Sex/Drug Tourism at the US/Mexico Border: Social Network Influences on HIV Risk.

简介(申请人提供)：本次导师研究科学家发展奖(K01)的目的有三个。这一奖项将使我：1)学习一套新的技能(社交网络分析；SNA)；2)在新的文化和环境背景下(美国和墨西哥边境)扩大我对吸毒者中艾滋病毒社会流行病学的理解；3)促进我过渡到加州大学圣地亚哥分校NIH资助的富有成效的独立研究员。培训目标将通过具体的讲习班和课程作业、动手实践以及与培训委员会的一对一指导相结合来实现，培训委员会由国际(特别是美国/墨西哥边境地区)艾滋病毒预防研究、行为干预设计、社会网络分析和艾滋病毒社会流行病学研究领域的专家组成。这项研究的目的将通过对墨西哥蒂华纳200名吸毒的女性性工作者(FSWs)男性客户中与艾滋病毒危险行为相关的社会网络因素进行横断面研究来实现。美国/墨西哥边境正在经历一场迅速蔓延的艾滋病毒疫情，集中在吸毒者和暗娼等高危群体中。在美国，社会网络分析(SNA)多年来一直被用来了解吸毒者社会网络在区域艾滋病毒传播中的作用，但很少被用于地区之间或跨国际边界，这些地区的特点是高度跨境流动。了解社会网络在高度流动的“桥梁”人群中的作用，对于更细致和更有背景地了解边境地区的传染病传播至关重要。拟议的研究将使我能够应用新获得的SNA技能来评估社会网络的结构、组成和影响，以及特别高危群体的毒品、性和社会网络之间的互动程度：美国和提华纳的FSWs吸毒男性客户。这一人群表现出很高的吸毒率(25%的人报告曾注射毒品，高达88%的人报告终身使用可卡因、海洛因或甲基苯丙胺)，并与FSWs和其他伴侣发生相当大的性行为风险(包括66%的人报告同时发生性行为和吸毒)。拟议研究的结果将对为边境地区通过性行为和药物使用而感染艾滋病毒的高危个人制定量身定制的干预措施，以及对未来对流动-艾滋病毒风险途径的研究发展至关重要。此外，发展社交网络分析技能将使我成为药物滥用领域为数不多的拥有此类技能的混合方法研究人员之一，也是加州大学圣地亚哥分校全球公共卫生部门唯一的研究人员。

DESCRIPTION (provided by applicant): The purpose of this Mentored Research Scientist Development Award (K01) is threefold. This award will allow me to: 1) learn a new skill set (social network analysis; SNA), 2) broaden my understanding of the social epidemiology of HIV among drug 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 practicum, and one-on-one mentoring with a Training Committee comprised of experts in the areas of HIV prevention research among vulnerable populations, behavioral intervention design, social network analysis, and HIV social epidemiology research in international contexts (and specifically the US/Mexico border region). The research aims will be accomplished by conducting a cross-sectional study of the social network factors associated with HIV risk behavior among 200 drug-using male clients of female sex workers (FSWs) in Tijuana, Mexico. The US/Mexico border is experiencing a burgeoning HIV epidemic, concentrated among high-risk groups such as drug users and FSWs. Social network analysis (SNA) has been used for many years in the US to understand the role of drug user social networks in regional HIV transmission, but rarely has it been used between regions or across international borders, which are characterized by high levels of cross-border mobility. Understanding the role of social networks in highly mobile "bridging" populations is critical to a more nuanced and contextualized understanding of infectious disease transmission in border regions. The proposed research will allow me to apply newly acquired skills in SNA to evaluate the structure, composition, and influence of social networks, and the degree of interaction among drug, sex, and social networks of a particularly high-risk group: US and Tijuana-based drug-using male clients of FSWs. This population exhibits high rates of drug use (25% report ever injecting drugs, and up to 88% report lifetime use of cocaine, heroin, or methamphetamine) and considerable sexual risk behavior with both FSWs and other partners (including 66% who report concurrent sex and drug use). Findings from the proposed research will be critical for developing tailored interventions for individuals at risk for HIV via sex and drug use in border regions, and for the development of future research into the mobility-HIV risk pathway. Further, developing skills in social network analysis will uniquely position me as one of only a handful of mixed-methods researchers in the field of drug abuse possessing such skills, and the only one in the Division of Global Public Health at the University of California San Diego.