HIV & STI Transmission Dynamics along Transport Routes Linking the Americas

描述（由申请人提供）：本项目的目标是调查墨西哥连接北美和中美洲的主要交通走廊沿着高危人群的流动性、风险行为和传染病传播。流动性与家庭分离、文化变化、贫困和相关的高风险行为有关，这些行为可能传播性传播感染和血液传播感染。长途卡车运输路线已被确定为艾滋病毒和新病毒亚型传播的重要走廊。该项目的具体目标是：（1）收集关于卡车运输公司政策和连接美洲的几条主要卡车运输路线的信息;（2）评估高风险性行为和吸毒行为的背景和类型以及艾滋病毒在a）路线经过墨西哥的高风险长途卡车司机和B）以卡车司机为客户的女性性工作者中的流行情况; 3）描述墨西哥两个主要运输走廊（连接北美和中美洲）卡车司机和FSW中艾滋病毒的遗传多样性。为了实现目标1，我们将咨询运输公司和官员，并补充目标2中从卡车司机那里获得的信息，以数字方式绘制卡车运输路线，并了解其员工当前的健康和工作政策。为了实现目标2，我们将在最大的北方墨西哥/美国商业货运走廊（新拉雷多）和沿着墨西哥/危地马拉边境（伊达尔戈城）对100名高风险卡车司机和100名FSW进行访谈。访谈将包括关于卡车路线和停靠站、风险行为、艾滋病毒/性传播感染知识和获得卫生服务的问题;所有人都将通过快速检测进行艾滋病毒和梅毒筛查。此外，将在每个城市对卡车司机进行15次面对面的深入访谈，以提供有关风险行为背景的信息和数据，以产生新的假设。为了满足目标3，我们将对目标2中发现阳性的FSW和卡车司机的HIV-1样本进行测序。HIV序列将使我们能够评估这些城市是否出现了HIV-1的重组体或耐药株。由于主要的卡车运输路线已被确定为其他环境中疾病传播的重要走廊，它们可能是第一批确定新的艾滋病毒亚型的地方之一。这个项目是及时的，因为艾滋病毒的流行率正在上升，沿着美国和加拿大。墨西哥和墨西哥/危地马拉边境，我们已经在这些地区建立了一些两国合作关系。此外，我们将能够探索9/07开始的一项试点计划的影响，该计划允许墨西哥和美国的卡车司机在各自的国家送货。拟议的项目将为一项更大规模的研究提供初步数据，并加强墨西哥的艾滋病毒/毒品使用研究能力，预计将有助于更好地了解与卡车司机危险行为有关的因素，并可能有助于影响政策，以减少传染病在北美的传播。

DESCRIPTION (provided by applicant): The objective of this project is to investigate mobility, risk behaviors, and infectious disease transmission in at risk groups along major transportation corridors in Mexico, linking North and Central America. Mobility is associated with family separation, cultural changes, poverty, and related high risk behaviors which can spread sexually transmitted infections (STIs) and blood-borne infections. Long-distance trucking routes have been identified as important corridors of transmission of HIV and new viral subtypes. The specific aims of this project are: 1) to gather information on trucking company policies and several major trucking routes linking the Americas; 2) to assess the context and type of high risk sexual and drug using behaviors and HIV prevalence among a) high risk long-distance truck drivers whose routes pass through Mexico and b) female sex workers (FSW) with truck driver clientele; 3) to characterize the genetic diversity of HIV in truck drivers and FSWs in two major transportation corridors in Mexico - linking North and Central America. To meet Aim 1, we will consult transportation companies and officials, supplemented with information obtained from truck drivers in Aim 2, to digitally map trucking routes and gain an understanding of current health and work policies of their employees. To meet Aim 2, we will conduct 100 interviews with high risk truck drivers and 100 with FSWs in the largest northern Mexico/U.S. commercial freight corridor (Nuevo Laredo) and along the Mexico/Guatemala border (Ciudad Hidalgo). Interviews will include questions on trucking routes and stops, risk behaviors, HIV/STI knowledge, and access to health services; all will be screened for HIV and syphilis via rapid testing. Additionally, 15 face-to-face, in-depth interviews with truck drivers will be conducted in each city in order to provide information on the context of risk behaviors and data to generate new hypotheses. To meet Aim 3, we will sequence HIV-1 samples from FSWs and trucker drivers found to be positive in Aim 2. HIV sequences will allow us to assess if recombinants or drug resistant strains of HIV-1 have appeared in these cities. As major trucking routes have been identified as important corridors of disease transmission in other settings, they may be one of the first places new HIV subtypes will be identified. This project is timely as HIV prevalence is on the rise along both the U.S./Mexico and Mexico/Guatemala borders, regions where we have already formed a number of binational collaborations. Further, we will be able to explore the effects of a pilot program that began in 9/07 that allows Mexican and U.S. truck drivers to make deliveries in each other's respective countries. The proposed project, which will generate preliminary data for a larger study and strengthen HIV/drug use research capacity in Mexico, is expected to lead to a better understanding of factors associated with risk behaviors in truck drivers and may help to influence policies in order to reduce the transmission of infectious diseases in North America.