To Reach Unrestricted Services for Transgender Women (TRUST)

为跨性别女性提供不受限制的服务 (TRUST)

• 批准号: 10252940
• 负责人: Elena Cyrus
• 金额: $ 24.89万
• 依托单位: UNIVERSITY OF CENTRAL FLORIDA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10252940
• 关键词: AIDS prevention; AIDS/HIV problem; Academic Training; Accreditation; Address; Adult; Affect; African; Alcohols; Back; Behavior; Caribbean region; Color; Communities; Control Groups; Country; Data; Data Collection; Development; Drug abuse; Epidemiologist; Evidence based intervention; Faculty; Fellowship; Florida; Focus Groups; Funding; Generations; Geography; Goals; Grant; HIV; HIV risk; HIV/STD; Health; Health Care Costs; Illicit Drugs; Immigrant; Incidence; Individual; Institution; International; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Knowledge; Latin America; Latina; Latino; Lead; Logistic Regressions; Manuals; Measures; Mentored Clinical Scientist Development Award (K08); Methodology; Methods; Minority; National Institute of Drug Abuse; Outcome Measure; Participant; Personal Satisfaction; Peruvian; Phase; Population; Positioning Attribute; Postdoctoral Fellow; Preparation; Prevalence; Primary Prevention; Procedures; Process; Prophylactic treatment; Public Health; Publications; Qualitative Methods; Qualitative Research; Randomized; Research; Research Activity; Research Methodology; Research Personnel; Risk; Sampling; Secondary Prevention; Secure; Services; Sexual and Gender Minorities; Special Population; Stigmatization; Strategic Planning; Stress; Substance Use Disorder; Substance abuse problem; Surveys; Target Populations; Testing; Time; Training; Training Activity; Translational Research; Translations; United States; United States National Institutes of Health; Universities; Visit; Visual; Vulnerable Populations; Work; acceptability and feasibility; arm; base; brief intervention; career; career development; comorbidity; data format; design; effective intervention; effective therapy; efficacy evaluation; efficacy testing; ethnic minority population; experience; follow-up; gender minority; health disparity; high risk; high risk population; improved; innovation; marginalized population; men who have sex with men; method development; post intervention; pre-exposure prophylaxis; prevent; primary outcome; racial and ethnic; randomized trial; screening; screening, brief intervention, referral, and treatment; skills; social determinants; societal costs; stem; stress disorder; stressor; substance abuse brief intervention; substance abuse prevention; substance use; tenure track; therapy development; transgender; transgender men; transgender women; transmission process; uptake

ABSTRACT/SUMMARY Background: Transgender women are disproportionally affected by substance abuse and HIV. Evidence-based interventions that can address both issues simultaneously may efficiently improve the overall health of transgender women and reduce burdensome health and societal costs associated with substance abuse and HIV. In South Florida, the majority of transgender women identify as Black or Latina, and can be grouped together as transgender women of color (TWOC). TWOC are at highest risk for substance abuse and HIV acquisition, due to multiple external stressors arising as a consequence of being a gender minority and a racial/ethnic minority. Studies have demonstrated Screening, Brief Intervention, and Referral to Treatment (SBIRT) to be effective in mitigating development of substance use disorders (SUDs) in other at-risk, marginalized populations. An adapted culturally-tailored SBIRT focused on linkage to substance use services and HIV pre- and post-exposure prophylaxis (PrEP/nPEP) may effectively reduce the odds of individuals in this special population developing a SUD and also facilitate their voluntary election of HIV screening and use of PrEP/nPEP for HIV prevention. Objectives: K99 –In preparation for the independent phase, the career development phase will include training in qualitative research methods and intervention development. R00 – In the independent phase, the study objectives will be to (a) use a mixed-methods approach to obtain formative data among 40 transgender women that will aid in adapting and developing an adapted culturally tailored SBIRT intervention (SBIRT-A), (b) pre-test and refine SBIRT-A in 15 transgender women based on formative work and, (c) pilot test SBIRT-A in a sample of 76 transgender to assess feasibility and acceptability. Pilot Design: Randomized trial among 76 adult (18 years or older) HIV uninfected transgender women at moderate risk for developing a substance use disorder who will be randomized to either SBIRT-A or the control condition (INFO-C). The INFO-C group will be a time-matched comparison control where information will be provided on substance use and PrEP services in a non-SBIRT format via printed and audio-visual study material. There will be a follow-up visit, three months after baseline, to assess linkage, and barriers and facilitators, to substance use services and PrEP/nPEP. Analysis: Bivariate difference tests (chi square and t-tests) will be used to test differences between SBIRT-A and INFO-C participants for the primary outcome measures (linkage to substance use services, PrEP, and nPEP) at the 3-month visit. Multivariate binary logistic regressions (post- and pre-intervention) will be used to determine substance use as a predictor of (1) HIV/STI screening in the past three months and (2 & 3) PrEP and nPEP uptake in the past three months. Significance: Results derived from this study will help elucidate the relationship between substance use and HIV among transgender women, including TWOC, in South Florida, and will provide evidence for a larger study that can test the efficacy of SBIRT-A to reduce prevalence of substance abuse and HIV in this special population. The aims of this study are parallel to the NIH/NIDA strategic plan to decrease HIV/AIDS health disparities, prevent HIV transmission, and better understand the interaction of drug abuse and HIV/AIDS.

