HIV/AIDS is rapidly increasing among injecting heroin users and sex workers in the Central Asian country of Tajikistan. The Tajikistan government and other stakeholders are concerned about the limited success of standard HIV prevention programs and recognize the need for targeted preventive interventions. In this US- Tajik collaborative study, we develop and pilot a woman-focused HIV preventive intervention for heroin using sex workers.
The specific aims of the study are: 1) To examine how key adverse social environmental conditions in Tajikistan make heroin using women sex workers at higher risk of HIV and interfere with HIV risk behavior change efforts; and 2) To design and a woman-focused HIV preventive intervention for heroin using woman sex workers and to pilot the intervention to assess feasibility. The key adverse social environmental conditions identified through the pilot research are addiction, poverty, gender inequality and violence against women, and lack of services. The conceptual framework of this study emphasizes the impact of social environment conditions on risk reduction. To inform intervention development, we will use ethnographic methods to interview 30 heroin using woman sex workers and to conduct focused field observations over three months. The ethnographic results will enable us to understand the impact of key adverse social environmental conditions on both HIV risk and prevention efforts. Participants will be recruited through community outreach workers. The woman-focused preventive intervention will be adapted from an existing manual that has been tested with drug involved women. Through a systematic qualitative process, the qualitative information will be used to adapt the intervention to tailor to the needs of the women in Tajikistan. Outcome measures will be piloted during the study. Results from this study will inform HIV prevention in Tajikistan, contribute to the science related to HIV risk and prevention with woman in adverse social environmental conditions, and lead to the development of a proposal to pilot the preventive intervention. ? ? ? ?
