The Transnational Cohort: global HIV epidemiology and prevention research for transwomen.

跨国队列：跨性别女性的全球艾滋病毒流行病学和预防研究。

• 批准号: 9065249
• 负责人: William McFarland
• 金额: $ 43.5万
• 依托单位: PUBLIC HEALTH FOUNDATION ENTERPRISES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-25 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9065249
• 关键词: AIDS prevention; Advocacy; Africa South of the Sahara; Ancillary Study; Area; Behavior; Behavioral; Benchmarking; Brazil; Cardiovascular system; China; Cities; Cohort Studies; Communicable Diseases; Country; Cross-Sectional Studies; Data; Diabetes Mellitus; Disease; Enrollment; Epidemic; Epidemiologic Studies; Epidemiology; Event; Family; Future; Gender; Goals; HIV; Health; Healthcare; Incidence; Infection; International; Investigation; Legal; Longitudinal Studies; Lung; Measures; Medical; Mental disorders; Minority; Minority Groups; Modeling; Names; Namibia; Online Systems; Outcome; Policies; Population; Prevalence; Prevention; Prevention Research; Prevention program; Preventive; Preventive Intervention; Procedures; Public Health; Research; Research Infrastructure; Respondent; Risk; Sample Size; Sampling; San Francisco; Site; Social Environment; Social Network; Stress; Surveys; Technology; Testing; Ursidae Family; Variant; Work; cohort; experience; follow-up; gender transition; genital surgery; health disparity; hormone therapy; innovation; malignant breast neoplasm; men who have sex with men; population based; programs; public health relevance; social; social stigma; therapy design; transgender women

 DESCRIPTION (provided by applicant): Transwomen bear a disproportionate burden of HIV worldwide, yet incidence is seldom measured and the determinants of acquiring infection are unknown. There is no HIV prevention intervention for transwomen with evidence of efficacy. Our project's goals are to create an international platform for HIV epidemiology and prevention research for transwomen, obtain benchmarks for HIV incidence, and characterize causal factors for infection. We propose a cohort study of 1,100 transwomen in San Francisco, USA and São Paulo, Brazil where capacities are ready for longitudinal research. The cohort will measure HIV incidence and test hypotheses on HIV acquisition related to social and biomedical gender transition events and components of the Gender Affirmation, Behavioral Ecological, and Minority Stress models. Meanwhile, little is known about transwomen in China, the world's largest country, or sub- Saharan Africa, where the HIV epidemic is most severe. Basic epidemiological research on transwomen in these regions is overdue. We therefore also propose a cross-sectional survey of 250 transwomen in Nanjing, China and a formative assessment of transwomen in Windhoek, Namibia. In addition to obtaining the first estimates of HIV prevalence among transwomen in China and the first focused study of transwomen in sub-Saharan Africa, we will prepare these sites for future inclusion in the cohort. Our specific aims for the current proposal are: 1) to establish a population-based cohort of transwomen in San Francisco and São Paulo to measure HIV incidence; 2) to test hypotheses on social and biomedical gender transition events as causal factors in HIV acquisition among transwomen; 3) to initiate HIV prevention research for transwomen in China and sub-Saharan Africa. We will use respondent-driven sampling (RDS) for recruitment in order to approximate population-based samples for high external validity. Social media and mobile and web-based technologies will be used to increase cohort retention for high internal validity. HIV is only one health disparity experienced by transwomen. Transwomen are at increased risk for multiple mental health disorders and little is known about the impact of gender transition procedures on non-communicable diseases. The project will culminate in an international collaborative for rigorous HIV prevention research with incident endpoints and an infrastructure for ancillary studies on transwomen health issues.

 描述（由适用提供）：跨性别者带有不成比例的艾滋病毒燃烧，但很少衡量事件，并且对收购感染的确定是未知的。跨性别者没有预防艾滋病毒的干预措施，具有效率的证据。我们项目的目标是为跨性别者创建一个国际艾滋病毒流行病学和预防研究，获得艾滋病毒事件的基准，并表征感染的因果因素。我们提出了一项在美国旧金山和巴西圣保罗的1,100个跨性别者的队列研究，那里的能力已准备好进行纵向研究。该队列将衡量与社会和生物医学性别过渡事件有关的HIV获取事件以及性别肯定，行为生态和少数族裔压力模型的成分有关的HIV事件的假设。同时，关于世界上最大的国家或撒哈拉以南非洲的跨性别者，艾滋病毒流行最为严重的跨国。这些地区对跨性别者的基本流行病学研究逾期。因此，我们还建议对中国南京的250个跨性别者进行横断面调查，并对纳米比亚温得和克的跨性别者进行形成性评估。除了获得中国跨性别者之间的艾滋病毒流行率的首次估计以及撒哈拉以南非洲跨性别者的首次重点研究外，我们还将为这些地点做准备，以使这些地点将来纳入同伙。我们对当前提案的具体目的是：1）在旧金山和圣保罗建立基于人群的跨性别者群体以衡量艾滋病毒事件； 2）检验有关社会和生物医学性别过渡事件的假设，作为跨性别者中艾滋病毒的因果因素； 3）在中国和撒哈拉以南非洲启动针对跨性别者的艾滋病毒预防研究。我们将使用响应驱动的采样（RDS）进行招聘，以便近似基于人群的样本以获得高度的外部有效性。社交媒体和移动和基于Web的技术将用于提高队列保留率，以提高内部有效性。 HIV只是Transwomen经历的健康差异。跨性别者对多种心理健康疾病的风险增加，对性别过渡程序对非通信疾病的影响知之甚少。该项目将在一项针对严格的HIV预防研究的国际合作培训，其事件终点和针对跨性别健康问题的辅助研究基础设施。