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

描述(申请人提供)：本申请涉及中亚男性劳工移民中艾滋病毒预防的主要全球健康问题。这项研究的重点是在莫斯科工作的塔吉克斯坦已婚男子，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的风险，然后将感染传播给他们的妻子或女性性伴侣。这项为期五年的定量和定性研究收集了莫斯科移民的数据，其中包括塔吉克斯坦的家庭、莫斯科的女性伴侣和性工作者，以及两地参与移民的组织。它发展了以下背景知识：1)社会、文化和心理因素塑造男性气概的过程；2)男性规范如何影响男性移民的艾滋病毒风险和预防行为；3)如何通过解决移民生活和与他们合作的组织的现实世界背景中的男性规范来提高艾滋病毒预防技能。这些目标既侧重于建立形成性知识，也侧重于制定创新的干预战略，为艾滋病毒预防提供信息。这项研究的具体目的是：1)描述极端条件下已婚男性的劳动力迁移如何形成男性规范和模式以及艾滋病毒风险和预防行为；2)表征女性(妻子、定期伴侣、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)评估已婚男性移民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)建立一个在已婚男性移民中预防艾滋病毒的经验模型，这将有助于制定专注于异性恋男性和男性规范的计划和政策。这些目标将通过对莫斯科塔吉克已婚男性移民的调查(n=400)、对莫斯科塔吉克移民(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)以及参与塔吉克斯坦和莫斯科移民的组织的服务提供者(n=40)的人种学访谈和观察来实现。这项研究的意义在于，通过关注男性和移民在塑造艾滋病毒风险和预防行为方面的作用，解决男性劳工移民艾滋病毒风险带来的主要全球健康问题。 公共卫生相关性：这项研究解决了中亚已婚男性劳工移民中艾滋病毒预防的主要全球健康问题，以及塔吉克斯坦艾滋病流行的公共卫生风险。它建立了关于男子气概作为男性移民性行为和艾滋病毒风险决定因素的作用的知识。它开发了如何切实解决男性规范的创新模式和战略，这将为设计、实施和评估针对男性劳工移民的艾滋病毒预防干预措施提供信息。

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.