A couples-based approach to HIV prevention for transgender women and their male partners

针对跨性别女性及其男性伴侣的基于夫妇的艾滋病毒预防方法

• 批准号: 10170430
• 负责人: Kristi E Gamarel
• 金额: $ 58.54万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-15 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10170430
• 关键词: AIDS prevention; Address; Adherence; Adult; Affect; Anus; Behavioral; Biological; Birth; Blood; Caring; Categories; Centers for Disease Control and Prevention (U.S.); Communication; Communities; Consultations; Control Groups; Couples; Cultural Sensitivity; Data; Enrollment; Evidence based intervention; Feedback; Female; Feminine; Gays; Gender; Gender Identity; Gender Sensitivity; Goals; Grant; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV diagnosis; HIV risk; Health behavior; Heterosexuals; Human immunodeficiency virus test; Individual; Intervention; Joints; Measures; Mediation; Mediator of activation protein; Methodology; Minority; Modeling; Outcome; Outcome Study; Participant; Population; Prevalence; Prevention program; Prevention strategy; Problem Solving; Randomized; Randomized Controlled Trials; Reporting; Research; Research Personnel; Risk; Risk Behaviors; Risk Reduction; Science; Self Efficacy; Sex Behavior; Sexually Transmitted Diseases; Spottings; Stress; Structure; Surveys; Testing; Time; Treatment outcome; United States; Unsafe Sex; Vagina; Viral; Viral Load result; Work; antiretroviral therapy; arm; base; condoms; coping; disparity reduction; efficacy evaluation; efficacy testing; experience; follow-up; gender minority; high risk; intervention effect; intervention program; male; male couples; medication compliance; men who have sex with men; pre-exposure prophylaxis; prevention service; preventive intervention; primary outcome; programs; racial diversity; recruit; sex; sexual risk behavior; skills; social; social factors; social stigma; social structure; standard of care; theories; therapy adherence; transgender; transgender women; transmission process; uptake

Transgender (`trans') women (i.e., individuals with a feminine and/or female gender identity who were assigned male at birth) are among the populations at highest risk for HIV in the United States and worldwide. One of the most consistently reported contexts for HIV transmission among trans women is within a primary partnership with a non-transgender male. Despite the critical importance of primary partnerships for HIV prevention, the vast majority of HIV prevention studies and interventions for trans women have been individually-focused. For the past 10 years we have conducted research to identify intervention targets for reducing HIV transmission among trans women and their male partners using qualitative, survey, and intervention adaptation methodologies (R01DA018621; R34MH093232). Based on our conceptual and empirical understandings of HIV transmission risks among these couples, we recently developed and pilot tested the first known couples- based HIV prevention intervention for trans women and their male primary partner dyads (called “Couples HIV Intervention Program”; CHIP), which was feasible, acceptable, and produced significant reductions in sexual risk behavior compared to the control group. Based on our highly successful R34 findings, we propose to test the efficacy of the CHIP program in large-scale randomized controlled trial (RCT) to reduce HIV risk among seroconcordant negative and serodiscordant couples. We will enroll racially diverse trans women and their male partners and randomize couples to either the CHIP intervention or an enhanced standard of care (SOC) control condition. Couples will be followed quarterly over 12-months. Analysis of study outcomes will utilize both individual- and dyadic-level data. Our primary outcome is a composite measure of risk for HIV transmission which encompasses validated behavioral indicators of HIV risk as well as biomedical confirmation of viral suppression and PrEP adherence. The CHIP intervention builds on years of formative work that targets interpersonal and social factors as mechanisms of HIV risk behavior among trans women and their male partners. If the CHIP intervention demonstrates efficacy in comparison to an enhanced SOC control condition, there will be support for implementing this approach within HIV prevention and care settings in order to reduce disparities in HIV transmission and acquisition among some of the highest priority HIV prevention populations.

跨性别（“trans”）女性（即具有女性和/或女性性别认同并被分配 出生时为男性）是美国和全世界感染艾滋病毒风险最高的人群之一。中的一个 最一致报告的跨性别女性艾滋病毒传播背景是在主要伙伴关系中 与非跨性别男性。尽管主要伙伴关系对于预防艾滋病毒至关重要，但 绝大多数针对跨性别女性的艾滋病毒预防研究和干预措施都是针对个人的。为了 在过去的 10 年里，我们进行了研究，以确定减少艾滋病毒传播的干预目标 使用定性、调查和干预适应方法对跨性别女性及其男性伴侣进行调查 方法（R01DA018621；R34MH093232）。基于我们的概念和经验理解 这些夫妇之间存在艾滋病毒传播风险，我们最近开发并试点测试了第一对已知夫妇 - 针对跨性别女性及其男性主要伴侣二人组（称为“夫妻艾滋病毒 干预计划”；CHIP），这是可行的、可接受的，并且显着减少了性行为 与对照组相比的危险行为。基于我们非常成功的 R34 发现，我们建议测试 CHIP 计划在大规模随机对照试验 (RCT) 中对降低 HIV 风险的有效性 血清一致阴性和血清不一致对。我们将招收不同种族的跨性别女性及其她们 男性伴侣并随机分配夫妇接受 CHIP 干预或增强护理标准 (SOC) 控制条件。夫妻双方将在 12 个月内每季度接受一次随访。研究结果分析将利用 个人和二元级别的数据。我们的主要结果是艾滋病毒风险的综合衡量标准 传播，包括经过验证的艾滋病毒风险行为指标以及生物医学确认 病毒抑制和 PrEP 依从性。 CHIP 干预措施建立在多年的形成性工作的基础上，其目标是 人际关系和社会因素作为跨性别女性及其男性艾滋病毒危险行为的机制 合作伙伴。如果 CHIP 干预与增强的 SOC 控制条件相比显示出有效性， 将支持在艾滋病毒预防和护理机构中实施这一方法，以减少 一些最优先的艾滋病毒预防人群中艾滋病毒传播和感染的差异。