Personal Networks of FSW-IDUs and their male partners: Broadening the context of HIV prevention

 

UCSD Center for AIDS RESEARCH (CFAR) Developmental Grant (Feb 2012-Feb 2013) PI: Karla Wagner

The goal of this research project is to provide preliminary data on the influence of social network factors on HIV/STI risk among female sex workers who inject drugs (FSW-IDUs) and their primary (non-commercial) male sexual partners in Tijuana, Mexico. FSW-IDUs in Mexican cities along the Mexico/US border, such as Tijuana, are at high risk for HIV and other STIs, both through unprotected sex and injection drug use. Among FSW-IDUs, commercial sexual and drug use partners influence women’s risk for HIV/STIs. However, their primary (non-commercial) partners also play an important role in influencing HIV/STI risk. For example, FSWs are less likely to use condoms consistently with their primary partners, and preliminary data suggest that up to one quarter of women’s primary partners also report having sex with someone else in the past year. In addition to exposing FSWs to HIV/STIs, primary sex and drug use partners also provide access to critical resources, such as safety, emotional support, drugs, money, and housing. Fear of losing these resources can make it difficult for FSW-IDUs to negotiate safer sexual and drug use behavior, ultimately influencing the success of HIV/STI interventions. Some research suggests that, in addition to the primary partner, other “influential members” of women’s social network may also influence the uptake and maintenance of HIV/STI prevention practices. Identifying network members who both increase HIV risk and help to support safer behavior is a critical step in developing interventions that address the social drivers of HIV risk. To extend our understanding of how social networks influence HIV risk behavior among FSW-IDUs and their primary male sex partners, we propose a mixed methods social network study with the following specific aims:
(1) Quantitatively describe and compare the social networks of FSWs and their primary male partners in Tijuana, Mexico, with regards to: size, composition (e.g.% FSWs, % male/female, % kin), network roles (e.g., sex partner, drug use partner), risk behavior, and availability of social support;
(2) Qualitatively describe the networks of FSWs and their primary male partners in terms of the importance and meaning of relationships, and network members’ influence on HIV risk and protective behaviors;
(3) Determine the network-level factors (e.g., presence of influential others, influence of overlapping vs. non-overlapping network members) necessary for informing the development of a successful multilevel (couple+network) intervention for FSWs and their primary non-commercial male sexual partners.
To achieve these aims, we will conduct mixed methods social network interviews with a sample of 40 participants from an existing NIH-funded longitudinal study of FSWs and their primary partners (the Parejas, or “partners”, study), which is collecting quantitative and qualitative data (but not network data).