Increasing PrEP Use in High-Risk Social Networks of African American MSM in Underserved Low-Uptake Cities

在服务不足、使用率低的城市中，增加非洲裔美国男男性接触者高风险社交网络中 PrEP 的使用

• 批准号: 10090689
• 负责人: Yuri A Amirkhanian
• 金额: $ 10万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-21 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10090689
• 关键词: AIDS prevention; Address; Administrative Supplement; Adoption; Alcohol or Other Drugs use; Attention; Attitude; Behavioral; Belief; Birth; Categories; Centers for Disease Control and Prevention (U.S.); Characteristics; Cities; Code; Communities; Data; Dimensions; Effectiveness; Enrollment; Epidemic; Face; Female; Focus Groups; Funding; Gender; Gender Identity; Goals; HIV; HIV Infections; HIV Seronegativity; Health; Health Care Visit; High Risk Woman; Human immunodeficiency virus test; Incidence; Intervention; Intervention Studies; Interview; Knowledge; Life; Maintenance; Measures; Medical; Methods; Midwestern United States; Minority; Minority Groups; Modality; Participant; Perception; Persons; Phase; Population; Predictive Factor; Prevalence; Prevention Research; Provider; Public Health; Qualitative Methods; Readiness; Recommendation; Recording of previous events; Reporting; Request for Applications; Research; Research Design; Research Methodology; Safety; Sampling; Self Efficacy; Services; Sexual and Gender Minorities; Social Network; Structure; Testing; United States; Visit; Woman; authority; black men who have sex with men; cost; experience; gender minority; gender nonconforming; health assessment; high risk; improved; male; men who have sex with men; minority communities; parent grant; parent project; peer; pre-exposure prophylaxis; preference; psychosocial; racial minority; recruit; response; social stigma; stress resilience; transgender; transgender women; uptake

Abstract Transgender women—especially racial minority transgender women—have HIV prevalence that is far higher than any other population segment in the United States. Nearly two-thirds of transgender women meet CDC criteria for pre-exposure prophylaxis (PrEP) indication but only 5% report ever taking PrEP. Most prior HIV prevention research has lumped together transgender women in a single category with men who have sex with men (MSM) even though these sexual and gender minority (SGM) groups may face different life challenges and have very different needs. Except for a handful of small focus group studies conducted in large cities on the East and West coasts, very little research has systematically explored factors responsible for low PrEP use among transgender women at high risk for contacting HIV infection and identified ways to increase PrEP adoption and sustained use. This proposal—submitted in response to Notice OD-20-032—requests an SGM administrative supplement to add a sample of racial minority transgender women to parent grant R01- NR017574, a project that tests approaches to increase PrEP use among African American MSM in Milwaukee and Cleveland, both Midwestern cities with stark HIV disparities. The supplement will employ a mixed-methods research design with 60 high-risk racial minority transgender women recruited from the community who will be added to the parent grant. During study visits, each woman will participate in a semi-structured in-depth interview to elicit perceptions, understandings, and beliefs about PrEP; concerns and barriers to PrEP use; factors that would facilitate the adoption and sustained use of PrEP; and preferences about PrEP delivery modalities and service access. Interviews will delve into how PrEP can be presented to transgender women in ways that affirm a positive, healthful, and proud sense of gender identity that counteracts the deleterious influence of intersectional stigma. In-depth interviews will be recorded, transcribed, coded, and qualitatively analyzed to identify how best to optimize and tailor interventions to reach and benefit the HIV prevention and health needs of transgender women. Participants will also be administered measures that are being employed in the parent grant to assess HIV testing and health history, sexual practices, substance use, and PrEP use knowledge, attitudes, behavioral intentions, norm perceptions, and self-efficacy, as well as a measure of gender minority stress and resilience validated with transgender and gender nonconforming persons. These quantitative data will be analyzed to identify whether—and how—the HIV prevention needs of racial minority transgender women differ from those of racial minority MSM as well as factors that facilitate or impede PrEP use among transgender women. Findings of this research will improve the field’s understanding of HIV health needs of transgender minority women—a vulnerable, understudied, and underserved SGM community population—and will inform implementation efforts to achieve the goals of the National Plan to End the HIV epidemic.

抽象的 跨性别妇女（尤其是种族少数跨性别妇女）的HIV患病率很远 高于美国任何其他人口细分市场。近三分之二的跨性别妇女见面 暴露前预防（PREP）指示的CDC标准，但只有5％的报告曾经有PREP。大多数 艾滋病毒预防研究已将跨性别女性融合在一起 即使这些性别和性别少数群体（SGM）群体可能面临不同的生活，即使男子（MSM） 挑战，有不同的需求。除了少数小型焦点小组研究以大型研究 东海岸和西海岸的城市很少有系统地探讨了导致低的因素 在接触艾滋病毒感染的高风险的跨性别妇女中使用的准备并确定了增加的方法 准备和持续使用。该提案（以回应通知OD-20-032）提出提议，要求 SGM行政补充剂以添加一个种族少数跨性别妇女样本到父母授予R01- NR017574，一个测试方法，以增加密尔沃基非裔美国人MSM的准备使用方法 克利夫兰（Cleveland）是中西部城市，艾滋病毒差异很明显。该补充剂将采用混合方法 从社区招募的60种高风险的种族跨性别妇女的研究设计将是 添加到父母赠款中。在学习访问期间，每个女人将参加半结构的深入 采访以引起人们的看法，理解和相信准备；预备使用的关注和障碍； 有助于采用和持续使用PREP的因素；以及关于准备交付的偏好 方式和服务访问。访谈将深入研究如何向跨性别妇女提出准备 肯定积极，健康和自豪的性别认同感，抵消有害的方式 将在定性上记录，转录，编码和进行深入的访谈 分析以确定如何最好地优化和量身定制干预措施，以达到预防艾滋病毒的预防和受益 变性妇女的健康需求。参与者也将接受正在雇用的措施 在父母赠款中评估艾滋病毒测试和健康史，性实践，药物使用和准备使用 知识，参与者，行为意图，规范看法和自我有效，以及 通过跨性别者和性别不合格的人证实的性别少数派压力和韧性。这些 定量数据将进行分析，以确定赛车少数族裔的艾滋病毒预防需求以及如何 跨性别妇女与少数族裔MSM的妇女以及促进或阻碍PrEP的因素 在变性妇女中使用。这项研究的结果将改善该领域对艾滋病毒健康的理解 跨性别少数妇女的需求 - 脆弱，理解和服务不足的SGM社区 人口 - 并将为实现终止艾滋病毒的国家计划的目标提供帮助 流行性。