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.

项目概要 有色人种跨性别女性在各种情况下遭受暴力，包括来自伴侣、 陌生人、执法部门、医疗保健提供者以及公共场所的暴力行为始终存在。 与艾滋病毒传播风险有关，并通过慢性压力等途径避免艾滋病毒预防服务， 创伤后应激障碍（PTSD）症状和药物滥用这些流行病是同时存在的。 相辅相成，构成一种“共病”或协同相互作用，有助于记录 在密歇根州底特律，有色人种跨性别女性是艾滋病毒预防连续体成果中的不平等现象之一。 艾滋病毒“高危”群体，在持续参与艾滋病毒预防服务方面存在显着差异。 对于这个 R21 探索性/开发性研究应用，我们建议调整、集成和试点测试 与文化相关、以证据为基础、基于创伤的暴力预防干预措施，以改善艾滋病毒预防 在 ADAPT-ITT 模型的指导下，我们的首要目标是进行系统的适应。 三种干预措施并将这些组成部分整合到创伤知情的组合预防中 对 TWOC 进行干预，重点关注艾滋病毒预防连续体成果，通过访谈 我们的社区咨询委员会由有色人种跨性别女性和主要利益相关者组成。 有色人种跨性别女性将审查所有改编材料。第二个目标旨在审查可行性和可行性。 单臂飞行员的​​创伤知情联合预防干预的可接受性以及后续行动 干预后立即和 3 个月的主要成果是艾滋病毒预防连续性的改善。 该项目还寻求收集心理健康和药物使用方面的结果和次要结果。 来自单臂试点参与者的定性数据，用于确定克服实施障碍的策略 针对有色人种跨性别女性的严格随机对照试验研究设计将提供以下结果。 为后续大规模临床试验中社区参与的功效试验奠定必要的基础。