Stigma Reduction and Gender Affirmation to Promote HIV Prevention/Testing in Trans Women

减少耻辱和性别肯定以促进跨性别女性的艾滋病毒预防/检测

• 批准号: 10301119
• 负责人: DON OPERARIO
• 金额: $ 18.63万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-16 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10301119
• 关键词: AIDS prevention; Address; Advocate; Age; Alprostadil; Area; Behavioral; Caring; Characteristics; Choices and Control; Collaborations; Communities; Community Services; Continuity of Patient Care; Control Groups; Counseling; Data; Development; Enrollment; Ensure; Epidemic; Exploratory/Developmental Grant; Face; Focus Groups; Foundations; Future; Gender; Gender Identity; General Population; Goals; HIV; HIV Infections; HIV diagnosis; HIV risk; Health Educators; Health Services; Holistic Health; Human immunodeficiency virus test; Individual; Intervention; Intervention Studies; Interview; Lead; Learning; Link; Mediating; Medical; Methodology; Minority; Modeling; Motivation; Outcome; Participant; Phase; Philippines; Population; Prevention; Privacy; Procedures; Protocols documentation; Qualitative Research; Randomized; Research; Research Personnel; Resources; Risk; Risk Reduction; Role; Safety; Science; Series; Services; Sexual and Gender Minorities; Social Work; Stress; Test Result; Testing; Time; Training Support; Universities; arm; base; care outcomes; care systems; control trial; design; empowerment; experience; gender expression; gender minority; high risk; improved; intervention participants; low and middle-income countries; mHealth; meetings; minority communities; mobile application; peer; prevention service; primary outcome; programs; recruit; retention rate; secondary outcome; self diagnosis; self testing; social stigma; success; transgender; transgender women; transphobia; uptake; young adult

Project Summary This collaboration between University of the Philippines Manila (UPM) and Brown University responds to PAR-19-326 (Reducing Stigma to Improve HIV/AIDS Prevention, Treatment and Care in Low- and Middle- Income Countries) by proposing rigorous procedures to develop and pilot test a gender-affirmation and stigma- reduction intervention to promote HIV self-testing (HST), behavioral risk reduction, and use of relevant HIV prevention/care and gender-related services for transgender women (TW) in the Philippines. TW are a priority population for HIV intervention research in the Philippines, where one of the world’s fastest growing epidemic currently takes place. Gender-minority stigma is a critical barrier to engaging Filipina TW in HIV services, and gender-affirmative interventions can counteract anticipated and internalized gender-minority stigma in this population. Currently, there are few evidence-supported gender-affirmative interventions for addressing gender-minority stigma and meeting the unique needs of TW in LMICs generally, and in the Philippines particularly. Building on the Gender Minority Stress framework and Gender Affirmation Model, as well as our prior mHealth research using mobile apps for HIV prevention and testing, we will design a gender-affirmative app-based intervention (entitled “Lakambini”) delivered by TW peer health educators, who will offer empowerment and gender-affirmative support to engage TW in HST and provide necessary counseling, referrals, and support in navigating services. Our first specific aim is to conduct iterative phases of qualitative research to inform gender-affirmative HST counseling, referrals, and navigation support protocols to be delivered via existing mobile app-based platforms for Filipina TW with high HIV risk. Our second specific aim is to examine the feasibility, acceptability, safety, and preliminary changes on HIV self-testing (primary outcome) as well as secondary outcomes: linkage to HIV prevention or care services; behavioral risk reduction; engagement in other medical, social, or community services for TW. We will conduct quantitative assessments at baseline, 3-month, and 6-month follow-ups. We will conduct qualitative exit interviews with participants to identify areas for further intervention improvement and identify methodological and design characteristics for a future RCT to address gender-minority stigma, gender affirmation, and HIV outcomes among TW in this setting. This R21 Exploratory/Developmental grant will thus provide the empirical foundation for a subsequent R-series application for a full RCT. Our approach builds on and extends our team’s collaborative experience working with gender and sexual minority communities in the Philippines, and will invest in capacity development for researchers and transgender HIV professionals and advocates in the Philippines.

项目摘要 菲律宾马尼拉大学（UPM）与布朗大学之间的这种合作对 PAR-19-326（减少污名以改善艾滋病毒/艾滋病的预防，治疗和护理 收入国家）提出严格的程序来开发和试点测试性别肯定和污名 减少干预措施以促进艾滋病毒自我测试（HST），降低行为风险和使用相关艾滋病毒 菲律宾的跨性别妇女（TW）的预防/护理和性别相关服务。 TW是优先事项 菲律宾的艾滋病毒干预研究人口，世界上增长最快的流行病之一 目前发生。性别少数污名是使菲律宾TW参与艾滋病毒服务的关键障碍，并且 性别证明的干预措施可以抵消预期的和内在的性别最少的污名 人口。目前，几乎没有证据支持的性别支持的干预措施 性别最少的污名并满足TW的独特需求，在菲律宾和菲律宾 特别。建立在性别少数压力框架和性别肯定模型以及我们的基础上 先前使用移动应用程序进行艾滋病毒预防和测试的MHealth研究，我们将设计一个性别肯定的 TW PEER Health Eductister提供的基于应用程序的干预（标题为“ Lakambini”），他们将提供 授权和性别支持的支持，以参与HST并提供必要的咨询， 转介和导航服务的支持。我们的第一个具体目的是进行定性的迭代阶段 研究以告知性别肯定的HST咨询，推荐和导航支持方案的研究 通过现有的基于移动应用程序的平台，用于具有高艾滋病毒风险的菲律宾TW。我们的第二个具体目标是 检查艾滋病毒自我测试的可行性，可接受性，安全性和初步变化（主要结果） 以及次要结果：与艾滋病毒预防或护理服务的联系；降低行为风险； 参与TW的其他医疗，社会或社区服务。我们将进行定量评估 在基线，3个月和6个月的随访中。我们将对参与者进行定性退出访谈 确定进一步干预改进的区域，并确定一个方法论和设计特征 未来的RCT解决性别少数污名，性别肯定和TW中的HIV结果 环境。因此，此R21探索/发展赠款将为后续的经验基础提供经验基础 完整RCT的R系列应用程序。我们的方法基础并扩展了我们团队的协作经验 与菲律宾的性别和性少数民族社区合作，并将投资 菲律宾研究人员和跨性别艾滋病毒专业人员和倡导者的发展。