A multicomponent intervention to address gender-based violence in HIV prevention for women

采取多方干预措施解决妇女艾滋病毒预防中基于性别的暴力问题

• 批准号: 10005664
• 负责人: Kristi E Gamarel
• 金额: $ 20.9万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-20 至 2022-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10005664
• 关键词: AIDS prevention; Address; Adherence; Affect; Alcohol or Other Drugs use; Caring; Chronic stress; Clinical Trials; Color; Communities; Community Developments; Community Health; Data; Development; Diagnosis; Drops; Education; Educational Curriculum; Enrollment; Epidemic; Future; Gender; Gender Identity; HIV; HIV diagnosis; HIV risk; Health Educators; Health Personnel; Healthcare Systems; Human immunodeficiency virus test; Imprisonment; Individual; Intervention; Interview; Law Enforcement; Length; Link; Medical; Mental Health; Methods; Michigan; Modeling; Outcome; Participant; Pathway interactions; Patient Self-Report; Phase; Population; Post-Traumatic Stress Disorders; Poverty; Preventive Intervention; Process; Protocols documentation; Public Health; Randomized Controlled Trials; Research; Research Design; Risk; Safety; Science; Screening procedure; Sexual and Gender Minorities; Surveys; Symptoms; System; Testing; Trauma; Treatment Efficacy; United States; Violence; Woman; Work; arm; base; community clinic; condoms; efficacy trial; evidence base; experience; follow-up; gender-based violence; health care settings; health disparity; improved; multi-component intervention; peer; post intervention; pre-exposure prophylaxis; prevention efficacy trial; prevention service; primary outcome; programs; racism; recruit; retention rate; screening; secondary outcome; sexual violence; social; social stigma; therapy design; transgender; transgender women; transmission process; violence prevention

PROJECT SUMMARY Transgender (`trans') women of color experience violence in a variety of contexts, including from partners, strangers, law enforcement, healthcare providers, and in public accommodations. Violence is consistently linked with HIV transmission risk and avoiding HIV prevention services via pathways including chronic stress, posttraumatic stress disorder (PTSD) symptoms, and substance use. These epidemics are concurrent and mutually reinforcing, constituting a “syndemic” or synergistic interaction that contributes to documented inequities in HIV Prevention Continuum outcomes. In Detroit, Michigan, trans women of color are one of the `most-at-risk' groups for HIV, with significant disparities in sustained engagement in HIV prevention services. In this R21 exploratory/developmental research application, we propose to adapt, integrate, and pilot test a culturally-relevant evidence-based trauma-informed violence prevention intervention to improve HIV Prevention Continuum outcomes. Guided by the ADAPT-ITT model, our first aim seeks to conduct a systematic adaptation of three interventions and integrate these components into a trauma-informed combination prevention intervention for TWOC, with a focus on HIV Prevention Continuum outcomes by conducting interviews with trans women of color and key stakeholders to inform the adaptation. Our community advisory board consisting of trans women of color will review all adapted materials. The second aim seeks to examine the feasibility and acceptability of the trauma-informed combination prevention intervention in a one-arm pilot with follow-ups immediate and 3-month post-intervention. The primary outcome is improvements in HIV Prevention Continuum outcomes and the secondary outcomes are mental health and substance use. The project also seeks to gather qualitative data from one-arm pilot participants to identify strategies to overcome barriers to implementing rigorous randomized controlled trial research designs with trans women of color. Study findings will provide the necessary groundwork for a community-engaged efficacy trial in a subsequent, large-scale clinical trial.

项目摘要 跨性别者（“跨性别”）有色妇女在各种情况下经历暴力，包括来自合作伙伴， 陌生人，执法，医疗保健提供者和公共住宿。暴力是一贯的 与艾滋病毒传播风险联系在一起，避免通过包括慢性压力在内的途径， 创伤后应激障碍（PTSD）症状和药物使用。这些情节是并发的 相互加强，构成“联合性”或协同的相互作用，有助于记录 艾滋病毒预防连续性结果的不平等。在密歇根州底特律，有色跨性别女性是 艾滋病毒的“大多数风险”群体在持续参与艾滋病毒预防服务方面存在很大的差异。在 R21探索性/发展研究应用程序，我们建议适应，整合和试点测试 以文化为基础的循证创伤信息预防暴力干预措施，以改善艾滋病毒的预防 连续结果。在适应性-ITT模型的指导下，我们的第一个目标试图进行系统适应 三种干预措施，并将这些组件整合到创伤性的组合预防中 两次干预，重点是预防艾滋病毒的连续性结果 有色人种和主要利益相关者的跨性别女性，以告知适应。我们的社区顾问委员会组成 有色人种的跨性别女性将审查所有适应材料。第二个目标旨在检查可行性和 在一臂之力的飞行员中，创伤性联合预防干预的可接受性 干预后立即和3个月。主要结果是改善HIV预防连续体 结果和次要结果是心理健康和药物使用。该项目还试图聚集 一臂飞行员参与者的定性数据，以确定克服实施障碍的策略 严格的随机对照试验研究设计，具有有色人种的跨性别女性。研究结果将提供 在随后的大规模临床试验中进行社区参与效率试验的必要基础。