Strengthening community responses to economic vulnerability and HIV inequities

加强社区应对经济脆弱性和艾滋病毒不平等问题的对策

• 批准号: 10625694
• 负责人: Kristi E Gamarel
• 金额: $ 25万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-20 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10625694
• 关键词: AIDS prevention; Address; Adherence; Area; Benchmarking; Black race; Black, Indigenous, People of Color; Businesses; Caring; Color; Communities; Consultations; Continuity of Patient Care; Data; Data Collection; Economics; Education; Emergency Situation; Employment; Ensure; Entrepreneurship; Epidemic; Funding; Future; Gender; Generations; Goals; Grant; HIV; HIV disparities; HIV risk; Health Disparities Research; Health Personnel; Homelessness; Housing; Human immunodeficiency virus test; Incidence; Income; Indigenous; Inequity; Institution; Institutional Racism; Intervention; Interview; Latina; Legal; Manuals; Measures; Mentors; Michigan; Modeling; Names; Occupations; Outcome; Participant; Persons; Phase; Poverty; Prevalence; Public Health; Race; Randomized; Randomized, Controlled Trials; Reporting; Research; Resources; Respondent; Sexual and Gender Minorities; Surveys; System; Training; Treatment Efficacy; United States; United States National Institutes of Health; Viral; Work; acceptability and feasibility; aged; antiretroviral therapy; arm; care outcomes; cisgender; community center; comparison intervention; efficacy trial; empowerment; epidemic preparedness; ethnic disparity; experience; financial literacy; follow-up; food insecurity; gender affirmation; gender minority community; housing instability; implementation process; improved; information gathering; intervention refinement; peer; pilot test; post intervention; pre-exposure prophylaxis; programs; public health relevance; racism; recruit; response; retention rate; social media; social structure; structural determinants; therapy design; transgender women; transphobia; treatment as usual; uptake; women of color

ABSTRACT In the United States, transgender women of color (`trans women of color') experience cyclical, interlocking systems of structural and institutional oppression rooted in racism and transphobia, which fuel economic vulnerability. Together, cycles of intersecting racism, transphobia, and economic vulnerability create conditions that give rise to extreme HIV inequities among trans women of color. Microeconomic interventions – designed to improve financial standing by increasing income generation and access to financial resources through entrepreneurship, cash transfers, and training — have the potential to address structural factors underlying HIV risk. Over the past few years, several trans-led organizations, including the Trans Sistas of Color Project, have integrated microeconomic strategies, specifically emergency assistance (i.e., unconditional cash grants) into their programming. Building on our formative work in Detroit, this project seeks to adapt and examine the acceptability and feasibility of an enhanced microeconomic intervention designed to address HIV prevention and care continua outcomes. The enhanced microeconomic intervention builds on our community partner's existing microeconomic interventions, which includes: (1) an emergency assistance; and (2) peer and legal support to obtain legal gender affirmation (i.e., legal name and gender markers on identification documents). The existing intervention will be enhanced to include (1) weekly educational sessions on economic empowerment (i.e., job acquisition, income generation through micro-business, and financial literacy) and HIV prevention and care; (2) employment-focused mentoring; (3) weekly social media posts of job openings in Detroit; and (4) an unconditional grant ($1,200) for use towards acquiring self-led or formal employment. Our community advisory board composed of trans women of color will provide ongoing consultation. The proposed research plan is directly in line with the prioritization of sexual and gender minority communities for health disparities research and the Ending the HIV Epidemic (EHE) initiative, as well as NIH priority areas for reducing HIV incidence. Findings will provide the necessary groundwork to examine intervention efficacy and implementation processes in a future, large-scale trial.

抽象的 在美国，跨性别有色人种女性（“跨性别有色人种女性”）经历着周期性、环环相扣的经历 根植于种族主义和跨性别者恐惧症的结构性和制度性压迫体系，助长了经济发展 种族主义、变性恐惧症和经济脆弱性的交叉循环共同创造了条件。 微观经济干预措施导致有色人种跨性别女性中出现极端的艾滋病毒不平等现象。 通过增加收入和获得财政资源来改善财务状况 创业、现金转移和培训——有可能解决艾滋病毒的结构性因素 在过去的几年里，包括 Trans Sistas of Color Project 在内的几个跨性别者领导的组织已经面临风险。 将微观经济战略，特别是紧急援助（即无条件现金补助）纳入 他们的规划以我们在底特律的形成工作为基础，旨在适应和检查 旨在解决艾滋病毒预防问题的强化微观经济干预措施的可接受性和可行性 增强的微观经济干预建立在我们社区合作伙伴的基础上。 现有的微观经济干预措施，包括：(1) 紧急援助；(2) 同行和法律援助； 支持获得合法的性别确认（即身份证件上的法定姓名和性别标记）。 现有的干预措施将得到加强，包括 (1) 每周一次的经济教育课程 赋权（即获得工作、通过微型企业创收和金融知识）和艾滋病毒 预防和护理；(2) 以就业为中心的指导；(3) 每周在社交媒体上发布职位空缺信息 底特律；(4) 无条件补助金（1,200 美元），用于获得自我领导或正式就业。 由有色人种跨性别女性组成的社区咨询委员会将提供持续的咨询。 研究计划直接符合性和性别少数社区的健康优先事项 差异研究和结束艾滋病毒流行 (EHE) 倡议，以及 NIH 的优先领域 研究结果将为检查干预效果和降低艾滋病毒发病率提供必要的基础。 未来大规模试验的实施过程。