Context & Correlates of Health Behaviors in South India

描述(申请人提供)：据估计，印度有510万艾滋病毒携带者，仅次于南非。特里帕西最近的一项定性研究发现，饮酒在几个也是艾滋病毒高危人群中很常见。深度采访表明，这些群体中的成员可能为了应对压力而喝酒，以增强愉悦和表现，他们的饮酒可能与艾滋病毒风险有关。我们对孟买男性性病患者的定量研究表明，报告在酒精影响下与女性性工作者发生性行为的男性也更有可能报告与这些伴侣发生无保护措施的性行为。然而，没有关于酒精或药物使用模式、酒精或物质使用情况或预期寿命的数据。因此，尽管在一些印度人群和环境中已经证明了酒精和艾滋病毒风险之间的联系，但人们对这种关系的性质知之甚少。目前的研究就是为了满足这一需求而设计的。它利用健康行为的信息-动机-行为(1MB)模型，结合性别和赋权理论的结构，指导研究措施的选择和试点干预的设计。这项研究将特里帕西的工作扩展到了南印度的男性移民工人(MMW)和女性性工作者(FSW)。拟议的研究还将建设印度科学家和工作人员的研究能力，方法是让YRG CARE的两个南印度非政府组织扩大合作伙伴；YRG CARE是泰米尔纳德邦钦奈的一个老牌艾滋病研究组织。具体而言，我们建议在吉拉拉邦、安得拉邦和喀拉拉邦的加里库特招募参与者，以： 1.定性审查：a)饮酒模式和背景；b)性风险接受模式；c)文化和人群特有因素；d)在这些环境中，妇女和妇女的动机、饮酒及其社会背景和性行为之间的关系。 2.制定和实施一项以理论为导向的量化调查，以衡量a)性冒险和饮酒的流行率和模式；b)性冒险模式；c)具体模型变量；d)目标人群中的性冒险、酒精消费类型和背景与其他动机、人际、社会文化和背景变量之间的关系。 3.与我们的印度合作伙伴以及当地和地区酒精研究人员、医疗保健提供者、公共卫生官员和非政府组织代表合作，制定、实施和试点一项针对文化的、理论指导的和以经验为基础的减少风险干预措施，以减少南印度性工作者和移徙工人在饮酒方面的艾滋病毒风险。

DESCRIPTION (provided by applicant): India is estimated to have 5.1 million people living with HIV infection, making it second only to South Africa. A recent qualitative study by Tripathi found that alcohol consumption is common in several subpopulations who are also at high risk for HIV. In-depth interviews suggest that members of these groups may drink to cope with stress, to enhance pleasure and performance, and that their alcohol use may be related to HIV risk taking. Our quantitative research with male STD patients in Mumbai showed that men who reported sex with female sex workers under the influence of alcohol were also more likely to report unprotected sex with these partners. However, no data were obtained on alcohol or drug use patterns, the context of alcohol or substance use, or on expectancies. Thus, although the link between alcohol and HIV risk taking has been demonstrated in some Indian population groups and settings, very little is known about the nature of this relationship. The current study has been designed to meet this need. It utilizes the Information-Motivation-Behavior (1MB) model of health behavior, incorporating constructs from gender and empowerment theory, to guide the selection of study measures and the design of a pilot intervention. The study extends Tripathi's work to male migrant workers (MMW) and female sex workers (FSW) in South India. The proposed study will also build research capacity of Indian scientists and staff by involving two South Indian NGO scale-up partners of YRG Care; an established AIDS research organization in Chennai, Tamil Nadu. Specifically, we propose to recruit participants in Chirala, Andhra Pradesh and Calicut, Kerala to: 1. Examine qualitatively: a) patterns and contexts of alcohol consumption; b) sexual risk taking patterns; c) culturally- and population-specific factors; and d) the relationship between motivation, alcohol consumption, its social context and sexual behaviors among MMWs and FSWs in these settings. 2. Develop and administer a theory-driven, quantitative survey to measure a) the prevalence and patterns of sexual risk taking and alcohol consumption; b) sexual risk taking patterns, c) model-specific variables; and d) the relationship between sexual risk taking, type and context of alcohol consumption and other motivational, interpersonal, sociocultural and contextual variables in the target populations. 3. Develop, implement and pilot test a culturally-specific, theoretically-guided and empirically-based risk reduction intervention in collaboration with our Indian partners as well as with local and regional alcohol researchers, health care providers, public health officials and NGO representatives to reduce HIV risk taking in the context of alcohol use among South Indian sex workers and migrant workers.