Using mixed methods to understand barriers to PrEP use among Black and Latinx transgender and gender-expansive youth and emerging adults: The impact of gender minority stress and gender affirmation.
使用混合方法了解黑人和拉丁裔跨性别者以及性别扩张型青年和新兴成年人使用 PrEP 的障碍:性别少数压力和性别肯定的影响。
基本信息
- 批准号:10548065
- 负责人:
- 金额:$ 3.82万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-09-01 至 2024-08-31
- 项目状态:已结题
- 来源:
- 关键词:Age-YearsAreaAwarenessBehaviorBlack PopulationsBlack raceBuffersCenters for Disease Control and Prevention (U.S.)CharacteristicsCommunitiesContinuity of Patient CareCross-Sectional StudiesDataDiagnosisDiscriminationDistalEligibility DeterminationEpidemicEquationEthnic OriginFundingGenderGender IdentityGeneral PopulationGoalsHIVHIV InfectionsHIV riskIncidenceIndividualInterventionInterviewJointsKnowledgeLatinxLatinx populationLegalLiteratureMediationMedicalMethodologyMethodsModelingNatureOutcomeOutcome StudyParticipantPersonsPlayPopulationPopulations at RiskPrevalenceProphylactic treatmentRaceRecording of previous eventsResearchResearch MethodologyResourcesRiskRoleSamplingStatistical MethodsStressStructureTimeTrainingUnited StatesUnited States National Institutes of HealthVulnerable PopulationsYouthage groupbehavioral responseclinical practicedesigneffective interventionemerging adultethnic diversityexperiencegender expressiongender minoritygender minority groupgender minority stressgender minority youthgenderqueerhigh riskminority stressorpeerpre-exposure prophylaxispreventprimary outcomeprogramspsychologicracial and ethnicracial and ethnic disparitiesrecruitresiliencesecondary outcomesocialsociodemographic factorssociodemographicsstressorsubstance usetransgenderuptake
项目摘要
PROJECT SUMMARY. Gender minority individuals 13-24 years of age experience disproportionate risk for
HIV, yet their rates of preexposure prophylaxis (PrEP) uptake to prevent HIV are the lowest of any key risk
group in the United States (>10%). This population includes young transgender individuals, as well as
substantial and growing numbers of those who identify as gender nonbinary, non-conforming, or genderqueer,
referred to here as "gender-expansive” individuals. (We refer to the population as “YTGE”). Further, Black and
Latinx (BL) YTGE individuals have higher HIV incidence, but lower PrEP use rates, than White YTGE. Yet, the
specific factors that influence engagement in the PrEP care continuum among BL-YTGE, and their causes and
meanings, are not well understood. The proposed study is grounded in the gender minority stress and gender
affirmative models and examines salient proximal and distal stressors, their effects (e.g., substance use), and
resilience factors, including gender affirmation, i.e., support for living in one’s gender identity/expression in
social, psychological, medical, and legal domains. Yet, because gender affirmation is a new area of research,
we know little about its relationship to engagement along the PrEP care continuum. The proposed study uses
an explanatory sequential mixed methods design to advance knowledge about specific factors that promote or
impede PrEP outcomes among BL-YTGE. The primary outcome is PrEP intentions, and PrEP awareness, use,
and persistence are secondary outcomes. The study aims to: examine the effects of gender minority stress,
including proximal and distal stressors, and behavioral responses to stress (substance use) on PrEP outcomes
among diverse YTGE who evidence HIV risk (Aim 1a); examine whether resilience (e.g., gender affirmation),
race/ethnicity or other sociodemographic factors heighten or buffer the effects of gender minority stress on
substance use and PrEP outcomes (Aim 1b); explore BL-YTGE’s perspectives on factors identified in Aim 1
that promote or impede PrEP outcomes and their meanings (e.g., substance use, discrimination), with a focus
on various types of gender affirmation, as well as emergent factors (Aim 2); and integrate findings from Aims 1
and 2 to determine how diverse YTGE experience the PrEP continuum and identify differences and similarities
across sociodemographic characteristics that impede or support PrEP uptake (Aim 3). Aim 1 will use a
moderated mediation structural equation modeling approach to analyze a racially/ethnically diverse (54% non-
White) national sample of N=1029 YTGE who engaged in a cross-sectional survey (CDC START study). Aim 2
will rely upon semi-structured interviews with BL-YTGE from the local NYC community (N=30, half prescribed
PrEP). For Aim 3 all results will be compared, contrasted, and integrated using the joint display method, to
contextualize and interpret findings. Statistical and research methods training will be a key component of this
study. If funded, this F31 will give the applicant protected time and will comprise the first stages of a program of
research to decrease HIV incidence in this population at high-risk for HIV but with serious barriers to PrEP.
