The purpose of this Mentored Research Scientist Development Award (K01) is threefold. This award will allow me to: 1) learn three new skill sets: quantitative and mixed methodologies;multilevel modeling;and the integration of qualitative data and advanced quantitative modeling data;2) broaden my understanding of substance use and HIV among substance 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 research project, and one-on-one mentoring with a Training Committee comprised of experts in the areas of HIV prevention research among vulnerable substance using populations, qualitative and mixed methods research, multilevel modeling, ethics, and drug use epidemiology research in international contexts (and specifically the US/Mexico border region).
The research aims will be accomplished by conducting a mixed-methods study of social and structural aspects of sex work environments influencing HIV risk among male clients of FSW in Tijuana, Mexico. The research will be conducted as an independent adjunct to an existing NIH/NIDA-funded R01, DA029008 (""""""""Safer Sex Intervention for Male Clients of Female Sex Workers in Tijuana, Mexico"""""""" aka Hombre Seguro, PI: Thomas Patterson), in order to capitalize on the infrastructure and expertise represented by that project. The US/Mexico border is experiencing a burgeoning HIV epidemic, concentrated among high-risk groups such as FSW, male clients, and drug users. While researchers have long applied mixed methods to HIV/STI prevention, few researchers have integrated rich information gleaned from qualitative methods with advanced statistical methods like multilevel, or hierarchical linear modeling. Further, researchers have yet to utilize mixed methods to provide a nuanced, contextual understanding of which sub-groups do and do not benefit from risk reduction interventions, as well as why and how. The proposed research will allow me to apply newly acquired skills in qualitative and mixed methods and integrating qualitative and multilevel modeling data to explore risk environments factors surrounding substance use in the context of sex with FSW in sex work venues. This work will be conducted in a particularly high-risk population (in Tijuana, HIV prevalence among female sex workers is 6% and 5% for male clients). Findings from the proposed research will be critical for developing multi-level interventions for substance using populations at risk for HIV in border regions and other international settings, and for the development of future mixed methods research integrating advanced quantitative techniques with qualitative approaches in HIV prevention. Further, developing skills in qualitative and mixed methods, and multilevel modeling will uniquely position me as one of only a handful of mixed-methods researchers in the field of substance use and sex work possessing such skills, and the only one in the Division of Global Public Health and the University of California San Diego.

Public Health Relevance

The US/Mexico border region is home to an evolving HIV epidemic among vulnerable groups such as female sex workers, male clients, and drug users, but little research has assessed the role of contextual (e.g., social and structural) factors influencing substance use and the transmission of HIV in this region. Findings from the proposed research will be critical to bi-national efforts to develop tailored, multi-level intervenion for substance users, including male clients and FSW, at risk for HIV and other negative consequences of substance use, and for the development of future long-term research into the influence of context on HIV risk among high risk populations. Further, developing skills in qualitative and mixed methods, and multilevel modeling will uniquely position me as one of only a handful of mixed-methods researchers in the field of substance use and sex work possessing such skills, and the only one in the Division of Global Public Health and the University of California San Diego.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
1K01DA036447-01
Application #
8602986
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Jenkins, Richard A
Project Start
2014-07-01
Project End
2019-06-30
Budget Start
2014-07-01
Budget End
2015-06-30
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of California San Diego
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
City
La Jolla
State
CA
Country
United States
Zip Code
92093
Fleming, Paul J; Patterson, Thomas L; Chavarin, Claudia V et al. (2016) Behavioral and Psychosocial Correlates of HIV Testing Among Male Clients of Female Sex Workers in Tijuana, Mexico. AIDS Behav :
Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A et al. (2016) Men's Behavior Predicts Women's Risks for HIV/AIDS: Multilevel Analysis of Alcohol-Serving Venues in South Africa. Prev Sci 17:472-82
Pitpitan, Eileen V; Kalichman, Seth C (2016) Reducing HIV Risks in the Places Where People Drink: Prevention Interventions in Alcohol Venues. AIDS Behav 20 Suppl 1:S119-33
Pitpitan, Eileen V; Patterson, Thomas L; Abramovitz, Daniela et al. (2016) Policing behaviors, safe injection self-efficacy, and intervening on injection risks: Moderated mediation results from a randomized trial. Health Psychol 35:87-91
Pines, Heather A; Goodman-Meza, David; Pitpitan, Eileen V et al. (2016) HIV testing among men who have sex with men in Tijuana, Mexico: a cross-sectional study. BMJ Open 6:e010388
Pitpitan, Eileen V; Smith, Laramie R; Goodman-Meza, David et al. (2016) ""Outness"" as a Moderator of the Association Between Syndemic Conditions and HIV Risk-Taking Behavior Among Men Who Have Sex with Men in Tijuana, Mexico. AIDS Behav 20:431-8
Pitpitan, Eileen V; Kalichman, Seth C; Garcia, Randi L et al. (2015) Mediators of behavior change resulting from a sexual risk reduction intervention for STI patients, Cape Town, South Africa. J Behav Med 38:194-203
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
Pitpitan, Eileen V; Strathdee, Steffanie A; Semple, Shirley J et al. (2015) Buffering Syndemic Effects in a Sexual Risk-Reduction Intervention for Male Clients of Female Sex Workers: Results From a Randomized Controlled Trial. Am J Public Health 105:1866-71
Abler, Laurie; Sikkema, Kathleen J; Watt, Melissa H et al. (2015) Traumatic stress and the mediating role of alcohol use on HIV-related sexual risk behavior: results from a longitudinal cohort of South African women who attend alcohol-serving venues. J Acquir Immune Defic Syndr 68:322-8

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