Harnessing the power of technology to develop a population-based HIV prevention program for trans girls

利用技术的力量为跨性别女孩制定基于人口的艾滋病毒预防计划

• 批准号: 10634678
• 负责人: Michele L. Ybarra
• 金额: $ 44.12万
• 依托单位: CENTER FOR INNOVATIVE PUBLIC HEALTH RESEARCH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-08 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10634678
• 关键词: 18 year old; AIDS prevention; Address; Adolescence; Adolescent; Adoption; Advisory Committees; Affect; Area; Behavior; Behavioral; Centers for Disease Control and Prevention (U.S.); Clinical; Data; Decision Making; Disparate; Ensure; Feedback; Focus Groups; Fostering; Gender; Gender Identity; Gender Role; Goals; HIV; HIV Seropositivity; HIV risk; HIV/STD; Health Status; Individual; Intervention; Intervention Studies; Mental Health; Motivation; National Institute of Mental Health; Outcome; Outcome Measure; Population; Prevention program; Preventive; Property; Protocols documentation; Public Health; Research; Research Project Grants; Resources; Risk; Risk Reduction; Sampling; Sexual Partners; Technology; Teenagers; Testing; Text Messaging; Textiles; Time; Treatment outcome; United States; Youth; acceptability and feasibility; behavioral outcome; cisgender; cost; cost effective; deafening; evidence base; experience; fluidity; follow-up; gender affirmation; gender affirming hormone therapy; gender minority; gender minority group; girls; health disparity; healthy sexuality; high risk sexual behavior; hormone therapy; improved; intersectionality; male; member; population based; pre-exposure prophylaxis; programs; recruit; response; scale up; sex; sexual minority boys; skills; social; transgender; transgender women; transphobia; uptake

Estimates suggest that one in five transgender girls may be HIV positive In the face of this health disparity, the near-complete absence of gender-inclusive healthy sexuality programs is deafening. To address the lack of gender inclusive HIV prevention programming, we propose to develop and test #TranscendentHealth. Content will focus on providing girls with a panoply of risk reduction strategies, including frequent HIV/STI testing and initiating PrEP, so that they can choose options that fit best for them. Messaging will be gender affirming while increasing one’s HIV preventive information, motivation, and behavioral skills. Content will foster pride in girls’ gender identity and reduce internalized transphobia they may be experiencing. We will harness the reach and wide adoption of text messaging among youth to deliver intervention content. This national reach will increase its generalizability and translational properties. In response to RFA-OD-19-029, this proposal addresses NIMH’s high priority area of research: Intervention research to improve HIV prevention and treatment outcomes for transgender individuals that focuses on the influences of sex and gender (Strategic Goal 1.3). Specifically, we aim to: Specific Aim 1: Explore how the intersectionality of sex and gender inform the sexual decision making of transgirls 14-18 years of age (n=80). Little is known about how transgirls decide when and with whom to have sex or not, as well as how their understanding of their gender within the context of their sex influences their sexual decision-making. To explore these issues, we will conduct online focus groups. Specific Aim 2: Iteratively develop #TranscendentHealth, a gender inclusive HIV prevention program for transgirls, with ongoing input from transgirls (n=35). We will integrate findings from the focus groups into content tailored to the lived experiences of transgirls 14-18 years of age. To ensure that the messaging is affirming and acceptable, we then will conduct Content Advisory Teams (CATs), and then t a beta test to confirm the protocol. Specific Aim 3: Test the #TranscendentHealth HIV prevention program with transgirls 14-18 years of age across the United States (n=200). Our main outcome measures will be feasibility and acceptability. Behavioral outcomes will be exploratory and include those on the HIV prevention continuum41: 1) acceptability of, 2) motivation for, and 3) uptake of PrEP, if clinically indicated; and 3) HIV/STI testing and receipt of results at 3-month follow-up. Photo-verified testing also will be explored. Specific Aim 4: Understand how the intersectionality of sex and gender impact the intervention experience. We will examine whether transgirls who are undergoing gender affirming hormone therapy, have internalized transphobia, and different gender identities experience the intervention differently than other gender minority teens.

据估计，五分之一的跨性别女孩可能感染艾滋病毒 差距，几乎完全缺乏性别包容的健康性行为计划，这一点令人震惊。 由于缺乏性别包容性艾滋病毒预防规划，我们建议制定和测试 #TranscendentHealth。内容将侧重于为女孩提供一整套降低风险的策略，包括 频繁的 HIV/STI 检测并启动 PrEP，以便他们可以选择最适合自己的选项。 将肯定性别，同时增加一个人的艾滋病毒预防信息、动机和行为技能。 内容将培养女孩对性别认同的自豪感，并减少她们可能经历的内在跨性别恐惧症。 我们将利用短信在年轻人中的影响力和广泛采用来提供干预内容。 这种全国性的影响力将提高其普遍性和转化性。 作为对 RFA-OD-19-029 的回应，该提案涉及 NIMH 的高优先级研究领域： 旨在改善跨性别者艾滋病毒预防和治疗结果的干预研究 重点关注性和性别的影响（战略目标 1.3）。 具体目标 1：探索性别和性别的交叉性如何影响性决定 关于 14-18 岁变性女孩（n=80）的形成，人们对变性女孩如何决定何时以及与谁一起知之甚少。 与谁发生性关系，以及他们在性别背景下如何理解自己的性别 为了探讨这些问题，我们将开展在线焦点小组活动。 具体目标 2：迭代开发#TranscendentHealth，一种性别包容的艾滋病毒预防方法 跨性别女孩计划，以及跨性别女孩（n = 35）的持续投入，我们将整合重点调查结果。 小组融入适合 14-18 岁变性女孩生活经历的内容，以确保 如果消息是肯定且可以接受的，我们将组建内容咨询团队 (CAT)，然后 Beta 测试以确认协议。 具体目标 3：针对 14-18 岁变性女孩测试 #TranscendentHealth 艾滋病毒预防计划 美国各地的年龄（n=200）。我们的主要成果指标将是可行性和 行为结果将是探索性的，包括艾滋病毒预防连续体中的结果41：1) 2) 动机和 3) 接受 PrEP（如果有临床指征）和 3) HIV/STI 检测的可接受性； 还将探讨在 3 个月的随访中收到经过照片验证的测试结果。 具体目标 4：了解性别和社会性别的交叉性如何影响干预措施 我们将检查正在接受性别肯定激素治疗的变性女孩是否有这种经历。 内化的跨性别恐惧症，不同的性别认同所经历的干预措施与其他人不同 性别少数青少年。