谈将集中在生活史、同伴群体、性网络、伴侣史、避孕套使用模式、艾滋病毒/性病相关知识和其他因素。定性分析将确定与使男子面临感染和传播艾滋病毒风险的行为有关的因素和影响途径。第二阶段：将在北方邦育龄夫妇中进行一项以人口为基础的横断面调查，目的是：3)调查与艾滋病毒/性传播疾病有关的知识、对风险的认识以及使他们面临感染这些疾病风险的相关行为的模式和决定因素；4)确定和比较已婚妇女和男子寻求性传播疾病症状的健康行为的决定因素。将抽取3000对夫妇的概率样本，他们分别生活在北方邦的五个地理区域中的两个最大的城市和一个农村地区。符合条件的女性在面试时年龄在14- 49岁之间，已婚，与丈夫住在一起。符合条件的男性将是由符合条件的女性确定的配偶。将把妻子和丈夫提供的数据联系起来并用于多变量分析，以调查配偶之间在有关结果的模式和决定因素方面的差异，特别侧重于妇女自主和男子对其妻子的社会支持的影响。

The overall objective of the present study is to describe the potential for the spread of HIV/AIDS in the northern state of Uttar Pradesh, India (UP). UP, the most populous state of India, is characterized by conditions that have exacerbated the AIDS epidemic elsewhere: low socio-economic development, poor health outcomes particularly for women, and high gender stratification. The study's two consecutive phases will address the four specific aims: Phase I: Qualitative methods will be used to: 1) Develop a set of explanatory models to elucidate the combination of factors that place men in urban UP at risk for engaging in sexual bridging behavior; 2) inform the development of the male survey instrument for Phase II and aid the interpretation of Phase II results. Men who engage in bridging behavior will be identified from among clients of female sex workers and STD patients in the same cities selected for the Phase II population-based survey. In-depth, interviews with these men will focus on life history, peer groups, sexual networking, partner history, patterns of condom use, HIV/STD-related knowledge, and other factors. Qualitative analyses will identify factors and pathways of influence associated with behavior that places men at risk for becoming infected with and transmitting HIV infection. Phase II: A cross-sectional, population-based survey among couples of reproductive age in UP will be conducted to: 3) Investigate the patterns and determinants of HIV/STD-related knowledge, and perceptions of risk, and of related behavior that places them at risk for these infections, 4) identify and compare the determinants of married women's and men's health seeking behavior for symptoms of sexually transmitted diseases. A probability sample of 3,000 couples living in the two largest cities and a rural area in each of the five geographical regions that comprise UP will be drawn. Eligible women will be aged 14- 49, married, and residing with their husbands at the time of interview. Eligible men will be the spouses identified by eligible women. Data provided by wives and husbands will be linked and used in multivariate analyses to investigate the differentials between spouses in the patterns and determinants of the outcomes of interest, with a particular focus on the effects of women's autonomy and men's social support for their wives.