PrEP Engagement Trajectories Among Transgender Women in the United States

美国跨性别女性的 PrEP 参与轨迹

• 批准号: 10461799
• 负责人: Erin Eileen Cooney
• 金额: $ 4.4万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2023-05-19
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10461799
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Adherence; Advanced Development; American; Americas; Behavioral; Behavioral Sciences; Belief; Black Populations; Black race; Cohort Studies; Data; Development; Diagnosis; Distal; Enrollment; Epidemic; Fellowship; Future; Geography; Goals; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Healthcare; Heterogeneity; High Prevalence; Hormones; Incidence; Infection; Infrastructure; Intervention; Interview; LGBT Health; Latina; Latinx population; Link; Logistic Regressions; Longitudinal Surveys; Longitudinal cohort; Marketing; Medical; Mentors; Mentorship; Methodology; Methods; Modality; Modeling; National Institute of Mental Health; Nature; Oral; Parents; Pathway Analysis; Pattern; Persons; Population; Poverty; Prevalence; Public Health Schools; Recommendation; Reporting; Research; Research Personnel; Research Priority; Research Training; Risk; Risk Factors; Sample Size; Sampling; Shoulder; Site; Strategic Planning; System; Tenofovir; Time; Tissues; Training; Transportation; United States; United States National Institutes of Health; Variant; base; cohort; data infrastructure; demographics; design; doctoral student; experience; follow-up; health care service; housing instability; innovation; pre-exposure prophylaxis; prevent; prospective; rectal; secondary analysis; skill acquisition; social stigma; socioeconomics; tool; training opportunity; transgender women; transphobia; uptake; women of color

PROJECT SUMMARY/ABSTRACT Background: Transgender women (TW) shoulder the highest prevalence of HIV compared to other key populations in the epidemic with 14% of all TW in the United States (US) living with HIV. HIV pre-exposure prophylaxis (PrEP) has been available in the US since 2012 yet uptake has been slow and challenges related to adherence have emerged. A comprehensive understanding of the socioeconomic, behavioral and systems factors that contribute to PrEP uptake, adherence and persistence among TW will illuminate potential mechanisms for optimizing PrEP engagement and reducing HIV incidence. Study Goal and Aims: This study will identify factors that will optimize PrEP uptake, adherence and persistence among transgender women at risk for HIV acquisition in the United States. Specific aims are to: 1) Identify groups of TW with distinct longitudinal PrEP engagement trajectories; 2) Examine associations between membership in each PrEP engagement group with demographic, socioeconomic, behavioral and systems indicators; and 3) Develop a model for the mechanisms by which socioeconomic, behavioral and systems factors impact TW's PrEP engagement trajectories. Approach: This explanatory, sequential mixed-methods study will leverage the data and infrastructure of an existing parent study, which has established a longitudinal cohort of 1,215 TW at risk of HIV acquisition in the United States. Aims 1 and 2 will be secondary analyses of longitudinal survey data collected by the parent study. Aim 1 will utilize group-based trajectory modeling, an extension of latent class analysis appropriate for longitudinal data, to identify groups of TW who follow similar patterns of PrEP uptake, adherence and persistence over 24-months of follow-up. Aim 2 will use multinomial logistic regression to identify factors associated with membership in each PrEP trajectory group identified in Aim 1. Building on findings from Aims 1 and 2, Aim 3 will qualitatively explore the mechanisms by which socioeconomic, behavioral and systems factors impact TW's PrEP engagement trajectories through in-depth interviews with TW and stakeholders. Findings will be triangulated to develop a more nuanced understanding of this important topic. Fellowship Information: The proposed research is the doctoral dissertation of Ms. Erin Cooney, PhD student at Johns Hopkins Bloomberg School of Public Health. The training is mentored by experts in HIV prevention including one Sponsor, two Co-sponsors, and two Scientific Advisors with complementary methodological and topical expertise. The training plan outlines formal coursework, ongoing mentorship, research implementation, and other advanced training opportunities to prepare Ms. Cooney to become a leading independent researcher in HIV prevention. The proposed study directly aligns with the NIMH's Division of AIDS Research priorities of expanding approaches to integrate behavioral science with effective biomedical strategies for HIV prevention.

