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.

Public Health Relevance

The US/Mexico border is home to an evolving HIV epidemic among vulnerable groups such as drug users, including female sex workers (FSWs) and their clients, but little social epidemiological research has assessed the role of social networks in influencing transmission of HIV in this region. Findings from the proposed research will be critical to bi-national efforts to develop tailored interventions for drug users at risk for HIV, and for the development of future long-term research into the influence of social networks on HIV risk among mobile bridging populations who have the potential to connect higher- and lower-risk groups. Further, developing skills in social network analysis will uniquely position the candidate 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. Project Narrative The US/Mexico border is home to an evolving HIV epidemic among vulnerable groups such as drug users, including female sex workers (FSWs) and their clients, but little social epidemiological research has assessed the role of social networks in influencing transmission of HIV in this region. Findings from the proposed research will be critical to bi-national efforts to develop tailored interventions for drug users at risk for HIV, and for the development of future long-term research into the influence of social networks on HIV risk among mobile bridging populations who have the potential to connect higher- and lower-risk groups. Further, developing skills in social network analysis will uniquely position the candidate 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.

Agency
National Institute of Health (NIH)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
7K01DA031031-05
Application #
8717623
Study Section
AIDS Behavioral Research Subcommittee (NIDA)
Program Officer
Hartsock, Peter
Project Start
Project End
Budget Start
Budget End
Support Year
5
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Nevada Reno
Department
Miscellaneous
Type
Organized Research Units
DUNS #
City
Reno
State
NV
Country
United States
Zip Code
89557
Pitpitan, Eileen V; Strathdee, Steffanie A; Semple, Shirley J et al. (2015) Perceived stigma of purchasing sex among Latino and non-Latino male clients of female sex workers in Tijuana, Mexico. J Immigr Minor Health 17:172-80
Robertson, Angela M; Garfein, Richard S; Wagner, Karla D et al. (2014) Evaluating the impact of Mexico's drug policy reforms on people who inject drugs in Tijuana, B.C., Mexico, and San Diego, CA, United States: a binational mixed methods research agenda. Harm Reduct J 11:4
Syvertsen, Jennifer L; Robertson, Angela M; Strathdee, Steffanie A et al. (2014) Rethinking risk: gender and injection drug-related HIV risk among female sex workers and their non-commercial partners along the Mexico-U.S. border. Int J Drug Policy 25:836-44
Wagner, Karla D; Armenta, Richard F; Roth, Alexis M et al. (2014) Use of synthetic cathinones and cannabimimetics among injection drug users in San Diego, California. Drug Alcohol Depend 141:99-106
Volkmann, Tyson; Wagner, Karla D; Strathdee, Steffanie A et al. (2014) Correlates of self-efficacy for condom use among male clients of female sex workers in Tijuana, Mexico. Arch Sex Behav 43:719-27
Wagner, Karla D; Davidson, Peter J; Iverson, Ellen et al. (2014) "I felt like a superhero": the experience of responding to drug overdose among individuals trained in overdose prevention. Int J Drug Policy 25:157-65
Ludwig-Barron, Natasha; Wagner, Karla D; Syvertsen, Jennifer L et al. (2014) "When you get old like this … you don't run those risks anymore": influence of age on sexual risk behaviors and condom use attitudes among methamphetamine-using heterosexual women with a history of partner violence. Womens Health Issues 24:620-8
Wagner, Karla D; Pitpitan, Eileen V; Chavarin, Claudia V et al. (2013) Drug-using male clients of female sex workers who report being paid for sex: HIV/sexually transmitted infection, demographic, and drug use correlates. Sex Transm Dis 40:619-23
Wagner, Karla D; Bloom, Jennifer Jackson; Hathazi, Susan Dodi et al. (2013) Control over drug acquisition, preparation and injection: Implications for HIV and HCV risk among young female injection drug users. ISRN Addict 2013:
Lankenau, Stephen E; Wagner, Karla D; Silva, Karol et al. (2013) Injection drug users trained by overdose prevention programs: responses to witnessed overdoses. J Community Health 38:133-41

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