Examining HIV Risk, Relationship Power and Partner Violence in Cebu, Philippines

描述（由申请人提供）：亲密伴侣暴力（IPV）与艾滋病毒风险之间的复杂相互作用需要进一步研究，特别是关注关系权力的二元因素及其对IPV和艾滋病毒风险的影响。长期目标是建立一个研究体系，为解决IPV和HIV风险的干预措施的发展提供信息，申请人提出了一项横断面混合方法研究，该研究以菲律宾为基础，抽样年轻成年人（20-24岁的男性和女性）及其伴侣。本研究的具体目的是：(1)检验菲律宾年轻人中IPV行凶和/或受害与HIV风险之间的关系；(2)确定男性和女性伴侣报告的HIV风险、IPV和关系权力之间的一致程度；(3)评估亲密关系权力在IPV和HIV风险之间的关系中作为潜在的中介或调节因子；(4)探索影响IPV的性别和社会规范。亲密关系权力和艾滋病毒风险的亚样本菲律宾年轻人和他们的伴侣。参与者将来自宿务纵向健康和营养调查（CLHNS） （n=483），并将包括目标2中接受采访的已婚或同居伴侣（n=438）。这两个群体都将被有意抽样，以参与目标4的焦点小组。这项研究将在菲律宾进行，那里的艾滋病毒感染率仍然很低，但艾滋病毒的风险很高，因为一些社会因素，如大量移民、商业性行业、越来越年轻的初次性行为和有限的艾滋病毒知识普及，使该国面临艾滋病毒病例爆炸的风险。采用混合方法，将在定性焦点小组中寻求文化、社会和制度背景，以增强和解释定量部分中首先检查的关系。这项研究将增加关于IPV、关系权力和艾滋病毒风险之间相互作用的有限数据，并且对于修改现有的干预和预防工作，解决IPV和艾滋病毒之间的联系至关重要。该提案与NIMH艾滋病、健康和行为研究部（DAHBR）的倡议保持一致，该倡议“支持创新的跨学科艾滋病毒预防研究，旨在更好地了解影响艾滋病毒风险降低的个人、群体、社区、社会和结构因素，以改善持续的预防行为。”拟议的研究与菲律宾和美国的公共卫生有关，菲律宾移民占亚洲人口的20%，其中近70%是外国出生的。进一步了解IPV与艾滋病毒风险之间的联系，将有助于制定具有文化敏感性的预防性干预措施，以减轻IPV和预防艾滋病毒传播为目标。

DESCRIPTION (provided by applicant): The complex interplay between intimate partner violence (IPV) and HIV risk requires further research, particularly in focusing on the dyadic factor of relationship power and its influence on IPV and HIV risk. With the long term goals of building a body of research that informs the development of interventions that address both IPV and HIV risk, the applicant proposes a cross-sectional mixed methods study, based in the Philippines and sampling young adults (male and female aged 20-24) and their partners. The specific aims of the research are (1) to examine the relationships between IPV perpetration and/or victimization on HIV risk among Filipino young adults, (2) to determine the level of agreement between reports of male and female partners' reports of HIV risk, IPV, and relationship power, (3) to evaluate intimate relationship power as a potential mediator or moderator in the relationship between IPV and HIV risk, and (4) to explore gender and societal norms that influence IPV, intimate relationship power and HIV risk among a sub-sample of Filipino young adults and their partners. Participants will be from the Cebu Longitudinal Health and Nutrition Survey (CLHNS) (n=483) and will include the interviewed married or cohabitating partners (n=438) for Aim 2. Both groups will be purposively sampled to participate in focus groups for Aim 4. This study will be based in the Philippines where HIV prevalence is still low, but HIV risk is high as several societalfactors such as heavy migration, commercial sex industry, increasingly younger sexual debut and limited widespread HIV knowledge put the country at risk for an explosion of HIV cases. Using a mixed methods approach, a cultural, social, and institutional context will be sought in qualitative focus groups to augment and explain the relationships first examined in the quantitative section. This study will add to the limited data on the interplay between IPV, relationship power, and HIV risk, and is critical to modify existing intervention and prevention efforts addressing the linkage between IPV and HIV. This proposal is aligned with the NIMH Division of AIDS and Health and Behavior Research (DAHBR) initiative to "support innovative, interdisciplinary HIV prevention research designed to better understand individual, dyadic, community, social, and structural factors that impact HIV risk-reduction in order to improve sustained preventive behaviors." The proposed study is relevant to public health in the Philippines as well as in the United States, where Filipino immigrants compose 20% of the Asian population, with nearly 70% being foreign bom. Further understanding of the link between IPV and HIV risk will contribute to the development of culturally sensitive, preventive interventions that target both mitigation of IPV and prevention of HIV transmission.