Strengthening community responses to economic vulnerability and HIV inequities

摘要 在美国，有色人种的跨性别者女性(“有色人种跨性别者女性”)经历着周期性的、连锁的 根植于种族主义和跨性别恐惧症的结构性和制度性压迫制度，助长了经济 脆弱性。种族主义、跨性别恐惧症和经济脆弱性交织在一起的循环共同创造了条件 这在有色人种变性妇女中造成了极端的艾滋病毒不平等。微观经济干预--设计 通过以下途径增加创收和获得财政资源，以改善财务状况 创业、现金转移和培训--有可能解决导致艾滋病毒的结构性因素 风险。在过去的几年里，几个跨性别领导的组织，包括跨色彩西斯塔项目， 综合微观经济战略，特别是紧急援助(即无条件现金赠款) 他们的程序。建立在我们在底特律的形成工作的基础上，该项目寻求适应和检查 加强旨在预防艾滋病毒的微观经济干预措施的可接受性和可行性 并关心持续的结果。增强的微观经济干预建立在我们社区合作伙伴的 现有的微观经济干预措施，包括：(1)紧急援助；(2)同行和法律 支持获得合法的性别确认(即身份证件上的法律名称和性别标志)。 现有的干预措施将得到加强，包括(1)每周举行一次关于经济问题的教育会议 赋权(即就业、通过微型企业创收和金融知识)和艾滋病毒 预防和护理；(2)以就业为重点的指导；(3)每周在社交媒体上发布#年职位空缺 底特律；以及(4)无条件赠款(1,200美元)，用于获得自我领导或正式就业。我们的 由有色人种妇女组成的社区咨询委员会将提供持续的咨询。建议数 研究计划直接与性少数群体和性别少数群体的健康优先顺序一致 差异研究和结束艾滋病毒流行(EHE)倡议，以及NIH的优先领域 减少艾滋病毒的发病率。调查结果将提供必要的基础，以检查干预效果和 实施过程将在未来进行大规模试验。

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.