BEHAVIORAL DYNAMICS OF HIV/AIDS IN UTTAR PRADESH, INDIA

本研究的总体目标是描述艾滋病毒/艾滋病在印度北部北方邦(UP)传播的可能性。Up是印度人口最多的邦，其特点是在其他地方加剧了艾滋病的流行：社会经济发展缓慢，特别是妇女的健康状况不佳，以及高度的性别分层。这项研究的连续两个阶段将涉及四个具体目标：第一阶段：将使用定性方法：1)开发一套解释性模型，以阐明将城市男性置于从事性桥接行为风险的因素组合；2)为第二阶段男性调查工具的开发提供信息，并帮助解释第二阶段的结果。参与搭桥行为的男性将从女性性工作者和性病患者的客户中确定，这些客户位于同一城市，被选为第二阶段基于人口的调查。对这些男性的深入访谈将集中在生活史、同龄人群体、性网络、性伴侣史、避孕套使用模式、艾滋病毒/性传播疾病相关知识和其他因素。定性分析将确定与将男性置于感染和传播艾滋病毒感染风险的行为相关的影响因素和途径。第二阶段：将在UP的育龄夫妇中进行一项基于人口的横断面调查，以：3)调查艾滋病毒/性病相关知识的模式和决定因素，以及使他们面临这些感染风险的风险认知和相关行为，4)确定和比较已婚女性和男性性传播疾病症状的求医行为的决定因素。我们将对居住在两个最大的城市和五个组成UP的五个地理区域中的一个农村地区的3000对夫妇进行概率抽样。符合条件的女性将年龄在14-49岁，已婚，并在面试时与丈夫一起居住。符合条件的男性将是符合条件的女性确定的配偶。妻子和丈夫提供的数据将被联系起来，并用于多变量分析，以调查配偶之间在感兴趣的结果的模式和决定因素方面的差异，特别侧重于妇女自主权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.