摘要/摘要 背景：跨性别妇女受滥用药物和艾滋病毒的影响不成比例。循证 可以简单地解决这两个问题的干预措施可能会有效地改善转移的整体健康状况 妇女并减少与药物滥用和艾滋病毒相关的繁殖健康和社会成本。在南佛罗里达州， 大多数跨性别妇女将其视为黑人或拉丁裔，可以将其分组为有色人种的跨性别妇女 （Twoc）。由于多种外部压力源为 是性别少数和种族/族裔少数群体的结果。研究表明筛查，简短 干预，转介到治疗（SBIRT）可有效缓解药物使用障碍的发展 （SUD）在其他高危人群中。专注于与底物联系的适应性的文化定制的SBIRT 使用服务以及暴露前后预防（PREP/NPEP）可能有效地减少个人的几率 这种特殊的人群发展了SUD，还促进了他们自愿选举艾滋病毒筛查和使用 预防HIV的准备/NPEP。目标：K99 - 为独立阶段准备职业发展阶段做准备 将包括定性研究方法和干预开发的培训。 R00 - 在独立阶段， 研究目标将是（a）使用混合方法方法在40位变性妇女中获取形成性数据 将有助于适应和开发适应的文化量身定制的SBIRT干预措施（SBIRT-A），（b）预测试和完善 基于形成性工作的15名变性妇女的sbirt-a和（c）试验测试Sbirt-a在76个跨性别样本中 评估可行性和可接受性。试点设计：76名成年人（18岁以上）HIV未感染的随机试验 跨性别妇女患有中等风险患药物使用障碍的妇女将被随机分为sbirt-a 或控制条件（INFO-C）。 Info-C组将是一个时间匹配的比较控制 可以通过印刷和视听研究材料以非床格式提供药物使用和准备服务。那里 将是在基线三个月后的后续访问，以评估联系，以及障碍和促进者，以底物使用 服务和准备/NPEP。分析：将使用双变量差异测试（CHI正方形和t检验）来测试差异 在SBIRT-A和Info-C参与者之间进行主要结果指标（与药物使用服务的联系，PREP，PREP， 和NPEP）在3个月的访问中。多元二进制逻辑回归（后和干预后）将用于 在过去三个月中确定物质使用作为（1）HIV/STI筛查的预测因子，以及（2＆3）PREP和NPEP 在过去三个月中的吸收。意义：这项研究得出的结果将有助于阐明 跨性别妇女（包括Twoc）在佛罗里达州的跨性别妇女中使用和艾滋病毒，并将提供证据 可以测试SBIRT-A效率以降低药物滥用和HIV的效率的大型研究 人口。这项研究的目的与NIH/NIDA战略计划平行，以减少艾滋病毒/艾滋病的健康分布， 防止艾滋病毒传播，并更好地了解药物滥用和艾滋病毒/艾滋病的相互作用。