HIV Risk & Migration -Young Yi Minority - Sichuan China

描述（由申请人提供）：东南亚和中亚正在见证全球市场经济的快速渗透。城市化加速了这一经济转型，随之而来的是传染病的蔓延，而且往往是在公共卫生资源有限的地区。移民在城市非正规劳动部门的参与扩大尤其令人关切，因为城市中心和偏远农村地区之间的流动可能成为传播行为风险做法和传染病本身的机制。彝族是中国南方一个特别脆弱的民族，长期以来在社会和经济上被边缘化，越来越依赖城市的外来劳动力。这种社会经济脆弱性可能由于该区域对艾滋病毒和性传播疾病的传播普遍缺乏了解而加剧。作为一个探索性的试点研究，使用R21机制，本申请提出了一套有针对性的人种学方法，以阐述我们的理解，如何以及为什么移民劳动力可能会带来独特的健康风险，特别是高风险暴露于毒品和性风险的做法。我们建议把重点放在年轻的成年彝族，因为我们的初步工作表明，许多彝族成为参与移民劳动力在他们的成年生活的早期，暴露于毒品和性风险也发生在早期。由于我们的试点工作表明，性别是一个重要的影响，男性和女性在移民劳动力中占据的经济角色，我们建议研究男性和女性。根据既定的人种学研究设计，研究将从一系列形成性研究活动开始开始，这些活动将有助于研究小组在进行研究的当地社区中确定方向。此外，将招募一小组关键参与者进行一系列人种学访谈，其中包括生活史和生活过程事件、家庭经历、教育和技能获得、生计和创收策略、对艾滋病毒/性病的知识和信念、开始毒品和性风险活动以及耻辱经历等问题（N=60）。访谈将产生的信息，将使我们能够构建一个初步的流行病学轨迹的药物和性风险的做法是如何启动的，以及行为风险的早期过程中的关键特征，这将需要在未来的研究和预防活动的预期。

DESCRIPTION (provided by applicant): Southeast and central Asia are witnessing rapid penetration by the global market economy. The urbanization that has paralleled this economic transformation has brought with it an increased spread of communicable diseases, often in areas with limited public health resources. Expansions in migrants' involvement in the urban-based informal labor sector is of particular concern because movement between urban centers and remote rural regions may serve as a mechanism for diffusing both behavioral risk practices as well as infectious diseases themselves. With a long history of social and economic marginalization, and increasing dependence on urban-based migrant labor, the Yi minorities are an especially vulnerable ethnic group in southern China. This socio-economic vulnerability may be exacerbated by the general lack of knowledge about transmission of HIV and STD's in the region. Developed as an exploratory pilot study using the R21 mechanism, this application proposes a targeted set of ethnographic methods with which to elaborate our understanding of how and why migrant labor may confer unique health risks, notably high risk for exposure to drug and sexual risk practices. We propose to focus on young adult Yi because our preliminary work suggests that many Yi become involved in migrant labor early in their adult lives and that exposure to drug and sexual risk also occur early. Since our pilot work suggests that gender is an important influence on the economic roles that men and women occupy in migrant labor, we propose to study both men and women. Based on an established ethnographic research design, the study will begin with a set of formative research activities that will serve to orient the research team in the local communities where the study will be conducted. Additionally, a small group of key participants will be recruited for a series of ethnographic interviews that will include questions about life history and life course events, family experience, education and skills acquisition, subsistence and income generating strategies, knowledge and beliefs about HIV/STD's, initiation of drug and sexual risk activities, and experiences of stigma (N=60). Interviews will yield information that will allow us to construct a preliminary epidemiological trajectory of how drug and sexual risk practices are initiated, and key features of the early course of behavioral risk, that would need to be anticipated in future research and prevention activities.