Trauma-Informed Investigation of TGNBI Experiences in HIV Stigma Research

7.项目总结 变性人和非二元个体(TGNBI)在艾滋病毒研究中受到越来越多的关注， 记录污名在造成和维持健康不平等方面所起的普遍作用的研究。然而， 艾滋病毒污名研究在这一人群中的激增也引起了人们对研究做法的担忧 可能会无意中污蔑或重新伤害他们原本打算受益的社区。正在进行 耻辱研究对于产生关于艾滋病毒流行病学、风险和保护的准确信息至关重要 TGNBI的影响因素和干预策略。然而，几乎没有研究直接检验这些经历 参加这些研究时，或确定具体的研究做法(例如，招聘)时的TGBNI 材料/研究框架、具体调查方法的选择、数据收集方案、研究人员行为) 这可能会影响研究的参与度、保留率和数据质量。同样重要的是，研究还没有充分地 检查了由于参与此类活动而经历的精神痛苦所造成的意外伤害的可能性 研究和哪些具体的策略可以缓解潜在的痛苦的研究经验。使 在污名研究方面迈出有意义的一步，当务之急是制定一套有经验基础的实践 建议使用TGNBI以以人为中心、创伤为中心的方式进行这项研究 知情的，并积极地去污名化。这一调查领域是及时的，特别是考虑到NIH 致力于培养研究人员进行跨部门多学科污名研究的能力。在……里面 2021年10月，美国国立卫生研究院发布了耻辱和歧视研究工具包，这是一个重要的贡献 致力于与健康相关的污名研究，代表着通过健康解决污名的根本性转变 股权框架。然而，这个工具包中的一个关键缺陷是缺乏对经验进行检查的研究 在研究范围内消除污名，并确定提高数据质量和减少 在研究招募、方法和/或实施中的无意伤害。因此，这一行动的具体目标是 试探性R21项目将：(1)对TGNBI进行深入访谈，按性别认同和艾滋病毒分层 状况，以更好地了解TGNBI如何理解和体验参与艾滋病毒相关的耻辱和 歧视研究；(2)与进行艾滋病毒相关耻辱的两名调查员进行深入访谈 以及与TGNBI和为TGNBI提供护理的精神健康专业人员进行的歧视研究，以更好地 了解对TGNBI进行污名和歧视研究的看法和经验，以及 汇编现有的减轻伤害的战略；以及(3)利用改进的德里技术开发一套 与TGNBI合作开展艾滋病毒污名研究的经验指南。本研究将是 第一，(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)提高所收集数据的质量；c)减少 艾滋病毒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.