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American Cohort to Study HIV Acquisition among Transgender Women in High Risk Areas

美国队列研究高风险地区跨性别女性的艾滋病毒感染情况

基本信息

批准号：
10405712
负责人：
Sari Reisner
金额：
$ 39.85万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-23 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10405712
关键词：
AIDS prevention AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adherence Affect American Ancillary Study Area Baltimore Behavioral Biological Blood Boston Caring Cohort Studies Collection Continuity of Patient Care Country Cross-Sectional Studies Data Development Eligibility Determination Enrollment Environment Epidemic Epidemiology Exposure to Funding Future General Population Guidelines HIV HIV Infections HIV risk Health Health Services High Prevalence Hormone use Incidence Individual Infrastructure Intervention Intervention Studies Laboratories Longitudinal cohort Measures Mental Health Meta-Analysis Methods New York City Outcome Participant Patient Self-Report Phase Population Population Intervention Populations at Risk Prevalence Prevention Prevention Research Principal Investigator Productivity Prospective cohort Research Research Priority Risk Risk Factors Sample Size Sampling Sampling Biases Site Specimen Subgroup Technology Testing Time United States United States National Institutes of Health Validation Viral Load result Visit Washington Woman base behavioral health biobehavior care systems cohort comparison group design evidence base follow-up high risk improved men who have sex with men metropolitan new technology physical conditioning placebo group pre-exposure prophylaxis prevent prevention service preventive intervention prospective racial and ethnic recruit response screening self testing social social structure socioeconomics success testing services transgender women transmission process trend

项目摘要

Abstract: In the United States (U.S.), transgender women (TW) are one of the populations most affected by HIV infection. The high prevalence of HIV infection among U.S. TW is driven by, and/or concomitant with, structural barriers that limit access to HIV prevention, care, and health services. Despite an emergence of research to characterize the HIV epidemic among TW, the majority of studies are cross-sectional designs and typically include small sample sizes, often subsuming TW among broader risk groups, such as men who have sex with men. These practices have thwarted identification of acceptable, effective recruitment and study methods for use among TW and prevented temporal assessment, causal inference, and generalizability of study findings to the TW population. To date, there is no robust estimate of HIV incidence and no intervention with evidence of efficacy for the prevention of HIV acquisition among TW. The proposed American Cohort study will address these limitations by establishing a multi-site, longitudinal cohort of TW spanning eastern and southern U.S. (Boston, New York City, Baltimore-Washington, Atlanta, and Miami metropolitan areas) to characterize HIV incidence and risk factors for HIV acquisition, access to biobehavioral HIV prevention methods, and linkage to care for those who HIV seroconvert. The cohort will include a racially/ethnically and culturally diverse sample of TW, supported by the use of technology-infused recruitment and retention methods. The specific aims are: 1) To determine the efficiency and acceptability of novel, technology-infused recruitment methods to enroll HIV- uninfected TW into a prospective cohort. 2) To describe the demographic, socioeconomic, behavioral, and physical and mental health profiles of HIV-uninfected TW in the first, multi-site cohort of TW in the eastern and southern U.S. 3) To estimate HIV incidence among TW in high-risk eastern and southern U.S. areas, trends in incidence, and associated individual, social, and structural risk factors. 4) To estimate the HIV Prevention Continuum among HIV-uninfected participants, and the HIV Care Continuum among newly HIV-infected TW. To achieve these aims we will recruit 1,750 TW who will be enrolled in either a HIV-uninfected cohort or an HIV-infected cross-sectional comparison group. These data will be used to assess differences between cohort participants and the wider population and for cross-sectional incidence estimation at enrollment. The HIV- uninfected cohort will be followed for at least 24 months to estimate HIV incidence, trends, and risk factors for HIV acquisition. Cohort participants who seroconvert will be followed for an additional 6 months to assess prospective engagement in the HIV Care Continuum. Study findings will provide critical epidemiologic parameters for future HIV prevention research among TW, provide a platform upon which other research questions can be explored, and inform the development of evidence-based and acceptable HIV interventions to reduce HIV acquisition among TW in the U.S.

文摘: