Intimate Partner Violence and HIV Prevention Continuum Engagement Among Transgender and Nonbinary Populations

跨性别和非二元人群中的亲密伴侣暴力和艾滋病毒预防持续参与

• 批准号: 10762298
• 负责人: Erik D. Storholm
• 金额: $ 77.65万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10762298
• 关键词: AIDS prevention; Address; Alcohol consumption; Behavior; Characteristics; Child Abuse; Communities; Coping Skills; Data; Development; Diagnosis; Emotional; Enrollment; Etiology; Exclusion; Family; Frequencies; Gender; Gender Role; Goals; HIV; HIV Seronegativity; HIV Seropositivity; HIV risk; Human immunodeficiency virus test; Individual; Infection prevention; Interruption; Intervention; Knowledge; Life Experience; Link; Longitudinal cohort; Measures; Mediating; Mental Health; Methodology; Methods; Modeling; Outcome; Participant; Pathway interactions; Persons; Population; Psychosocial Factor; Recommendation; Recording of previous events; Reporting; Research; Research Activity; Research Priority; Risk; Risk Assessment; Risk Behaviors; Risk Factors; Services; Severities; Sex Behavior; Sexually Transmitted Diseases; Shapes; Social support; Subgroup; Substance abuse problem; Testing; Time; Unsafe Sex; Victimization; Violence; Work; assigned female at birth; assigned male at birth; cisgender; cohort; design; ethnic diversity; experience; follow-up; gender affirmation; gender diversity; gender expression; gender transition; high risk; inattention; infection risk; innovation; intimate partner violence; male; minority stress; nonbinary; observational cohort study; peer; pre-exposure prophylaxis; prevent; prevention service; primary outcome; prospective; protective behavior; psychologic; racial diversity; recruit; resilience factor; secondary outcome; sexual minority men; sexual risk behavior; sexual risk taking; social; structural determinants; substance use; syndemic; theories; transfeminine; transgender; transmasculine; uptake; violence prevention

SUMMARY/ABSTRACT Transgender and non-binary (TGNB) persons experience intimate partner violence (IPV) at alarming rates twice that of their cisgender peers. Prior work has linked IPV to sexual risk behavior and increased risk for HIV seroconversion among TGNB, but less is known about the impact of IPV on HIV and sexually transmitted infection (STI) testing, pre- exposure prophylaxis (PrEP) uptake, and persistence among TGNB. While past findings suggest the potential for IPV to have a strong deleterious effect on HIV prevention continuum engagement, IPV experiences and impacts on HIV/STI risk and prevention behaviors have yet to studied among a diverse group of TGNB persons. Additional research is currently needed to model pathways between IPV and HIV risk for subgroups of trans feminine (TF), trans masculine (TM), and gender non-binary (GNB) persons. Guided by a framework that combines Syndemic and Minority Stress Theory, the proposed innovative observational cohort study will examine how specific forms of IPV (e.g., physical, sexual, emotional, controlling gender expression and/or transition) in the context of steady or casual intimate relationships contribute to HIV/STI risk and protective behaviors among subgroups of TGNB persons over a 24-month timeframe. Specifically, we aim to: 1. Using qualitative methodologies, explore the perceived associations between IPV, relationship characteristics and dynamics, and HIV risk and prevention behaviors among gender diverse TGNB persons. 2. Examine gender-based differences in the longitudinal associations of IPV with HIV testing, PrEP uptake, PrEP persistence, STI diagnosis (primary outcomes), condomless sex, and HIV seroconversion (secondary outcomes) among a racially and ethnically diverse cohort of TGNB persons (TF, TM, and GNB groups). 3. Determine the individual-, interpersonal-, network-, community-, and structural-level risk and resilience factors that mediate (or moderate) the associations between IPV and HIV risk and protective behaviors for each group. 4. Make recommendations for interventions that interrupt the pathways between IPV and HIV/STI risk based on quantitative data from the cohort and qualitative data, guided by technical experts. We will assess sexual risk behavior, conduct HIV and STI testing, and assess PrEP uptake and persistence over the 24 months of follow-up. We hypothesize that there will be differences in the frequency, severity, and overall impact of IPV on HIV/STI risk among subgroups of TGNB persons. We also suspect greater frequency of IPV will be associated with history of childhood abuse, mental health problems, substance use, sexual risk taking and lower levels of HIV testing, PrEP uptake, and PrEP persistence. We anticipate that alcohol and substance use among participants and their partners will be highly associated with episodes of IPV and with HIV risk behavior. We also hypothesize that experiences of gender affirmation, coping skills and social support will mediate the effects of IPV on risk behavior, HIV testing, PrEP uptake, and PrEP persistence. The proposed study will advance our understanding of both the risk and resiliency factors relevant to preventing and reducing IPV, reducing IPV-associated risk behaviors, and increasing HIV protective behaviors among diverse TGNB persons. This research will inform the development and adaptation of IPV, HIV, and substance abuse interventions for TGNB persons.

摘要/摘要 跨性别和非二进制（TGNB）人以两倍的惊人率经历亲密的伴侣暴力（IPV） 他们的sisgender同龄人。先前的工作将IPV与性风险行为联系起来，并增加了HIV血清转化的风险 在TGNB中，关于IPV对HIV和性传播感染（STI）测试的影响鲜为人知 暴露预防（PREP）吸收和TGNB之间的持久性。虽然过去的发现暗示了IPV的潜力 对艾滋病毒预防连续性参与，IPV经历和影响 艾滋病毒/STI风险和预防行为尚未在不同的TGNB人群中进行研究。额外的 目前需要进行研究来模拟IPV和HIV风险之间的跨性别女性亚组（TF），Trans 男性（TM）和性别非二进制（GNB）人。在结合联合学和的框架的指导下 少数族裔压力理论，拟议的创新观测队列研究将研究特定形式的IPV （例如，身体，性，情感，控制性别表达和/或过渡）在稳定或休闲的背景下 亲密的关系有助于TGNB人群中的艾滋病毒/STI风险和保护行为 一个24个月的时间范围。具体而言，我们的目标是：1。使用定性方法，探索感知的关联 在IPV，关系特征和动态以及性别之间的艾滋病毒风险和预防行为之间 多元化的TGNB人。 2。检查IPV纵向关联中基于性别的差异，并检查HIV检验， 预备摄取，准备持久性，性传播感染诊断（主要结果），无避孕套性别和HIV血清转化 （次要结果）在种族和种族多样的TGNB人群中（TF，TM和GNB组）。 3。 确定个人，人际，网络，社区和结构性的风险以及弹性因素，这些因素 调解IPV与HIV风险与保护行为之间的关联（或中等）。 4 建议基于定量的干预措施中断IPV和HIV/STI风险之间的途径 来自队列和定性数据的数据，在技术专家的指导下。我们将评估性风险行为，行为 在24个月的随访中，HIV和STI测试，并评估预先吸收和持久性。我们假设这一点 IPV对IPV的频率，严重程度和总体影响会存在差异 TGNB人。我们还怀疑IPV的频率更高将与儿童虐待的历史，精神 健康问题，药物使用，性风险服用以及较低的艾滋病毒测试水平，摄取预备和持久性。 我们预计参与者及其伴侣之间的酒精和用途将与 IPV发作和HIV风险行为。我们还假设性别肯定的经历，应对技能 社会支持将调解IPV对风险行为，艾滋病毒测试，预先吸收和持久性的影响。 拟议的研究将促进我们对与预防和预防和弹性因素的理解 减少IPV，减少IPV相关的风险行为，并增加不同TGNB的HIV保护行为 人。这项研究将为IPV，HIV和药物滥用干预措施的发展和适应 对于TGNB人。