MINORITY PREDOCTORAL FELLOWSHIP

描述（由申请人提供）：泰国男性性工作者（MSW）中的艾滋病毒流行尚未得到充分研究，据估计，在过去几年中发病率有所增加。此外，大多数城市固体废物是无证件的少数民族，贫困，教育水平低；使她们特别容易感染艾滋病毒。城市固体废物的流动性也很强；他们在主要旅游城市工作几个月，赚了钱，然后离开；因此，极其难以准确地衡量艾滋病毒和性传播感染的流行和发病率。我的假设是，城市生活垃圾的特征与清迈的女性性工作者（FSW）明显不同，并且城市生活垃圾中的艾滋病毒和性传播感染发生率比女性生活垃圾或一般人群高许多倍。拟议的研究将与泰国公共卫生部合作，对泰国清迈的男性和女性性工作者进行公开的前瞻性队列研究。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，特别是使用频率指数计算最近与长期的艾滋病毒感染。次要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。研究结果将有助于形成针对泰国都市固体废物的有针对性和具有文化敏感性的公共卫生干预措施，并为决策提供信息；特别是对这一弱势群体的预算拨款。此外，测试在这一高度流动的人群中使用亲和力指数计算来估计发病率的可行性将有助于在资源有限的环境中采用成本效益方法来监测艾滋病毒和性传播感染。

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.