Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Marginalized populations, such as injection drug users (IDU) and female sex workers (FSW) are overly-represented in HIV statistics. Although resources have been directed at individually-focused interventions, a growing body of work suggests these approaches are limited. Socio-epidemiologic perspectives acknowledge risk behaviours cannot be separated from multi-level factors. However, the specific pathways by which contextual factors are operationalized, and how this might change over time are poorly understood. Developing conceptual frameworks outlining interdependencies between individuals and their environments, and how this translates into risk behaviours can inform evidence-based programs. Scientific inquiry into dynamic relationships has been hampered by conceptual and methodological limitations. Complex systems dynamic modeling (CSDM) approaches address these limitations by accounting for dynamic relationships between behaviours and risk environments. Therefore, combining traditional methods of epidemiologic inquiry with CSDM approaches, the proposed project will examine two marginalized populations in Winnipeg, Manitoba and southern India. These two populations were chosen because they reflect both Canadian and global situations. The goal of the proposed project is to develop conceptual frameworks of behavioural patterns for IDU and FSWs. The specific objectives are: A) to investigate variations in the impact of sharing networks among IDUs in Winnipeg, and to relate these variations to behavioural patterns; and B) to investigate the influence of sex work organization, geography and individual attributes on behaviours in migrant FSWs in India. Examination of two different populations will ensure broader applicability of the results of this project. The conceptual framework can be used to understand why heterogeneity in resiliency and vulnerability exists in marginalized populations.