Social Patterns and Pathways of HIV Care among HIV Positive Transgender Women

HIV 阳性跨性别女性的 HIV 护理社会模式和途径

• 批准号: 8510481
• 负责人: Dana Darnell Hines
• 金额: $ 3.73万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-03 至 2015-07-02
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8510481
• 关键词: Acquired Immunodeficiency Syndrome; Address; Affect; African American; Applications Grants; Area; Behavior; Biological; Bisexual; Caring; Centers for Disease Control and Prevention (U.S.); Cessation of life; Development; Diagnosis; Environmental Risk Factor; Event; Food; Foundations; Gays; Gender; General Population; HIV; Health; Health Professional; Healthcare; Healthcare Systems; Housing; Human immunodeficiency virus test; Individual; Inequality; Infection; Institute of Medicine (U.S.); Intervention; Knowledge; Lesbian; Life; Literature; Medical; Methods; Minority; Modeling; Morbidity - disease rate; Newly Diagnosed; Outcome; Outpatients; Pathway interactions; Patients; Pattern; Persons; Policies; Population; Prevalence; Prevalence Study; Prevention; Process; Prostitution; Provider; Psyche structure; Public Health; Recommendation; Reporting; Research; Research Personnel; Research Support; Role; Science; Social Development; Social Network; Solid; Structure; Support System; System; Time; United States; United States National Institutes of Health; Virus Diseases; Visit; Woman; behavioral health; career; demographics; design; disorder prevention; experience; follow-up; health care service utilization; high risk; improved; interest; men; men who have sex with men; minority health; mortality; programs; sexual minority; social; theories; transgender; transmission process

DESCRIPTION (provided by applicant): The Centers for Disease Control and Prevention (CDC) estimate that there are more than one million people living with Human Immunodeficiency Virus (HIV) in the United States and each year there are approximately 56,300 new cases of infection. Transgender women (TGW), (i.e.,biological men who live their lives as women), are at particularly high risk for HIV infection and HIV-related morbidity and mortality. Various studies indicate that TGW have the highest HIV prevalence rates of all gender and sexual minorities. However, research also shows that they are less likely to enter and be retained in HIV care. Consequently, they are more likely to suffer adverse health outcomes and infect others. Even once they know they are HIV-infected, TGW are also less likely than other sexual minorities, such as men who have sex with men and bisexual men, to enter HIV care. Historically, research on gender and sexual minorities has included the transgender population in the collective group of lesbian, gay, and bisexual persons. Recent recommendations by the Office of National AIDS Policy and the Institute of Medicine have cautioned that this combined approach has obscured the differences that exist within and between these populations, and has resulted in inadequate examination of the health needs and experiences of the transgender population. This study aims to address these concerns and will explore TGW's experiences of HIV health care utilization (seeking, entering, or being retained in care). Specifically, it will examine the role of social network factors on TGW's decisions to enter into and remain engaged in care and describe the social dynamics (processes) that undergird their use of HIV care throughout the course of their illness. Given the paucity of research with this population, a grounded theory approach will be used to explore how social network norms influence TGW's decisions about when, where, how, and if to seek HIV care, as well as the patterns and pathways through which they enter, progress through, and are retained in care. HIV/AIDS is one of the most critical public health crises confronting gender and sexual minorities, especially TGW. Findings from this study will facilitate a better understanding of the social factors that determine HIV health care utilization behaviors (entry into and retention in care) of TGW following an HIV diagnosis. In addition, this study will contribute to the state of the science of transgender health by expanding knowledge of health care inequalities and transgender-specific health needs, two priority areas outlined by the Institute of Medicine. Results from this study wil provide a strong foundation for establishing a program of research in gender and sexual minority health. Importantly, the results will also be used to educate health care professionals about the needs of HIV infected TGW and to inform the development of strategies to facilitate HIV health care utilization in this population.

描述（由申请人提供）：美国疾病控制与预防中心 (CDC) 估计，美国有超过 100 万人感染人类免疫缺陷病毒 (HIV)，每年约有 56,300 例新感染病例。跨性别女性 (TGW)（即像女性一样生活的生理男性）感染 HIV 以及与 HIV 相关的发病率和死亡率的风险特别高。多项研究表明，TGW 的艾滋病毒感染率在所有性别和性少数群体中最高。然而，研究还表明，他们进入并留在艾滋病毒护理机构的可能性较小。因此，他们更有可能遭受不良健康后果并感染他人。即使 TGW 知道自己感染了艾滋病毒，他们也比其他性少数群体（例如男男性行为者和双性恋男性）接受艾滋病毒护理的可能性更小。从历史上看，对性别和性少数群体的研究已将变性人群纳入女同性恋、男同性恋和双性恋者的集体群体中。国家艾滋病政策办公室和医学研究所最近提出的建议警告说，这种综合方法掩盖了这些人群内部和之间存在的差异，并导致对跨性别人群的健康需求和经历的检查不充分。本研究旨在解决这些问题，并将探讨 TGW 在艾滋病毒医疗保健利用方面的经验（寻求、进入或保留在护理中）。具体来说，它将研究社交网络因素对 TGW 决定进入和继续参与护理的作用，并描述支持他们在整个疾病过程中使用艾滋病毒护理的社会动态（过程）。鉴于针对这一人群的研究很少，将采用扎根理论方法来探讨社交网络规范如何影响 TGW 关于何时、何地、如何以及是否寻求 HIV 护理的决定，以及他们进入、进展和保留护理的模式和途径。艾滋病毒/艾滋病是性别和性少数群体（尤其是 TGW）面临的最严重的公共卫生危机之一。这项研究的结果将有助于更好地了解决定 HIV 诊断后 TGW 的 HIV 医疗保健利用行为（进入和保留护理）的社会因素。此外，这项研究将通过扩大对医疗保健不平等和跨性别特定健康需求的了解，为跨性别健康科学状况做出贡献，这两个领域是医学研究所概述的优先领域。这项研究的结果将为建立性别和性少数群体健康研究计划奠定坚实的基础。重要的是，研究结果还将用于教育卫生保健专业人员了解感染艾滋病毒的 TGW 的需求，并为制定促进该人群艾滋病毒卫生保健利用的战略提供信息。