项目总结/摘要 背景：与其他关键人群相比，跨性别女性（TW）的艾滋病毒感染率最高 艾滋病毒感染者占美国（US）所有TW的14%。HIV暴露前 自2012年以来，预防性治疗（PrEP）已在美国上市，但采用速度缓慢， 出现了一个新的趋势。全面了解社会经济，行为和系统 有助于TW中PrEP摄取、依从性和持久性的因素将阐明 优化PrEP参与和降低HIV发病率的机制。 研究目标和目的：本研究将确定优化PrEP摄取、依从性和 在美国，有感染艾滋病毒风险的变性妇女中持续存在。具体目标是：1） 识别具有不同纵向PrEP参与轨迹的TW组; 2）检查关联 在每个PrEP参与组的成员之间， 系统指标;以及3）制定一个机制模型， 系统因素影响TW的PrEP参与轨迹。 方法：这项解释性的、顺序的混合方法研究将利用数据和基础设施 现有的母研究，该研究建立了一个纵向队列，其中有1，215 TW存在艾滋病毒感染风险， 美国的目的1和2是对母公司收集的纵向调查数据进行二次分析 study.目标1将利用基于组的轨迹建模，这是潜在类分析的扩展，适用于 纵向数据，以确定遵循类似PrEP摄取模式的TW组，坚持和 持续24个月的随访。目标2将使用多项逻辑回归来确定因素 与目标1中确定的每个PrEP轨迹组的成员资格相关。以目标1的调查结果为基础 目标3将定性地探索社会经济、行为和系统 通过与TW和利益相关者的深入访谈，了解影响TW PrEP参与轨迹的因素。 调查结果将进行三角分析，以更细致地了解这一重要主题。 奖学金信息：拟议的研究是博士生Erin Cooney女士的博士论文 在约翰霍普金斯布隆伯格公共卫生学院。培训由艾滋病毒预防专家指导 包括一名申办者、两名共同申办者和两名科学顾问， 专题知识。培训计划概述了正式的课程，正在进行的指导，研究实施， 以及其他高级培训机会，为库尼女士成为领先的独立研究员做好准备 艾滋病预防。这项拟议的研究直接符合NIMH艾滋病研究部门的优先事项， 扩大方法，将行为科学与有效的预防艾滋病毒的生物医学战略相结合。

项目成果

"A slap in the face": Institutional betrayal, burnout, and career choice regret among frontline health care workers serving COVID-19 patients.

“一记耳光”：为COVID-19患者服务的一线医护人员的制度背叛、倦怠和职业选择遗憾。

• DOI: 10.1002/jts.22967
• 发表时间: 2023
• 期刊: Journal of traumatic stress
• 影响因子: 3.3
• 作者: Park,Soim;Closser,Svea;Cooney,ErinE;Atkins,Kaitlyn;Thrul,Johannes;McDonald,KathrynM;Langhinrichsen-Rohling,Jennifer;Veenema,TenerGoodwin
• 通讯作者: Veenema,TenerGoodwin

Betrayal-Based Moral Injury and Mental Health Problems Among Healthcare and Hospital Workers Serving COVID-19 Patients.

为 COVID-19 患者提供服务的医疗保健和医院工作人员中基于背叛的道德伤害和心理健康问题。

• DOI: 10.1080/15299732.2023.2289195
• 发表时间: 2024
• 期刊: Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD)
• 作者: Park,Soim;Thrul,Johannes;Cooney,ErinE;Atkins,Kaitlyn;Kalb,LutherG;Closser,Svea;McDonald,KathrynM;Schneider-Firestone,Sarah;Surkan,PamelaJ;Rushton,CyndaH;Langhinrichsen-Rohling,Jennifer;Veenema,TenerG
• 通讯作者: Veenema,TenerG

Understanding the social and structural context of oral PrEP delivery: an ethnography exploring barriers and facilitators impacting transgender women who engage in street-based sex work in Baltimore, Maryland.

• DOI: 10.1186/s12981-023-00556-6
• 发表时间: 2023-09-20
• 期刊: AIDS research and therapy
• 影响因子: 2.2