Risk and Protective Factors for Adherence to Pre-Exposure Prophylaxis (PrEP) in Transwomen of Color

有色变性女性坚持暴露前预防 (PrEP) 的风险和保护因素

• 批准号: 9347219
• 负责人: Erik D. Storholm
• 金额: $ 23.13万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9347219
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Alcohol or Other Drugs use; Anti-Retroviral Agents; Attenuated; Behavior Therapy; Birth; California; Clinical; Clinical Research; Color; Coping Skills; Data; Development; Discrimination; Drug Combinations; Effectiveness; Emotional; Enrollment; Equation; Ethnic Origin; Event; Female; Funding; Future; Gender; Gender Identity; Grant; HIV; HIV Infections; HIV Seropositivity; HIV risk; Hormones; Individual; Intervention; Interview; Investigation; Life; Life Experience; Measures; Mental Health; Methods; Minority; Modeling; National Institute of Drug Abuse; Persons; Pilot Projects; Population; Prevention; Prevention strategy; Public Health; Race; Reporting; Research; Research Methodology; Research Personnel; Resistance development; Resources; Risk; Risk Behaviors; Role; Sampling; Social support; Stress; Substance Use Disorder; Substance abuse problem; Tenofovir; Testing; Time; Trauma; Treatment Failure; United States; Victimization; Woman; alcohol abstinence; base; cisgender; coping; emtricitabine; ethnic diversity; ethnic minority population; experience; high risk; high risk population; improved; male; men who have sex with men; pre-exposure prophylaxis; prevent; programs; racial and ethnic; racial diversity; resilience; sex risk; stress resilience; therapy development; transgender; transgender women; transmission process; transphobia; treatment adherence

Project Abstract Transgender women (TW) are currently the SGM population at highest risk for HIV infection in the United States, especially those who are racial/ethnic minorities. TW also report the highest levels of discrimination, victimization, traumatic life events, and other stressful experiences and are of the highest risk groups for substance abuse and mental health problems. HIV researchers have suggested resiliency may be a largely untapped resource in behavioral interventions and that it may be associated with reductions in mental health problems, substance abuse, and HIV related risk among marginalized populations. Daily pre-exposure prophylaxis (PrEP) is extremely effective in preventing HIV infection among those who are HIV-negative. While this is an exciting development for HIV prevention among minority TW, HIV prevention efforts must now shift focus to research on optimizing PrEP adherence among this high-risk population facing multiple recurring stressful life events and numerous structural barriers. In the proposed study, we will leverage an ongoing study of (N =300) racially and ethnically diverse TW enrolled in the Southern California based PrEP demonstration project, in order to conduct mixed-methods research, first using structural equation modeling (SEM) to assessing the risk and resiliency factors most associated with PrEP adherence among TW. Then using the SEM findings to inform follow-on, in-depth qualitative interviews with a sub-sample of high- to low-adherence minority TW to further explore those risk and resiliency factors and experiences most salient to PrEP adherence among high-risk minority TW. This study will provide the preliminary data to support the submission of an intervention development grant (NIDA R34) to develop a resilience-based intervention focused on improving PrEP adherence for TW.

项目摘要 跨性别女性（TW）是目前美国感染艾滋病毒风险最高的 SGM 人群 各州，尤其是那些少数种族/族裔的州。台湾还报告了最严重的歧视， 受害、创伤性生活事件和其他压力经历，是遭受伤害的最高风险群体 药物滥用和心理健康问题。艾滋病毒研究人员认为，弹性可能在很大程度上是一个因素 行为干预方面尚未开发的资源，可能与心理健康状况的下降有关 边缘化人群中的问题、药物滥用和艾滋病毒相关风险。每日预曝光 预防（PrEP）对于预防 HIV 阴性者感染 HIV 非常有效。尽管 这是少数民族台湾人艾滋病毒预防方面令人兴奋的进展，艾滋病毒预防工作现在必须转变 重点研究如何优化面临多重复发的高危人群的 PrEP 依从性 压力性的生活事件和众多的结构性障碍。在拟议的研究中，我们将利用正在进行的研究 (N = 300) 名不同种族和民族的台湾人参加了南加州 PrEP 示范活动 项目中，为了进行混合方法研究，首先使用结构方程模型（SEM） 评估与 TW 中 PrEP 依从性最相关的风险和弹性因素。然后使用 SEM 调查结果可为后续对高依从性到低依从性的子样本进行深入的定性访谈提供信息 少数族裔 TW 进一步探讨对 PrEP 最重要的风险和弹性因素及经验 高风险少数族裔台湾人的依从性。本研究将提供初步数据以支持提交 干预发展补助金（NIDA R34），用于开发基于复原力的干预措施，重点关注 提高 TW 的 PrEP 依从性。