MINORITY PREDOCTORAL FELLOWSHIP

描述（由申请人提供）：泰国男性性工作者（MSW）中的艾滋病毒流行研究不足，估计发病率在过去几年中有所增加。此外，大多数城市固体废物是无证少数民族，贫困，教育水平低，使他们特别容易感染艾滋病毒。城市固体废物也是高度移动的;他们在主要旅游城市工作几个月，挣到钱，然后离开;因此，很难准确衡量艾滋病毒和性传播感染的流行率和发病率。我的假设是，在清迈，城市固体废物的特点是明显不同的女性性工作者（FSW），艾滋病毒和性传播感染的发病率是城市固体废物比FSW或一般人群高出许多倍。与泰国公共卫生部（MOPH）合作，拟议的研究将是一个开放的前瞻性队列研究的男性和女性性工作者在泰国清迈。该研究的主要目标是描述和比较清迈男性和女性性工作者中艾滋病毒和性传播感染的流行病学，特别是通过使用亲和力指数计算的近期与长期艾滋病毒感染。第二个目标是确定这一人群中艾滋病毒和性传播感染的社会和行为风险因素。研究结果将有助于为泰国的城市固体废物制定有针对性和文化敏感的公共卫生干预措施，并为政策决策提供信息，特别是对这一弱势群体的预算分配。此外，测试使用热情指数计算来估计这一高度移动的人群发病率的可行性，将有助于在资源有限的情况下对艾滋病毒和性传播感染监测采取成本效益办法。

DESCRIPTION (provided by applicant): The HIV epidemic among male sex workers (MSW) in Thailand is understudied and incidence was estimated to have increased over the past few years. Furthermore, most MSW are undocumented ethnic minorities, are impoverished, and have low levels of education; making them particularly vulnerable to HIV infections. MSW are also highly mobile; they work in major tourist cities for few months, earn money, and then leave; thus making it extremely difficult to accurately measure HIV and STI prevalence and incidence. My hypothesis is that the characteristics of MSW are markedly different from female sex workers (FSW) in Chiang Mai, and that HIV and STI incidence is many times higher among MSW than FSW or the general population. In collaboration with the Thai Ministry of Public Health (MOPH), the proposed research will be an open prospective cohort study of male and female sex workers in Chiang Mai, Thailand. The primary goal of the < study is to describe and compare the epidemiology of HIV and STI among male and female sex workers in Chiang Mai, particularly recent versus longer-term HIV infections by use of the avidity index calculation. The Secondary goal is to determine HIV and STI social and behavioral risk factors among this population. Study findings will aid in forming targeted and culturally sensitive public health interventions for MSW in Thailand, and inform policy decisions; particularly budget allocations to this vulnerable population. Moreover, testing the feasibility of using the avidity index calculation to estimate incidence in this highly mobile population will contribute to a cost-benefit approach to HIV and STI surveillance in resource-limited settings.