Violence and viral suppression among gender diverse people

性别多样化人群中的暴力和病毒抑制

• 批准号: 10556092
• 负责人: Rob B. Stephenson
• 金额: $ 10万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-01 至 2025-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10556092
• 关键词: Adherence; Administrative Supplement; Affect; Alberta province; Award; Behavior; Biological Markers; Birth; Budgets; Canada; Caring; Clinic; Clinical; Cohort Studies; Couples; Cross-Sectional Studies; Data; Data Collection; Emotional; Enrollment; Epidemic; Female; Frequencies; Future; Gender; Gender Identity; HIV; HIV Seropositivity; HIV diagnosis; Heterosexuals; Hospitalization; Individual; Interruption; Intervention; Knowledge; Link; Literature; Measures; Meta-Analysis; Methodology; Methods; Monitor; Outcome; Parents; Participant; Pathway interactions; Patient Self-Report; Patients; Persons; Positioning Attribute; Prevalence; Prospective cohort; Reporting; Research; Research Activity; Research Design; Research Project Grants; Risk; Risk Behaviors; Role; Sample Size; Sampling; Severities; Sexual and Gender Minorities; Shapes; Social support; System; Time; United States; Victimization; Violence; Viral; Viral Load result; Virginia; Woman; behavioral response; biological adaptation to stress; cisgender; clinical care; clinically relevant; cohort; design; experience; follow-up; gender minority group; health care availability; innovation; intimate partner violence; male; men who have sex with men; minority stressor; perpetrators; population based; prospective; recruit; response; same-sex partnership; sex; sexual minority men; sexual violence; social stigma; substance use; synergism; transfeminine; transgender; violence perpetration; violence victimization

PROJECT SUMMARY/ABSTRACT There is increasing evidence that transfeminine individuals (TF) experience dual epidemics of HIV and intimate partner violence (IPV), yet understanding of the synergies between these two epidemics is underdeveloped. Transfeminine individuals continue to be of the the risk groups most severely affected by HIV in the United States. In parallel, estimated prevalence for receipt of IPV among TF range from 12% to 62%. Emergent evidence demonstrates associations between the experience of IPV among TF and the risk of HIV acquisition or participation in risk behaviors that heighten the risk of HIV (i.e. substance use), but the relationship between the experience of IPV for TF living with HIV and HIV clinical care is less understood. The overwhelming majority of evidence linking IPV and sub-optimal HIV care comes from studies of heterosexual women. A recent meta- analysis showed that women's experience of IPV was associated with 55% lower odds of self-reported adherence and 36% decreased odds of viral suppression. Studies that have looked at associations between clinical care and IPV for sexual and gender minority groups living with HIV have all been hampered by methodological limitations: cross-sectional study designs with clinic-based populations that limit the ability to draw conclusions as to how IPV affects engagement in HIV care for partnered TF living with HIV. We propose an innovative 6- month cohort study of HIV-positive TF – as a supplement to an existing cohort study of HIV positive men who have sex with men - to identify the pathways and points of intervention between IPV and HIV care for US TF. The proposed research activities include a prospective 6-month cohort of 100 HIV-positive partnered TF (>18 years) recruited online from across the US. The cohort study will employ a measure of IPV developed specifically to capture IPV as experienced by TF, and will consider the experience of IPV (victimization, perpetration and bidirectional IPV), and severity and frequency of IPV as drivers of engagement in HIV care. Biomarkers of viral load will be collected from all participants. The overall aim of the proposed activities is to provide new knowledge of how victimization or perpetration of IPV shapes engagement in HIV care and is associated with the ability to achieve and maintain viral suppression.

项目概要/摘要 越来越多的证据表明，跨性别女性 (TF) 经历了艾滋病毒和亲密关系的双重流行。 伴侣暴力（IPV），但对这两种流行病之间的协同作用的了解尚不充分。 变性女性仍然是美国受艾滋病毒影响最严重的高危人群 与此同时，新兴证据显示 TF 中接受 IPV 的患病率在 12% 至 62% 之间。 证明 TF 中的 IPV 经历与感染 HIV 的风险之间存在关联，或 参与增加艾滋病毒风险的危险行为（即物质使用），但两者之间的关系 绝大多数人对 IPV 对 HIV 感染者的经验和 HIV 临床护理了解较少。 最近一项针对异性恋女性的研究表明，IPV 与次优艾滋病毒护理之间存在关联。 分析表明，女性经历过 IPV 后自我报告的依从性降低 55% 病毒抑制的几率降低了 36% 针对感染艾滋病毒的性少数群体和性别少数群体的 IPV 均受到方法论的阻碍 局限性：基于临床人群的横断面研究设计限制了得出结论的能力 关于 IPV 如何影响感染 HIV 的合作 TF 参与 HIV 护理，我们提出了一个创新的 6-。 HIV 阳性 TF 月队列研究——作为现有 HIV 阳性男性队列研究的补充 与男性发生性关系 - 为 US TF 确定 IPV 和 HIV 护理之间的途径和干预点。 拟议的研究活动包括由 100 名 HIV 阳性伴侣 TF（> 18 岁）组成的为期 6 个月的前瞻性队列 该队列研究将采用专门开发的 IPV 测量方法。 捕获 TF 所经历的 IPV，并将考虑 IPV 的经历（受害、加害和 双向 IPV），以及 IPV 的严重程度和频率作为参与 HIV 护理的驱动因素。 拟议活动的总体目标是提供新知识。 IPV 的受害或实施如何影响艾滋病毒护理的参与，并与以下能力相关： 实现并维持病毒抑制。