Venue-level Risks for HIV/STI among Male Clients of FSWs in Tijuana, Mexico

描述（由申请人提供）：这个指导研究科学家发展奖（K 01）的目的是三重。这个奖项将使我：1）学习三种新的技能：定量和混合方法;多层次建模;以及定性数据和高级定量建模数据的整合; 2）在新的文化和环境背景下扩大我对物质使用者中物质使用和艾滋病毒的理解（美国/墨西哥边境）; 3）促进我成为加州圣地亚哥大学的一名富有成效的NIH资助的独立调查员。培训目标将通过具体的讲习班和课程、实践研究项目以及与培训委员会进行一对一辅导来实现，培训委员会由易受伤害的药物使用人群中的艾滋病毒预防研究、定性和混合方法研究、多层次建模、伦理学、国际背景下的药物使用流行病学研究（特别是美国/墨西哥边境地区）。研究目标将通过对影响墨西哥蒂华纳FSW男性客户艾滋病毒风险的性工作环境的社会和结构方面进行混合方法研究来实现。该研究将作为现有NIH/NIDA资助的R 01，DA 029008（“墨西哥蒂亚戈州女性性工作者男性客户的安全性干预”，又名Hombre Seguro，PI：托马斯帕特森）的独立附属项目进行，以利用该项目所代表的基础设施和专业知识。美国/墨西哥边境正在经历一场迅速发展的艾滋病毒流行病，集中在高危人群中，如FSW，男性客户和吸毒者。 虽然研究人员长期以来一直将混合方法应用于艾滋病毒/性传播感染预防，但很少有研究人员将定性方法收集的丰富信息与高级统计方法（如多层次或分层线性模型）相结合。此外，研究人员还没有利用混合的方法来提供一个微妙的，上下文的理解，哪些亚组做，不从减少风险的干预措施，以及为什么和如何受益。拟议的研究将使我能够应用新获得的技能，在定性和混合方法，并整合定性和多层次建模数据，以探索风险环境因素周围的物质使用的背景下，与FSW在性工作场所。这项工作将在特别高风险的人群中进行（在蒂华纳，女性性工作者的艾滋病毒感染率为6%，男性客户为5%）。从拟议的研究结果将是至关重要的发展多层次的干预措施，在边境地区和其他国际环境中的艾滋病毒风险的药物使用人群，并为未来的混合方法研究的发展，结合先进的定量技术与艾滋病毒预防的定性方法。此外，发展定性和混合方法的技能，以及多层次建模将使我成为物质使用和性工作领域少数几个拥有此类技能的混合方法研究人员之一，也是全球公共卫生部和加州圣地亚哥大学的唯一一个。

DESCRIPTION (provided by applicant): The purpose of this Mentored Research Scientist Development Award (K01) is threefold. This award will allow me to: 1) learn three new skill sets: quantitative and mixed methodologies; multilevel modeling; and the integration of qualitative data and advanced quantitative modeling data; 2) broaden my understanding of substance use and HIV among substance users in a new cultural and environmental context (the US/Mexico border); and 3) facilitate my transition to becoming a productive NIH-funded independent investigator at the University of California San Diego. The training aims will be accomplished through a combination of specific workshops and coursework, a hands-on research project, and one-on-one mentoring with a Training Committee comprised of experts in the areas of HIV prevention research among vulnerable substance using populations, qualitative and mixed methods research, multilevel modeling, ethics, and drug use epidemiology research in international contexts (and specifically the US/Mexico border region). The research aims will be accomplished by conducting a mixed-methods study of social and structural aspects of sex work environments influencing HIV risk among male clients of FSW in Tijuana, Mexico. The research will be conducted as an independent adjunct to an existing NIH/NIDA-funded R01, DA029008 ("Safer Sex Intervention for Male Clients of Female Sex Workers in Tijuana, Mexico" aka Hombre Seguro, PI: Thomas Patterson), in order to capitalize on the infrastructure and expertise represented by that project. The US/Mexico border is experiencing a burgeoning HIV epidemic, concentrated among high-risk groups such as FSW, male clients, and drug users. While researchers have long applied mixed methods to HIV/STI prevention, few researchers have integrated rich information gleaned from qualitative methods with advanced statistical methods like multilevel, or hierarchical linear modeling. Further, researchers have yet to utilize mixed methods to provide a nuanced, contextual understanding of which sub-groups do and do not benefit from risk reduction interventions, as well as why and how. The proposed research will allow me to apply newly acquired skills in qualitative and mixed methods and integrating qualitative and multilevel modeling data to explore risk environments factors surrounding substance use in the context of sex with FSW in sex work venues. This work will be conducted in a particularly high-risk population (in Tijuana, HIV prevalence among female sex workers is 6% and 5% for male clients). Findings from the proposed research will be critical for developing multi-level interventions for substance using populations at risk for HIV in border regions and other international settings, and for the development of future mixed methods research integrating advanced quantitative techniques with qualitative approaches in HIV prevention. Further, developing skills in qualitative and mixed methods, and multilevel modeling will uniquely position me as one of only a handful of mixed-methods researchers in the field of substance use and sex work possessing such skills, and the only one in the Division of Global Public Health and the University of California San Diego.