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

描述(由申请人提供)：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，大多数是边缘人群的一部分。跨性别女青年是被污名化和边缘化的青年群体，感染艾滋病毒的风险不成比例。迄今为止，对变性女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，特兰瑟斯的艾滋病毒感染率是所有人口中最高的，年轻人中艾滋病病例的比例最高，艾滋病导致的死亡率也是该市最快的。尽管变性人女青年感染艾滋病毒的风险极高，但科学文献对她们的研究不足。由于横断面研究设计只代表风险最高的亚群，因此数据中存在差距，这些研究设计使用了仅代表风险最高的亚群的TRANSYSS样本。部分由于这些差距，到目前为止，还没有专门为这一人群制定的艾滋病毒预防干预措施。我们建议对300名16-24岁的变性女性青年进行一项纵向的定性和流行病学研究，以检查艾滋病毒相关的危险行为，并确定弹性的保护因素。我们将采取一种创新的方法，利用社交互动技术调整受访者驱动的抽样，从而接触并留住参与者。这项应用的具体目的是调整和完善保护因素的测量方法，并探索残缺口腔中的复原力，确定特定于发育的风险因素，解释残缺口腔中参与艾滋病毒相关危险行为的原因，并确定残缺口腔中HIV相关危险行为的保护因素。这项研究将要调查、改进和应用的方法对于MSM和其他边缘群体的不同人群预防艾滋病毒的证据基础至关重要。这一拟议的项目将填补文献中的重要空白，通过提供来自不同的、具有代表性的特兰斯茅斯样本的第一组因果数据，解决该人群面临的挑战和他们拥有的最终干预措施以减少艾滋病毒感染的优势。

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.