We propose to study and assess potential associations between two cultural constructs particular to Asian cultures, """"""""harmonious control"""""""" and """"""""fatalism"""""""" and HIV risk and prevention. This research will be conducted in a highly affected and marginalized population of young at-risk women working in the sex and entertainment industry in Phnom Penh, Cambodia.
This research aims to: (1) assess the association between """"""""harmonious control"""""""" and """"""""fatalism"""""""" with HIV infection and other biological markers of HIV risk;(2) determine the association between """"""""harmonious control"""""""" and """"""""fatalism"""""""" and preventive and risk behaviors including (a) condom use (preventive sexual behavior) (b) use of amphetamine-type substances (drug use), and (c) adherence to a preventive vaccine schedule (HPV vaccine will be offered and studied as a proxy for HIV vaccine in susceptible participants);and (3) generate knowledge regarding the integration of socio-cultural beliefs (""""""""harmonious control"""""""" and """"""""fatalism"""""""") in the design and implementation of HIV prevention programs and HIV prevention research.
These aims will inform future HIV prevention programs and clinical trials in Cambodian women through the process of integrating across socio-cultural and bio-behavioral domains. The research will be conducted by a multi-disciplinary collaborative prevention research group that includes researchers from: the U.S. at the University of California San Francisco;Australia at the University of New South Wales;the Cambodia National Center for HIV/AIDS, Dermatology, and STDs, and a community-based organization, the Cambodian Women's Development Association. It will be implemented in two phases: 1st, a formative phase during which qualitative and ethnographic data will be collected examining the views of young high-risk women regarding the apriori socio-cultural constructs of harmonious control and fatalism, HIV, risk and protective behaviors, and attitudes toward biomedical prevention technologies. This will be followed by prospective observational study (Phase 2), with clinical and serological assessments for HIV and STI, sexual and drug risk behaviors and measurement of adherence to a preventive vaccine regimen. The research will generate scientific knowledge in a culturally sensitive and appropriate way. Knowledge gained about cultural influences on risk and resilience will be highly relevant to the development of appropriate interventions aimed at reducing HIV among young women in Cambodia.

Public Health Relevance

This research will assess two cultural measures particular to Asian cultures, """"""""harmonious control"""""""" and """"""""fatalism"""""""" and their association with HIV infection and HIV related risks (sex and drug use behavior) and preventive behavior, including adherence to a multidose preventive HPV vaccine series, in a highly affected and highly marginalized population of young high-risk women working in the sex and entertainment industry in Phnom Penh, Cambodia. The study will have two phases: 1st, a formative, qualitative ethnographic phase to assess the priori socio-cultural constructs of harmonious control and fatalism, HIV, risk behaviors, and attitudes toward biomedical prevention technologies, followed by a by prospective observational phase (2) with clinical and serological assessments for HIV and STI, sexual and drug risk behaviors and measurement of adherence to a preventive vaccine regimen. The research will be conducted by a multi-disciplinary collaborative research group that includes academic, governmental and community partners.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR010995-02
Application #
7753857
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Wasserman, Joan
Project Start
2009-01-01
Project End
2011-12-31
Budget Start
2010-01-01
Budget End
2010-12-31
Support Year
2
Fiscal Year
2010
Total Cost
$397,108
Indirect Cost
Name
University of California San Francisco
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Duff, Putu; Evans, Jennifer L; Stein, Ellen S et al. (2018) High pregnancy incidence and low contraceptive use among a prospective cohort of female entertainment and sex workers in Phnom Penh, Cambodia. BMC Pregnancy Childbirth 18:128
Draughon Moret, Jessica E; Carrico, Adam W; Evans, Jennifer L et al. (2016) The impact of violence on sex risk and drug use behaviors among women engaged in sex work in Phnom Penh, Cambodia. Drug Alcohol Depend 161:171-7
Couture, Marie-Claude; Page, Kimberly; Sansothy, Neth et al. (2016) High prevalence of unhealthy alcohol use and comparison of self-reported alcohol consumption to phosphatidylethanol among women engaged in sex work and their male clients in Cambodia. Drug Alcohol Depend 165:29-37
Maher, Lisa; Dixon, Thomas; Phlong, Pisith et al. (2015) Conflicting Rights: How the Prohibition of Human Trafficking and Sexual Exploitation Infringes the Right to Health of Female Sex Workers in Phnom Penh, Cambodia. Health Hum Rights 17:E102-13
Wadhera, Priya; Evans, Jennifer L; Stein, Ellen et al. (2015) Human papillomavirus knowledge, vaccine acceptance, and vaccine series completion among female entertainment and sex workers in Phnom Penh, Cambodia: the Young Women's Health Study. Int J STD AIDS 26:893-902
Maher, Lisa; Mooney-Somers, Julie; Phlong, Pisith et al. (2013) Condom negotiation across different relationship types by young women engaged in sex work in Phnom Penh, Cambodia. Glob Public Health 8:270-83
Page, Kimberly; Stein, Ellen; Sansothy, Neth et al. (2013) Sex work and HIV in Cambodia: trajectories of risk and disease in two cohorts of high-risk young women in Phnom Penh, Cambodia. BMJ Open 3:e003095
Evans, Jennifer L; Couture, Marie-Claude; Stein, Ellen S et al. (2013) Biomarker validation of recent unprotected sexual intercourse in a prospective study of young women engaged in sex work in Phnom Penh, Cambodia. Sex Transm Dis 40:462-8
Kab, Vannda; Evans, Jennifer; Sansothy, Neth et al. (2012) Testing for amphetamine-type stimulant (ATS) use to ascertain validity of self-reported ATS use among young female sex workers in Cambodia. Addict Sci Clin Pract 7:11
Couture, Marie-Claude; Page, Kimberly; Stein, Ellen S et al. (2012) Cervical human papillomavirus infection among young women engaged in sex work in Phnom Penh, Cambodia: prevalence, genotypes, risk factors and association with HIV infection. BMC Infect Dis 12:166

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