Impact of Social Cohesion and Social Capital in PrEP Uptake and Adherence Among Transwomen of Color

社会凝聚力和社会资本对跨性别有色人种女性 PrEP 的采用和坚持的影响

• 批准号: 9926730
• 负责人: Dustin T Duncan
• 金额: $ 51.63万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-11 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9926730
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Area; Behavior; Biological; Birth; Censuses; Clinic; Code; Cohort Studies; Color; Communities; Dancing; Data; Data Set; Devices; Eligibility Determination; Environment; Epidemic; Ethnic Origin; Exposure to; Female; Feminine; Funding; Gender Identity; General Population; Geographic Locations; Geography; Global Positioning System; Goals; HIV; HIV Infections; HIV Seronegativity; Incidence; Individual; Intervention; Link; Literature; Location; Longitudinal Studies; Measures; Methodology; Methods; Minority Groups; Neighborhoods; Network-based; New York City; Odds Ratio; Outcome; Participant; Pathway Analysis; Patient Self-Report; Pattern; Physical activity; Policies; Polygamy; Population; Prevalence; Prevention; Protocols documentation; Race; Research; Research Project Grants; Resources; Risk; Sampling; Scientific Advances and Accomplishments; Sexual and Gender Minorities; Social Environment; Social Network; Structure; Subgroup; Technology; Time; Travel; United States; United States National Institutes of Health; Woman; Work; base; cohort; condomless anal sex; contextual factors; epidemiology study; experience; feasibility research; follow-up; health disparity; improved; infection rate; innovation; male; men who have sex with men; metropolitan; multidisciplinary; next generation; novel strategies; pre-exposure prophylaxis; preventive intervention; racial disparity; recruit; sex; skills; social; social capital; social cohesion; social epidemiology; success; surveillance study; therapy development; transgender; transgender women; transmission process; uptake; urban area; willingness

PROJECT SUMMARY This project seeks to use real-time geospatial methods to investigate relationships between social cohesion and social capital within Global Positioning System (GPS)-defined activity space neighborhoods and social networks in relation to HIV pre-exposure prophylaxis (PrEP) uptake and adherence cross-sectionally and longitudinally among transgender women (TW) of color (TWOC) in the New York City metropolitan statistical area (MSA) followed over two years. We will recruit 250 TWOC in the proposed The N2 Study: Transgender Women's Neighborhood and Networks Cohort Study to address the aims of the research. Eligibility requirements include: identifying as a transgender woman (individuals who were assigned a male sex at birth who identify as women, female, trans women, trans female, male-to-female or another diverse trans feminine gender identity on the spectrum) of color; HIV-seronegative; being 18 to 55 years old; residing in the New York City MSA; self-report no plans to move outside of the New York City metropolitan area in the next two years; self-reporting no restrictions to usual physical activity; and self-report willingness to carry a small GPS device for two-weeks at five points over the course of two years. Participants will wear the GPS device following protocols used in our previous feasibility research projects, including studies among TW. In this longitudinal study, six months after completing the initial 2-week GPS protocol, participants will carry the GPS device for an additional 2-weeks every six-months over the two-year study period—for a total of five times. Multiple GPS measures and multiple measures of social networks (at different time points) can better capture the breadth of people's exposure to neighborhood-level factors and dynamics in social networks. Also, GPS activity space environment and social networks data at baseline could potentially influence PrEP outcomes over time, providing a clear temporal ordering and an ability to consider potential time-lags. The proposed study will be the largest GPS study of HIV disparities in any transgender population and presents a remarkable opportunity to study environmental influences on HIV. Findings from the proposed research will impact HIV prevention intervention activities. First, the project will inform specific neighborhood-level policy interventions. For example, increased community efforts through increased social cohesion in neighborhoods may be an HIV prevention intervention that can reduce HIV health disparities. Second, from the GPS dataset we will know the travel patterns of TW and therefore be able to identify optimal geographic locations for HIV prevention interventions. This will advance the literature given that such interventions are seldom geographically targeted. Third, examining changes in spatial mobility (i.e. activity spaces) over time will be useful in knowing whether the risks of particular spaces change or remain constant because different neighborhoods will have different risk profiles. Finally, our dynamic network analysis we propose will deepen understanding of the effects of social networks on HIV prevention behaviors and will improve network-based HIV prevention interventions.

项目概要 该项目旨在使用实时地理空间方法来调查社会凝聚力之间的关系 全球定位系统 (GPS) 定义的活动空间邻里和社交范围内的社会资本 与 HIV 暴露前预防 (PrEP) 的跨部门吸收和依从性相关的网络 纽约市统计数据中跨性别有色人种女性 (TW) (TWOC) 的纵向分布 我们将在两年多的时间里招募 250 名 TWOC 参与拟议的 N2 研究：跨性别者。 妇女邻里和网络队列研究旨在解决研究的目标。 要求包括： 识别为跨性别女性（出生时被指定为男性的个人） 认为自己是女性、女性、跨性别女性、跨性别女性、男变女性或其他不同跨性别女性的人 性别认同）、HIV 血清阴性；居住在纽约； 市 MSA；自我报告未来两年内没有搬出纽约市大都市区的计划； 自我报告对日常身体活动没有限制；以及自我报告愿意携带小型 GPS 设备 参与者将在两年内的五个地点佩戴 GPS 设备，为期两周。 我们之前的可行性研究项目中使用的协议，包括 TW 之间的研究。 研究中，完成最初的为期两周的 GPS 协议六个月后，参与者将携带 GPS 设备进行一次 在两年的研究期间，每六个月额外进行两周——总共五次多重 GPS。 社交网络的测量和多重测量（在不同时间点）可以更好地捕捉社交网络的广度 人们接触社区层面的因素和社交网络的动态以及 GPS 活动空间。 随着时间的推移，基线环境和社交网络数据可能会影响 PrEP 结果， 提供明确的时间顺序和考虑潜在时间滞后的能力。 关于跨性别人群中艾滋病毒差异的最大 GPS 研究，提供了一个非凡的机会 研究环境对艾滋病毒的影响 拟议研究的结果将影响艾滋病毒的预防。 首先，该项目将告知具体的社区层面的政策干预。 例如，通过增加社区的社会凝聚力来加强社区努力可能是艾滋病毒 可以减少艾滋病毒健康差异的预防干预措施 其次，从 GPS 数据集中我们可以知道 台湾的旅行模式，因此能够确定艾滋病毒预防的最佳地理位置 鉴于此类干预措施很少具有地理针对性，这将推动文献的发展。 第三，检查空间流动性（即活动空间）随时间的变化将有助于了解是否 特定空间的风险会发生变化或保持不变，因为不同的社区会有不同的风险 最后，我们提出的动态网络分析将加深对风险的影响的理解。 艾滋病毒预防行为的社交网络，并将改善基于网络的艾滋病毒预防干预措施。