Strengthening community responses to economic vulnerability and HIV inequities

摘要 在美国，有色人种的跨性别女性（“transwomen of color”）经历着周期性的、连锁的、 根源于种族主义和跨性别恐惧症的结构性和体制性压迫制度， 易损性.种族主义、跨性别恐惧症和经济脆弱性交织在一起， 这导致了有色人种跨性别女性中艾滋病毒的极端不平等。微观经济干预-设计 通过增加创收和获得财政资源的机会，改善财政状况， 创业、现金转移和培训--有可能解决艾滋病毒的结构性因素 风险在过去的几年里，几个由跨性别者领导的组织，包括跨性别者色彩项目， 综合微观经济战略，特别是紧急援助（即，无条件现金赠款） 他们的编程。基于我们在底特律的形成性工作，该项目旨在适应和研究 旨在预防艾滋病毒的强化微观经济干预措施的可接受性和可行性 和护理连续性结果。加强微观经济干预建立在我们的社区合作伙伴的基础上， 现有的微观经济干预措施，包括：（1）紧急援助;（2）同行和法律的 支持获得法律的性别平等确认（即，身份证件上的法律的姓名和性别标记）。 现有的干预措施将得到加强，以包括：（1）每周一次的经济和社会问题教育会议; 授权（即，就业机会、通过微型企业创收和金融知识）和艾滋病毒 预防和护理;（2）以就业为重点的辅导;（3）每周在社交媒体上发布职位空缺， 底特律;（4）无条件赠款（1,200美元），用于获得自我领导或正式就业。我们 由有色人种跨性别妇女组成的社区咨询委员会将提供持续的咨询。拟议 研究计划直接符合性和性别少数群体健康的优先次序 差距研究和结束艾滋病毒流行病（EHE）倡议，以及NIH的优先领域， 降低艾滋病毒感染率。调查结果将为检查干预效果提供必要的基础， 在未来的实施过程中，进行大规模的试验。

ABSTRACT In the United States, transgender women of color (`trans women of color') experience cyclical, interlocking systems of structural and institutional oppression rooted in racism and transphobia, which fuel economic vulnerability. Together, cycles of intersecting racism, transphobia, and economic vulnerability create conditions that give rise to extreme HIV inequities among trans women of color. Microeconomic interventions – designed to improve financial standing by increasing income generation and access to financial resources through entrepreneurship, cash transfers, and training — have the potential to address structural factors underlying HIV risk. Over the past few years, several trans-led organizations, including the Trans Sistas of Color Project, have integrated microeconomic strategies, specifically emergency assistance (i.e., unconditional cash grants) into their programming. Building on our formative work in Detroit, this project seeks to adapt and examine the acceptability and feasibility of an enhanced microeconomic intervention designed to address HIV prevention and care continua outcomes. The enhanced microeconomic intervention builds on our community partner's existing microeconomic interventions, which includes: (1) an emergency assistance; and (2) peer and legal support to obtain legal gender affirmation (i.e., legal name and gender markers on identification documents). The existing intervention will be enhanced to include (1) weekly educational sessions on economic empowerment (i.e., job acquisition, income generation through micro-business, and financial literacy) and HIV prevention and care; (2) employment-focused mentoring; (3) weekly social media posts of job openings in Detroit; and (4) an unconditional grant ($1,200) for use towards acquiring self-led or formal employment. Our community advisory board composed of trans women of color will provide ongoing consultation. The proposed research plan is directly in line with the prioritization of sexual and gender minority communities for health disparities research and the Ending the HIV Epidemic (EHE) initiative, as well as NIH priority areas for reducing HIV incidence. Findings will provide the necessary groundwork to examine intervention efficacy and implementation processes in a future, large-scale trial.