Injection Practices and HIV Risk Behavior among Transgendered Persons in Pue

描述（由申请人提供）：艾滋病毒/艾滋病继续不成比例地影响拉丁裔社区，在美国有超过20万例病例归因于这一人群。生活在加勒比岛屿上的波多黎各人是拉丁美洲人中艾滋病毒流行率最高的人之一，这一模式与波多黎各日益严重的注射毒品流行病密切相关。虽然对波多黎各的静脉注射毒品做法进行了研究，但某些弱势群体和注射做法在很大程度上被忽视了。这项提案的重点是男变女的变性人（MTF-TG），他们通常没有出现在波多黎各产生的科学文献中，而且感染艾滋病毒的风险很高。除了MTF-TG嵌入在主要由注射毒品驱动的艾滋病毒流行病中之外，我们的初步研究表明，他们参与了涉及使用非法市场激素和硅胶注射的身体改造实践。我们的社区合作伙伴正在进行唯一的MTF-TG艾滋病毒预防干预，他们表示，这一人群的成员经常在“抽水派对”期间进行自我注射，以达到身体改造的目的，以及在吸毒期间。这些做法尚未得到科学研究，也没有对这一人群中注射的社会背景、意义和做法进行集中的描述性研究。因此，我们的研究旨在：（1）确定药物和激素注射在波多黎各变性社区的意义和做法;（2）描述和映射药物和激素注射在这一人群的社会背景;（3）记录药物，激素和硅胶注射的做法和艾滋病毒的风险之间的关系在波多黎各。我们将对32名理论上抽样的MTF-TG进行定性访谈;对MTF-TG中药物、硅胶和激素注射的社会背景进行人种学绘图;并对通过应答者驱动抽样（RDS）招募的96名MTF-TG进行调查。由美国国立卫生研究院资助的一组艾滋病毒/艾滋病研究人员领导，他们在这个文化区域有变性人和弱势群体的经验，这项研究将产生关于这个社区被忽视的风险做法的重要信息，并将提供它们发生的社会背景的详细描述。这将有助于指导今后的试点干预措施，以减少这一弱势群体中的艾滋病毒感染和高危吸毒及注射做法。

DESCRIPTION (provided by applicant): HIV/AIDS continues to affect the Latino community disproportionately, with more than 200,000 cases in the US attributed to this population. Puerto Ricans living on the Caribbean island have among the highest prevalence rates of HIV among Latinos, a pattern that is closely connected to the large and growing injecting drug epidemic in Puerto Rico. While intravenous drug injection practices have been studied in Puerto Rico, certain vulnerable populations and injection practices have been largely neglected. This proposal focuses on male-to-female transgendered persons (MTF-TG), who are generally absent from the scientific literature generated in Puerto Rico, and are at high risk of HIV infection. In addition to the fact that MTF-TG are embedded in an HIV epidemic that is mostly driven by injecting drug use, our preliminary studies show that they engage in body modification practices involving the use of illegal market hormone and silicone injections. Our community partners, who are conducting the only HIV prevention intervention with MTF-TG, indicate that members of this population often engage in self-injection practices during "pumping parties" for the purpose of body modification, as well as during drug use. These practices have not been scientifically studied, nor are there focused descriptive studies of the social context, meanings, and practices of injection in this population. Therefore, our study aims to: (1) identify the meanings and practices of drug and hormone injection in the transgendered community in Puerto Rico; (2) describe and map the social contexts of drug and hormone injection in this population; and (3) document the relationship between drug, hormone, and silicone injection practices and risk for HIV in Puerto Rico. We will conduct qualitative interviews with 32 theoretically sampled MTF-TG; ethnographic mapping of the social contexts of drug, silicone, and hormone injection among MTF- TG; and surveys with 96 MTF-TG recruited through respondent-driven sampling (RDS). Led by a team of NIH- funded HIV/AIDS researchers with experience with transgendered persons and vulnerable populations in this cultural region, the study will yield important information on risk practices that have been overlooked in this community and will provide detailed descriptions of the social contexts in which they occur. This will help guide future pilot interventions aimed at reducing HIV infection and high-risk drug use and injection practices in this vulnerable group.