The overall goal of this study is to study the context and epidemiology of HIV, STIs and associated risk behaviors among high risk female sex workers (FSWs) and their non-commercial male partners in two Mexico- US border cities. Preliminary data collected by our binational team over the past 5 years suggest that FSWs' non-commercial partners may be significant drivers of HIV/STI acquisition and/or their re-infection, which is supported by literature in other countries. FSWs in our setting are more than twice as likely to engage in unprotected sex with their main non-commercial partner;half of these partners have concurrent partnerships and one third are IDUs. The proposed study of FSW-partner pairs (dyads) builds on our existing research infrastructure in Tijuana and Cd. Juarez to meet the following aims:
Aim 1 : To examine the a) context and b) patterns of high risk sexual and substance using behaviors among high risk FSWs and their main non- commercial male partners, both within and outside of the partnerships, using a mixed-methods approach;
Aim 2 : To determine prevalence of HIV and specific STIs (i.e., syphilis, gonorrhea, Chlamydia, HSV-2) and associated correlates at the individual and partner level;
Aim 3 : To prospectively identify predictors of STI incidence and their attributable risks at the individual and partner level;
Aim 4 : To determine the feasibility of conducting a behavioral intervention trial among high risk FSWs and their main non-commercial male partner at the a) partner level and b) individual level, using mixed methods. To meet these aims, we will recruit 100 FSW-partner dyads in both Tijuana and Cd. Juarez (i.e., 200 couples), who will undergo interviews and HIV/STI testing at baseline and follow-up for 24 months to address both clinical and behavioral outcomes (Aims 2 and 3). A subset (25 couples per city) will undergo in-depth interviews at baseline and once during follow-up to refine the quantitative survey, and inform a mixed methods analysis to address Aims 1 and 4. Using qualitative and quantitative methods, we will assess each partner's interest in participating in a subsequent intervention, attrition and partnership dissolution, and potential barriers to interventions such as intimate partner violence (Aim 4). To our knowledge, the proposed study is the first prospective evaluation of FSWs and their non-commercial partners. Our binational research team is uniquely positioned to conduct this study, which will inform the response to the growing HIV crisis on the Mexico-US border and efforts to curtail HIV transmission among FSWs and their partners in other resource-constrained settings.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA027772-04
Application #
8307920
Study Section
Special Emphasis Panel (ZRG1-AARR-F (02))
Program Officer
Hartsock, Peter
Project Start
2009-08-01
Project End
2014-04-30
Budget Start
2012-05-01
Budget End
2013-04-30
Support Year
4
Fiscal Year
2012
Total Cost
$556,019
Indirect Cost
$151,261
Name
University of California San Diego
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
Palinkas, Lawrence A; Bazzi, Angela Robertson; Syvertsen, Jennifer L et al. (2016) Measuring Current Drug Use in Female Sex Workers and Their Noncommercial Male Partners in Mexico: Concordance Between Data Collected From Surveys Versus Semi-Structured Interviews. Subst Use Misuse 51:23-33
Bazzi, Angela R; Syvertsen, Jennifer L; Rolón, María Luisa et al. (2016) Social and Structural Challenges to Drug Cessation Among Couples in Northern Mexico: Implications for Drug Treatment in Underserved Communities. J Subst Abuse Treat 61:26-33
Ulibarri, Monica D; Roesch, Scott; Rangel, M Gudelia et al. (2015) ""Amar te Duele"" (""love hurts""): sexual relationship power, intimate partner violence, depression symptoms and HIV risk among female sex workers who use drugs and their non-commercial, steady partners in Mexico. AIDS Behav 19:9-18
Syvertsen, Jennifer L; Bazzi, Angela Robertson; Martinez, Gustavo et al. (2015) Love, Trust, and HIV Risk Among Female Sex Workers and Their Intimate Male Partners. Am J Public Health 105:1667-74
Goldenberg, Shira M; Silverman, Jay G; Engstrom, David et al. (2015) Exploring the context of trafficking and adolescent sex industry involvement in Tijuana, Mexico: consequences for HIV risk and prevention. Violence Against Women 21:478-99
Syvertsen, Jennifer L; Bazzi, Angela Robertson (2015) Sex Work, Heroin Injection, and HIV Risk in Tijuana: A Love Story. Anthropol Conscious 26:182-194
Pines, Heather A; Patterson, Thomas L; Rangel, Gudelia et al. (2015) STI/HIV test result disclosure between female sex workers and their primary, non-commercial male partners in two Mexico-US border cities: a prospective study. Sex Transm Infect 91:207-13
Oza, Karishma K; Silverman, Jay G; Bojorquez, Ietza et al. (2015) Examining negative effects of early life experiences on reproductive and sexual health among female sex workers in Tijuana, Mexico. Int J Gynaecol Obstet 128:169-73
Bazzi, Angela Robertson; Rangel, Gudelia; Martinez, Gustavo et al. (2015) Incidence and Predictors of HIV and Sexually Transmitted Infections Among Female Sex Workers and Their Intimate Male Partners in Northern Mexico: A Longitudinal, Multilevel Study. Am J Epidemiol 181:723-31
Mehta, Sanjay R; Wertheim, Joel O; Brouwer, Kimberly C et al. (2015) HIV Transmission Networks in the San Diego-Tijuana Border Region. EBioMedicine 2:1456-63

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