Tcher, Take Charge: Increasing PrEP Awareness, Uptake, and Adherence Through Health Care Empowerment and Addressing Social Determinants of Health Among Racially Diverse Trans Women in the Deep South

Tcher，负责：通过医疗保健赋权提高 PrEP 意识、采用率和依从性，并解决南方腹地多元化跨性别女性健康的社会决定因素

• 批准号: 10328021
• 负责人: Narquis Barak
• 金额: $ 69.5万
• 依托单位: NEW ORLEANS AIDS TASK FORCE, INC.
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-17 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10328021
• 关键词: AIDS prevention; Address; Adherence; Annual Reports; Awareness; Bisexual; Caring; Centers for Disease Control and Prevention (U.S.); Charge; Clinic; Communities; Community Health; Cost efficiency; Cross-Over Studies; Data; Deep South; Ecological momentary assessment; Effectiveness; Environment; Evidence based intervention; Face; Gays; Goals; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; HIV/STD; Health; Health Services Accessibility; Healthcare; Hearing; Intervention; Investments; Letters; Life; Louisiana; Measures; Media Campaign; Mediating; Methods; Modeling; Outcome; Participant; Persons; Population; Population Study; Randomized; Reporting; Research; Research Design; Research Personnel; Running; Sampling; San Francisco; Savings; Social support; Testing; Text; Time; Trust; Viral; Woman; Work; base; cis-male; community clinic; community engagement; design; digital; digital intervention; empowerment; evidence base; experience; high risk; improved; innovation; mHealth; member; men; motivational enhancement therapy; novel; peer; population based; pre-exposure prophylaxis; prevention service; psychological distress; racial diversity; recruit; response; social health determinants; social media; social stigma; substance use; surveillance data; surveillance study; therapy design; transgender; transgender women; uptake; web site

Abstract Trans women are highly underserved in the response to HIV, especially in the deep south. Southern states are disproportionately impacted by HIV. Among states in the deep south, which face the vast majority of new HIV infections, HIV diagnosis rates in Louisiana were second only to Georgia. In New Orleans, our team conducted the first population- base HIV surveillance study of trans women and 46% tested positive for HIV. These findings are consistent with the most recent Louisiana Department of Health (LDH) STD/HIV annual report in 2018 that identified Black gay/bisexual men and transgender women as bearing the largest burden of HIV of any population in Louisiana. Despite the impact of HIV on trans women in New Orleans, no evidence-based PrEP interventions or efforts are underway to meet community needs. In response to RFA-MH-21-151 Strengthening HIV Prevention Efforts for Women in the Southern U.S., our team proposes to test the T'Cher, Take Charge intervention to increase PrEP awareness, uptake, and adherence among trans women in New Orleans. T'Cher builds off the work conducted to inform and implement the first population-based study of trans women in 2019 with the adaptation of two evidence-based interventions for trans women recently completed by investigators. The intervention will include a social media campaign to increase PrEP awareness among trans women. It will also include peer navigation to build trust among trans people and provide PrEP navigation. We will tailor the peer navigation model from the Stay Study to be implemented digitally and enhanced using Health eNav methods. Namely, we will also use motivational interviewing and EMAs to increase health care empowerment and address social determinants of health barriers to PrEP uptake and adherence. We will recruit 200 trans women to participate in our study using methods proven successful in our prior HIV research with trans women. Trans women will be engaged in the intervention for 12 months, providing enough time to address barriers to PrEP and support adherence. The goals of this proposed T'Cher, Take Charge intervention are: (1) To develop, implement and measure the impact of a T'Cher, Take Charge social media campaign on PrEP awareness among trans women in New Orleans, LA using a population-based sample of trans women; (2) To test the impact of the T'Cher, Take Charge digital mHealth peer navigation model on increasing PrEP uptake and adherence among trans women in New Orleans, LA, using a randomized stepped wedge cross-over study design; and, (3) To assess changes in health care empowerment and support for social determinants of health as mediating factors in PrEP uptake and adherence. Our goal is to used lessons learned to adapt promising trans-specific HIV interventions to meet the HIV prevention needs of trans women in New Orleans, Louisiana. With evidence of effectiveness, we are prepared to test the intervention at scale throughout Louisiana to strengthen PrEP access and utilization among trans women Louisiana and throughout the deep south.

抽象的 跨性别妇女在对艾滋病毒的反应中，尤其是在南方的艾滋病毒反应方面非常不足。南部州是 受艾滋病毒的影响不成比例。在深南部面临绝大多数新艾滋病毒感染的州中， 路易斯安那州的HIV诊断率仅次于佐治亚州。在新奥尔良，我们的团队进行了第一个人口 - 跨性别妇女的基本HIV监测研究和46％的HIV阳性。这些发现与最一致 2018年，最近路易斯安那州卫生部（LDH）STD/HIV年度报告确定了黑人同性恋/双性恋男子和 跨性别妇女承担了路易斯安那州任何人口的最大艾滋病毒负担。尽管艾滋病毒对 在新奥尔良的跨性别妇女，没有进行基于证据的准备干预措施或努力来满足社区需求。在 我们的团队对RFA-MH-21-151的反应加强了美国南部妇女的艾滋病毒预防工作。 要测试T'Cher，请采取费用干预以提高跨性别妇女之间的意识，吸收和遵守 新奥尔良。 T'Cher建立了为介绍和实施第一个基于人群的跨性别研究的工作 妇女在2019年适应了最近完成的两项基于证据的跨性别妇女的干预措施 调查人员。干预措施将包括一项社交媒体运动，以提高跨性别妇女之间的准备意识。它 还将包括在跨性别人员之间建立信任并提供预备导航的同行导航。我们将定制同伴 使用健康ENAV方法以数字方式实施的住宿研究导航模型。即，我们 还将利用动机访谈和EMA来增加授权医疗保健并解决社会决定因素 预先吸收和依从性的健康障碍。我们将招募200名跨性别妇女参加我们的研究 在我们对跨性别女性的艾滋病毒研究中，方法证明了成功的方法。跨性别妇女将参与干预 在12个月内，提供足够的时间来解决准备和支持依从性的障碍。这个提议的目标 T'Cher，接受负责干预是：（1）开发，实施和衡量T'Cher的影响，负责 洛杉矶新奥尔良跨性别妇女之间有关跨性别妇女之间的预科意识的社交媒体运动，使用基于人群的样本 跨性别妇女； （2）要测试T'Cher的影响 洛杉矶新奥尔良的跨性别妇女之间的预先吸收和依从性，使用随机阶梯楔形交叉研究 设计; （3）评估授权医疗保健能力的变化和对健康的社会决定因素进行调解的变化 准备吸收和依从性的因素。我们的目标是使用学到的教训来适应有希望的跨性别艾滋病毒 为满足路易斯安那州新奥尔良跨性别妇女的艾滋病毒预防需求的干预措施。有证据 有效性，我们准备在整个路易斯安那州进行大规模测试干预措施，以加强准备访问和 路易斯安那州跨性别妇女之间的利用以及整个南方。