Intersectional discrimination and linkage to HIV prevention and care in transgender women in Ecuador

厄瓜多尔跨性别妇女的交叉歧视及其与艾滋病毒预防和护理的联系

• 批准号: 10762136
• 负责人: Rodrigo Armando Aguayo Romero
• 金额: $ 20.93万
• 依托单位: WHITMAN-WALKER INSTITUTE, INC.
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10762136
• 关键词: 3-Dimensional; AIDS prevention; Address; African ancestry; Age; Birth; Caring; Discrimination; Disparity population; Ecuador; Ecuadorian; Epidemic; Epidemiologic Methods; Exposure to; Grant; HIV; HIV Infections; Immigrant; Intervention; Intervention Trial; Interview; Knowledge; Latin America; Link; Mentored Research Scientist Development Award; Modeling; Outcome; Pathway interactions; Persons; Phase; Policy Developments; Policy Maker; Population; Positioning Attribute; Poverty; Prevalence; Qualitative Methods; Randomized, Controlled Trials; Research; Research Design; Research Personnel; Surveys; Testing; Training; United States National Institutes of Health; Woman; Writing; care outcomes; career; cis-male; classism; experience; high risk; high risk population; infection rate; intersectionality; male; marginalization; nonbinary; queer; racism; sex; skills; social stigma; therapy development; transfeminine; transgender women

7. Project Summary-Abstract Latin America did not achieve any reductions in new HIV cases in the last decade. In Ecuador, transgender women—those who identify as women or on the transfeminine spectrum and who were assigned a male sex at birth—who have sex with cisgender men are a key population in the HIV epidemic. HIV prevalence in Ecuador is between 20.7%-34.8% among transgender women—the highest in Latin America. Studies are urgently needed to guide HIV prevention and care efforts to curb HIV Infection rates. People with multiple marginalized identities, such as transgender women of African descent living in poverty, are at higher risk of exposure to intersectional discrimination than the general U.S. population and have high rates of HIV. Yet the extent to which Ecuadorian transgender women are burdened by intersectional discrimination and its effect on the linkage to HIV prevention and care outcomes remains unknown. This K01 Award will provide the candidate with training in intersectional qualitative, quantitative, intervention development, and grant writing to address the challenge of intersectional discrimination and HIV burden in transgender women in Ecuador. The proposed research will assess the mechanisms through which intersectional discrimination exerts its impact on linkage to HIV prevention and care for transgender women in Ecuador while extending and deepening candidate’s research skills. In Research Aim 1, the candidate will assess experiences of intersectional discrimination (e.g., HIV stigma, racism, classism) in relation to HIV prevention and care through in-depth qualitative interviews with transgender women (Training Aim 1: application of intersectionality to qualitative methods). In Research Aim 2, the candidate will conduct a survey to characterize and longitudinally test the pathways that link intersectional discrimination with HIV prevention and care linkage outcomes over a 6-month period (Training Aim 2: epidemiological methods and longitudinal quantitative research design). In Research Aim 3, the candidate will implement the first six phases of the systematic ADAPT-ITT model to adapt an HIV intervention for transgender women (Training Aim 3: skills for intervention development). Findings from this study and training will position the candidate to develop an R01 proposal to implement remaining steps of the ADAPT-ITT model and conduct a randomized controlled trial of the intervention (Training Aim 4: grant writing). As an Ecuadorian non-binary queer U.S. immigrant researcher, the candidate has the cultural and research background to leverage this proposed K01 to transition to career independence and address key knowledge and intervention gaps for HIV prevention and care in Ecuador.

7.项目摘要-摘要 拉丁美洲在过去十年中没有实现新的艾滋病毒病例的任何减少。在厄瓜多尔，变性人 女性--那些认为自己是女性或属于变性女性的人，并被指定为男性 出生--与顺性男性发生性关系的人是艾滋病毒流行的关键人群。厄瓜多尔的艾滋病毒流行率 在跨性别女性中，这一比例在20.7%-34.8%之间--是拉丁美洲最高的。研究迫在眉睫 需要指导艾滋病毒预防和护理工作，以遏制艾滋病毒感染率。患有多重边缘化的人 身份，如生活在贫困中的非洲裔变性人妇女，面临着更高的风险 跨部门歧视比普通美国人口更多，艾滋病毒感染率也很高。然而，到目前为止 哪些厄瓜多尔变性人妇女背负着跨部门歧视的负担及其对 与艾滋病毒预防和护理结果的联系仍不清楚。这一K01奖项将为候选人提供 在跨部门定性、定量、干预发展和赠款撰写方面进行培训，以解决 厄瓜多尔跨性别妇女面临的跨部门歧视和艾滋病毒负担的挑战。建议数 研究将评估跨界别歧视对与 厄瓜多尔对变性妇女的艾滋病毒预防和护理，同时扩展和深化候选人的 研究技能。在研究目标1中，候选人将评估跨部门歧视的经历(例如， 艾滋病毒污名、种族主义、分类)与艾滋病毒预防和护理有关 跨性别妇女(培训目标1：将交叉性应用于定性方法)。在研究目标2中， 候选人将进行一项调查，以表征和纵向测试连接交叉点的路径 6个月期间歧视与艾滋病毒预防和护理挂钩的结果(培训目标2： 流行病学方法和纵向定量研究设计)。在研究目标3中，候选人将 实施系统适应-ITT模式的前六个阶段，以适应艾滋病毒干预措施 跨性别妇女(培训目标3：制定干预措施的技能)。这项研究和培训的结果 候选人将负责制定R01提案，以实施Adapt-ITT模式的其余步骤 并进行干预的随机对照试验(培训目标4：赠与写作)。作为一名厄瓜多尔人 非二进制酷儿美国移民研究员，候选人有文化和研究背景 利用这一建议的K01过渡到职业独立性，并解决关键知识和干预问题 厄瓜多尔在艾滋病毒预防和护理方面的差距。