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.

跨性别者（“跨性别”）妇女（即具有女性和/或女性认同的人 男性出生时）是美国和全球遭受艾滋病毒最高风险的人群之一。中的一个 跨性别妇女之间艾滋病毒传播的最持续报道的环境是在主要伙伴关系内 与非转变男性。尽管主要伙伴关系在预防艾滋病毒方面至关重要，但 绝大多数艾滋病毒预防研究和针对跨性别妇女的干预措施是个人聚焦的。为了 在过去的10年中，我们进行了研究以确定减少艾滋病毒传播的干预目标 在跨性别妇女及其男性伴侣中，使用定性，调查和干预适应 方法（R01DA018621; R34MH093232）。基于我们对的概念和经验理解 在这些夫妇中，艾滋病毒传播风险，我们最近开发并试点测试了第一个已知的夫妇 - 基于跨性别女性及其男性主要伴侣二元组的基于艾滋病毒的预防干预（称为“夫妻艾滋病毒） 干预计划”；芯片），可行，可接受且产生了重大减少性的降低 与对照组相比，风险行为。根据我们非常成功的R34发现，我们建议测试 大规模随机对照试验（RCT）中芯片计划的效率降低了艾滋病毒风险 血清符号负面和血清旁夫妇。我们将注册大致多样化的跨性别妇女及其 男性伴侣并将夫妻随机与CHIP干预或增强的护理标准（SOC） 控制条件。夫妻将在每季度进行12个月以上。研究结果的分析将利用 个体和二元级数据。我们的主要结果是艾滋病毒风险的综合度量 传播包括验证的艾滋病毒风险行为指标以及生物医学确认 病毒抑制和依从性。 CHIP干预是建立在多年的形成性工作的基础上的 人际关系和社会因素作为跨性别妇女及其男性之间的艾滋病毒风险行为的机制 合作伙伴。如果与增强的SOC控制条件相比，芯片干预表现出效率， 将支持在艾滋病毒预防和护理环境中实施这种方法，以减少 艾滋病毒传播和获取的一些最高优先级艾滋病毒预防人群之间的差异。