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 跨性别者和非二元性别者 (TGNB) 遭受亲密伴侣暴力 (IPV) 的比率惊人，是其两倍 他们的顺性别同龄人。先前的研究已将 IPV 与性危险行为以及 HIV 血清转化风险增加联系起来 TGNB 中，但人们对 IPV 对 HIV 和性传播感染 (STI) 检测、预检测的影响知之甚少。 TGNB 中暴露预防 (PrEP) 的摄取和持续性。虽然过去的研究结果表明 IPV 的潜力 对艾滋病毒预防持续参与、IPV 经验和影响产生强烈的有害影响 尚未在不同的 TGNB 人群中研究 HIV/STI 风险和预防行为。额外的 目前需要研究来模拟跨性别女性 (TF)、跨性别者等亚群体的 IPV 和 HIV 风险之间的路径。 男性（TM）和非二元性别（GNB）人。以结合流行病和流行病的框架为指导 少数派压力理论，拟议的创新观察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/或转变）在稳定或随意的背景下 亲密关系导致 TGNB 人群中的 HIV/STI 风险和保护行为超过 24 个月的时间范围。具体来说，我们的目标是： 1. 使用定性方法，探索感知到的关联 性别间 IPV、关系特征和动态以及 HIV 风险和预防行为之间的关系 不同的 TGNB 人员。 2. 检查 IPV 与 HIV 检测纵向关联中基于性别的差异， PrEP 摄取、PrEP 持续性、STI 诊断（主要结果）、无套性行为和 HIV 血清转化 （次要结果）在种族和民族多样化的 TGNB 人群（TF、TM 和 GNB 群体）中进行。 3. 确定个人、人际、网络、社区和结构层面的风险和复原力因素 调节（或调节）IPV 和 HIV 风险以及每个群体的保护行为之间的关联。 4.制作 基于定量的干预措施建议，以中断 IPV 和 HIV/STI 风险之间的途径 来自队列的数据和定性数据，由技术专家指导。我们将评估性风险行为、行为 HIV 和 STI 检测，并评估 PrEP 的吸收和 24 个月随访期间的持续性。我们假设 在以下亚组中，IPV 对 HIV/STI 风险的频率、严重程度和总体影响存在差异 TGNB 人员。我们还怀疑较高的 IPV 频率与童年虐待史、精神虐待史有关。 健康问题、物质使用、性冒险和较低水平的艾滋病毒检测、PrEP 的吸收和 PrEP 的持续性。 我们预计参与者及其伴侣的酒精和药物使用与 IPV 发作和 HIV 危险行为。我们还假设性别肯定的经历、应对技巧 社会支持将调节 IPV 对危险行为、HIV 检测、PrEP 吸收和 PrEP 持续性的影响。 拟议的研究将增进我们对与预防和恢复相关的风险和弹性因素的理解。 减少 IPV、减少 IPV 相关风险行为并增加不同 TGNB 中的 HIV 保护行为 人。这项研究将为 IPV、HIV 和药物滥用干预措施的制定和调整提供信息 对于 TGNB 人员。