项目摘要。13-24岁的性别少数个体经历不成比例的风险,
艾滋病毒,但他们的暴露前预防(PrEP)摄入率,以防止艾滋病毒是最低的任何关键风险
在美国(>10%)。这一人群包括年轻的变性人,以及
越来越多的人认为自己是性别非二元、不一致或性别酷儿,
在这里被称为“性别扩张”个体。(We将人口称为“YTGE”)。此外,黑色和
拉丁裔(BL)YTGE个体的艾滋病毒发病率较高,但PrEP使用率较低,比白色YTGE。然而
影响BL-YTGE之间PrEP护理连续体参与的具体因素及其原因,
意义,并没有得到很好的理解。这项研究是基于少数性别的压力和性别
肯定模型并检查显著的近端和远端压力源,它们的影响(例如,物质使用),以及
复原力因素,包括性别平等,即,支持生活在一个人的性别认同/表达,
社会、心理、医学和法律的领域。然而,由于性别肯定是一个新的研究领域,
我们对它与沿着PrEP护理连续体的参与的关系知之甚少。拟议的研究使用
一种解释性的顺序混合方法,旨在促进对促进或
阻碍BL-YTGE之间的PrEP结果。主要结果是PrEP意向,以及PrEP意识,使用,
和持久性是次要结果。这项研究的目的是:检查性别少数压力的影响,
包括近端和远端压力源,以及对PrEP结果的压力(物质使用)的行为反应
在有艾滋病毒风险的不同青年男女两性平等者中(目标1a);检查是否有弹性(例如,性别肯定),
种族/民族或其他社会人口因素加剧或缓冲了性别少数压力对
物质使用和PrEP结果(目标1b);探索BL-YTGE对目标1中确定的因素的观点
促进或阻碍PrEP结果及其意义(例如,药物使用、歧视),重点是
关于各种类型的性别肯定,以及紧急因素(目标2);并整合目标1的调查结果
和2,以确定如何不同的YTGE经验的PrEP连续体,并确定差异和相似之处
阻碍或支持PrEP吸收的社会人口特征(目标3)。目标1将使用
适度中介结构方程建模方法来分析种族/民族多样性(54%非
白色)国家样本N=1029 YTGE谁从事横断面调查(CDC START研究)。目的2
我将依赖于来自纽约当地社区的BL-YTGE的半结构化访谈(N=30,一半规定
PrEP)。对于目标3,将使用联合显示方法对所有结果进行比较、对比和整合,
将调查结果置于背景中并加以解释。统计和研究方法培训将是这方面的一个关键组成部分。
study.如果获得资助,该F31将为申请人提供受保护的时间,并将包括以下项目的第一阶段:
研究减少艾滋病毒高危人群中的艾滋病毒发病率,但存在严重的PrEP障碍。
项目成果
期刊论文数量(0)
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会议论文数量(0)
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Sabrina R Cluesman其他文献
Sabrina R Cluesman的其他文献
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{{ truncateString('Sabrina R Cluesman', 18)}}的其他基金
Using mixed methods to understand barriers to PrEP use among Black and Latinx transgender and gender-expansive youth and emerging adults: The impact of gender minority stress and gender affirmation.
使用混合方法了解黑人和拉丁裔跨性别者以及性别扩张型青年和新兴成年人使用 PrEP 的障碍:性别少数压力和性别肯定的影响。
- 批准号:
10700885 - 财政年份:2022
- 资助金额:
$ 3.82万 - 项目类别:
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