title: Quantitative, Qualitative and Geospatial Methods to Characterize HIV Risk Environments.
abstract: Increasingly, 'place', including physical and geographical characteristics as well as social meanings, is recognized as an important factor driving individual and community health risks. This is especially true among marginalized populations in low and middle income countries (LMIC), whose environments may also be more difficult to study using traditional methods. In the NIH-funded longitudinal study Mapa de Salud, we employed a novel approach to exploring the risk environment of female sex workers (FSWs) in two Mexico/U.S. border cities, Tijuana and Ciudad Juárez. In this paper we describe the development, implementation, and feasibility of a mix of quantitative and qualitative tools used to capture the HIV risk environments of FSWs in an LMIC setting. The methods were: 1) Participatory mapping; 2) Quantitative interviews; 3) Sex work venue field observation; 4) Time-location-activity diaries; 5) In-depth interviews about daily activity spaces. We found that the mixed-methodology outlined was both feasible to implement and acceptable to participants. These methods can generate geospatial data to assess the role of the environment on drug and sexual risk behaviors among high risk populations. Additionally, the adaptation of existing methods for marginalized populations in resource constrained contexts provides new opportunities for informing public health interventions.
authors.affiliation: Department of Medicine, Division of Global Public Health, University of California San Diego, San Diego, CA, United States of America.|Joint Doctoral Program in Public Health, Global Health, University of California San Diego and San Diego State University, San Diego, CA, United States of America.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Conners
authors.affiliation: Department of Medicine, Division of Global Public Health, University of California San Diego, San Diego, CA, United States of America.
authors.forename: Brooke S
authors.initials: BS
authors.lastname: West
authors.affiliation: Drexel University School of Public Health, Philadelphia, PA, United States of America.
authors.forename: Alexis M
authors.initials: AM
authors.lastname: Roth
authors.affiliation: Department of Medicine, Division of Global Public Health, University of California San Diego, San Diego, CA, United States of America.
authors.forename: Kristen G
authors.initials: KG
authors.lastname: Meckel-Parker
authors.affiliation: Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign, Champaign, IL, United States of America.
authors.forename: Mei-Po
authors.initials: MP
authors.lastname: Kwan
authors.affiliation: Centro Nacional para la Prevención y el Control del VIH y el SIDA (CENSIDA), Mexico City, Mexico.
authors.forename: Carlos
authors.initials: C
authors.lastname: Magis-Rodriguez
authors.affiliation: Facultad de Medicina, Universidad Autónoma de Ciudad Juárez, Ciudad Juárez, Mexico.
authors.forename: Hugo
authors.initials: H
authors.lastname: Staines-Orozco
authors.affiliation: Ohio State University, Columbus, OH, United States of America.
authors.forename: John D
authors.initials: JD
authors.lastname: Clapp
authors.affiliation: Department of Medicine, Division of Global Public Health, University of California San Diego, San Diego, CA, United States of America.
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Brouwer
mesh_terms: D002140:California / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D062486:Public Health Surveillance; D036301:Qualitative Research; D012306:Risk; D011477:Sex Work; D060386:Sex Workers; D012931:Social Environment; D062206:Spatial Analysis; D011795:Surveys and Questionnaires