Migrancy, Masculinity, and Preventing HIV in Tajik Male Migrant Workers

说明（由申请人提供）：本申请涉及中亚男性劳工移民中预防艾滋病毒这一重大全球健康问题。这项研究的重点是在莫斯科工作的塔吉克斯坦已婚男性，以及他们通过与女性性工作者发生性关系而感染艾滋病毒并将其传染给妻子或女性性伴侣的风险。这项为期五年的定量和定性研究收集了来自莫斯科移民、塔吉克斯坦移民家庭、莫斯科女性伴侣和性工作者以及两地移民相关组织的数据。它发展了以下方面的背景知识：1)社会、文化和心理因素塑造男性气质的过程；2)男性化规范对男性流动人口HIV风险及预防行为的影响；3)如何通过解决移民生活的现实世界背景下的男性规范以及与他们合作的组织来提高艾滋病预防技能。这些目标的重点是建立形成性知识和制定创新的干预战略，为艾滋病毒预防提供信息。本研究的具体目的是：1)研究极端条件下已婚男性劳动力迁移对男性规范和图式、HIV风险和预防行为的影响；2)描述女性（妻子、固定伴侣、性工作者）及其对艾滋病毒、女性气质和男性气质的看法如何影响男性移民的艾滋病毒风险和预防行为；3)评估与已婚男性移民有关的组织在应对艾滋病毒和减轻影响男性性行为的男性规范方面的当前和潜在作用；4)建立一个基于经验的已婚男性流动人口艾滋病预防模型，这将有助于制定针对异性恋男性和男性规范的项目和政策。这些目标将通过对莫斯科塔吉克已婚男性移徙者（n=400）的调查、对莫斯科塔吉克移徙者（n=40）、他们在塔吉克斯坦（n=40）和莫斯科（n=30）的妻子/固定女性伴侣、莫斯科的性工作者（n=30）和与塔吉克斯坦和莫斯科移徙者有关的组织中的服务提供者（n=40）的民族志访谈和观察来实现。本研究的意义在于，通过关注男性特质和移民在艾滋病毒风险和预防行为形成中的作用，解决男性劳动力移民艾滋病毒风险带来的重大全球健康问题。

DESCRIPTION (provided by applicant): This application addresses the major global health problem of HIV prevention amongst male labor migrants in Central Asia. The study focuses on married men from Tajikistan working in Moscow and their risks for acquiring HIV through having sex with female sex workers and then transmitting the infection to their wives or female sexual partners. This five-year quantitative and qualitative study gathers data from migrants in Moscow, sending families in Tajikistan, female partners and sex workers in Moscow, and organizations involved with migrants in both locations. It develops contextual knowledge on: 1) the processes through which social, cultural, and psychological factors shape masculinity; 2) how masculine norms impact male migrants' HIV risk and preventive behaviors; and 3) how to enhance HIV prevention skills through addressing masculine norms in the real world contexts of migrants' lives and the organizations working with them. The goals are focused both on building formative knowledge and on developing innovative intervention strategies to inform HIV prevention. The specific aims of this study are: 1) To characterize how labor migration of married men under extreme conditions shapes masculine norms and schemas and HIV risk and preventive behaviors; 2) To characterize how women (wives, regular partners, sex workers) and their perceptions of HIV, femininity, and masculinity impact male migrants' HIV risk and preventive behaviors; 3) To assess the current and potential roles of the organizations involved with married male migrants in responding to HIV and in mitigating masculine norms impacting men's sexual behavior; 4) To build an empirically based model for preventing HIV amongst married male migrants that will help to develop programs and policies focused on heterosexual men and masculine norms. These aims will be accomplished by a survey of Tajik married male migrants in Moscow (n=400), ethnographic interviews and observations of the Tajik migrants in Moscow (n=40), their wives/regular female partners in Tajikistan (n=40) and Moscow (n=~30), sex workers in Moscow (n=30), and service providers (n=40) in organizations that are involved with migrants in Tajikistan and Moscow. This study's significance lies in addressing the major global health problems posed by male labor migrants' HIV risks through focusing on the roles of masculinity and migrancy in shaping HIV risk and preventive behaviors. PUBLIC HEALTH RELEVANCE: This research addresses the major global health problem of HIV prevention amongst married male labor migrants in Central Asia and the public health risk for an AIDS epidemic in Tajikistan. It builds knowledge on the role of masculinity as a determinant of male migrants' sexual behavior and HIV risk. It develops innovative models and strategies for how masculine norms may be practically addressed that will inform the design, implementation, and evaluation of HIV preventive interventions for male labor migrants.