Longitudinal Research to Assess HIV Risk and Resilience Among Trans-Female Youth

描述（由申请人提供）：在美国，大多数新的艾滋病毒病例发生在25岁以下的年轻人中。在受感染的青年中，大多数是边缘人口。跨性别女青年是一个被污名化和边缘化的青年群体，尤其容易感染艾滋病毒。迄今为止对变性女性青年进行的两项艾滋病毒风险研究发现，五分之一的人在25岁之前感染了艾滋病毒。在旧金山，跨性别青年的艾滋病毒感染率是所有人口中最高的，青年中艾滋病病例的比例最高，该市艾滋病死亡率最快。尽管跨性别女性青年感染艾滋病毒的风险很高，但她们在科学文献中却没有得到充分的研究。数据上的差距是由于横断面研究设计只代表最危险的亚人群的跨青年的方便样本。部分由于这些差距，迄今为止还没有专门针对这一人群制定艾滋病毒预防干预措施。我们建议对300名年龄在16-24岁的跨性别女性青年进行纵向定性和流行病学研究，以检查艾滋病毒相关的风险行为并确定恢复力的保护因素。我们将采用一种创新的方法，采用社会互动技术来适应受访者驱动的抽样，从而达到并留住参与者。本应用程序的具体目的是适应和完善保护因素的措施，并探索跨性别青少年的复原力，确定特定于发展的风险因素，解释跨性别青少年参与艾滋病毒相关风险行为，并确定跨性别青少年中艾滋病毒相关风险行为的保护因素。本研究的研究、改进和应用的方法对不同人群的男男性行为者和其他边缘群体的艾滋病毒预防的证据基础至关重要。这个拟议的项目将填补文献中的重要空白，提供来自不同的、有代表性的跨青年样本的第一组因果数据，解决这一人群面临的挑战和他们拥有的优势，最终干预减少艾滋病毒感染。

DESCRIPTION (provided by applicant): The majority of new HIV cases in the US occur among youth under 25 years old. Among infected youth, most are part of marginalized populations. Transgender female youth are a stigmatized and marginalized youth population disproportionately at risk for HIV. The two HIV risk studies of transgender female youth to date have found that one in five are HIV-infected before the age of 25. In San Francisco, transyouth have the highest HIV prevalence of any population, the highest proportion of AIDS cases among youth, and the fastest rate of death due to AIDS in the city. Despite their extraordinary risk for HIV, transgender female youth are understudied in the scientific literature. Gaps in the data exist due to cross-sectional study designs with convenience samples of transyouth who represent only the most risky sub- populations. In part due to these gaps, to date there are no HIV prevention interventions that have been developed specifically for this population. We propose to conduct a longitudinal qualitative and epidemiological study of 300 transgender female youth ages 16-24 years to examine HIV-related risk behaviors and identify protective factors for resilience. We will reach and retain participants by taking an innovative approach to adapting respondent driven sampling using socially interactive technologies. The Specific Aims of this application are to adapt and refine measures of protective factors and to explore resilience among transyouth, determine risk factors specific to development that explain engagement in HIV-related risk behaviors among transyouth, and identify protective factors for HIV-related risk behaviors among transyouth. The methods to be investigated, refined, and applied for this research are critical to the evidence base of HIV prevention for diverse populations of MSM and other marginalized groups. This proposed project will fill important gaps in the literature by providing the first set of causal data from a diverse, representative sample of transyouth addressing both the challenges this population faces and the strengths they possess to ultimately intervene to reduce HIV infection.