HIV and Substance Use in the Pacific

描述(申请人提供)：制衣和其他合同工占北马里亚纳群岛联邦(CNMI)人口的一半以上。大多数是来自亚洲和其他太平洋岛屿的年轻女性移民劳工，她们暴露在恶劣的工作和生活条件下。据称，一些妇女被迫从事性交易，而另一些妇女可能选择从事性行业(例如，因为这是有利可图的)。据推测，这些应激源导致物质使用和危险的性行为，这可能导致艾滋病毒和其他性传播疾病(STD)的获得。到目前为止，关于CNMI合同工的药物使用、性传播疾病和艾滋病毒危险行为的数据很少，然而，CNMI近年来经历了甲基苯丙胺的流行，其使用被认为是普遍的。这项前瞻性研究将通过面试者管理的问卷来衡量基线物质使用和性史，这是政府资助的艾滋病毒/性传播疾病筛查的一部分，这是工人进入CNMI后的雇佣合同所要求的。将确定药物使用、艾滋病毒和性传播疾病的流行率和相关性。六个月和一年后的后续检查将测量药物使用和性行为的变化，以及压力、抑郁和自杀行为，以及艾滋病毒/性传播疾病检测。查明外来女工中艾滋病毒/性传播疾病病例和感染的相关因素，有助于为合同工设计艾滋病毒/性传播疾病教育方案，防止艾滋病毒/性传播疾病在从事性交易的妇女之间传播，并为受感染的年轻妇女确定适当的治疗方案。

DESCRIPTION (provided by applicant): Garment and other contract workers account for more than half of the population of the Commonwealth of the Northern Marianas Islands (CNMI). The majority are immigrant laborers who are young women from Asia and other Pacific Islands, and who are exposed to harsh working and living conditions. Allegedly, some women have been forced into the sex trade, whereas others may choose to participate in the sex industry (e.g., because it is lucrative). It is hypothesized that these stressors result in substance use and risky sexual practices, which can lead to the aquisition of HIV and other sexually transmitted diseases (STDs). To date, data on substance use, STDs and HIV risk behaviors among CNMI contract workers are sparse, however, the CNMI experienced a methamphetamine epidemic in recent years and its use is believed to be prevalent. This prospective study will measure baseline substance use and sexual history via an interviewer-administered questionnaire as part of government-sponsored HIV/STD screening, which is required by the workers' employment contract upon entry into the CNMI. Prevalence and correlates of substance use, HIV and STDs will be determined. Subsequent visits at six months and one year would measure changes in substance use and sexual practices, as well as stress, depression, and suicidal behavior, in addition to HIV/STD testing. Identifying incident HIV/STD cases and the correlates of infection among the female migrant workers could aid in the design of HIV/STD education programs for contract workers, prevent spread of HIV/STDs to/from women working in the sex trade, and identifying appropriate treatment options for those infected young women.