Trauma-Informed Investigation of TGNBI Experiences in HIV Stigma Research

7.项目摘要 跨性别和非二元个体（TGNBI）在艾滋病毒研究中受到越来越多的关注， 研究记录了成见在造成和维持卫生不平等方面的普遍作用。但 对这一人群的艾滋病污名化研究的扩散也引起了人们对研究实践的关注， 可能会无意中侮辱或再次伤害他们的目的是受益的社区。进行 污名研究对于产生关于艾滋病毒流行病学、风险和保护性的准确信息至关重要。 影响因素及干预策略。然而，几乎没有任何研究直接考察了这些经历， TGBNI参与这些研究时，或确定具体的研究实践（例如，招聘 材料/研究框架，具体调查措施的选择，数据收集协议，研究者行为） 可能影响研究参与、保留和数据质量。同样重要的是， 研究了由于参与此类活动而经历的情绪困扰而造成意外伤害的可能性， 研究和什么具体的策略可以减轻对潜在的痛苦的研究经验。使 在污名研究的有意义的进展，必须制定一套基于实践的实用 建议以人为本的方式进行这项研究与TGNBI，创伤 知情，并积极去污名化。这一领域的调查是及时的，特别是考虑到国家卫生研究院的 致力于建设调查人员进行跨部门、多学科成见研究的能力。在 2021年10月，NIH发布了耻辱和歧视研究工具包，这是一项重要贡献 与健康有关的污名化研究，代表着通过健康问题解决污名化的根本转变。 公平框架。然而，这一工具包的一个关键缺陷是缺乏对经验的研究 研究背景下的污名化，并确定提高数据质量和减少 研究招募、方法和/或实施中的意外伤害。因此，这一具体目标 探索性R21项目是：（1）与TGNBI进行深入访谈，按性别认同和艾滋病毒分层 为了更好地了解TGNBI如何理解和体验参与艾滋病毒相关的耻辱， 歧视研究;（2）与进行艾滋病毒相关污名化的两名调查人员进行深入访谈 与TGNBI和心理健康专业人员进行歧视研究，他们为TGNBI提供护理， 了解与TGNBI进行污名化和歧视研究的看法和经验，以及 汇编现有的减轻伤害的策略;以及（3）利用修改后的德里技术来开发一套 与TGNBI一起进行艾滋病毒污名研究的专业指导方针。本研究将是 首先（据我们所知）制定循证研究指南，以：a）提高研究人员的能力， 在艾滋病毒相关污名研究中招募和保留TGNBI，B）提高收集数据的质量;以及c）减少 艾滋病污名研究方法中的无意伤害。

7. PROJECT SUMMARY Transgender and non-binary individuals (TGNBI) have received increasing attention within HIV research, with studies documenting the pervasive role stigma plays in creating and sustaining health inequities. However, the proliferation of HIV stigma research with this population has also raised concerns about research practices that may unintentionally stigmatize or re-traumatize the very communities they are designed to benefit. Conducting stigma research is critical for generating accurate information about HIV epidemiology, risk and protective factors, and intervention strategies for TGNBI. Yet little, if any, research has directly examined the experiences of TGBNI when participating in these studies, or identified specific research practices (e.g., recruitment materials/study framing, choice of specific survey measures, data collection protocols, researcher behaviors) that may influence study participation, retention, and data quality. Equally important, research has not adequately examined the potential for unintended harm due to emotional distress experienced by participating in such research and what specific strategies might mitigate against potential distressful research experiences. To make meaningful strides in stigma research, it is imperative to develop a set of empirically-grounded practical recommendations for conducting this research with TGNBI in a manner that is person-centered, trauma informed, and actively de-stigmatizing. This area of inquiry is timely and particularly relevant given the NIH’s commitment to building investigators’ capacity for conducting intersectional multidisciplinary stigma research. In October 2021, the NIH released a Stigma and Discrimination Research Toolkit, which is an important contribution to health-related stigma research and represents a foundational shift towards addressing stigma through a health equity framework. However, one of the critical gaps in this toolkit is the lack of research examining experiences of stigma within the research context and identifying strategies for improving data quality and reducing unintentional harm in study recruitment, methodology, and/or implementation. As such, the specific aims of this exploratory R21 project are to: (1) Conduct in-depth interviews with TGNBI, stratified by gender identity and HIV status, to better understand how TGNBI understand and experience participation in HIV related stigma and discrimination research; (2) Conduct in-depth interviews with both investigators who conduct HIV-related stigma and discrimination research with TGNBI and mental health professionals who provide care to TGNBI to better understand perceptions of and experiences with conducting stigma and discrimination research with TGNBI, and compile existing strategies for mitigating harm; and (3) Utilize a modified Delhi technique to develop a set of empirically-informed guidelines for conducting HIV stigma research with TGNBI. The present study will be the first (to our knowledge) to develop evidence-based research guidelines to: a) increase researchers’ capacity to recruit and retain TGNBI in HIV-related stigma research, b) enhance the quality of data collected; and c) reduce unintentional harm in HIV stigma research methodology.