Trans Women Connected: a mobile app delivered sexual health promotion program

摘要：Trans Women Connected：一款提供性健康促进计划的手机应用程序 在过去的20年里，艾滋病毒的流行严重影响了美国的变性人女性。 对于疾控中心来说，艾滋病发病率是所有风险群体中最高的(56%的黑人变性人妇女是 自我报告的流行率和艾滋病毒检测数据之间的差异表明，许多人 感染艾滋病毒的变性人妇女并不知道自己的艾滋病毒状况。其他公共卫生状况包括 变性人妇女包括基于歧视的身体和言语虐待、精神健康不良、酗酒和 药物使用，以及由于有限的医疗机会和消极的医疗保健而导致的未得到满足的医疗保健需求 相遇。这些共同发生的问题增加了变性人女性的性风险。尽管如此 健康差距和卫生保健获取障碍，美国国家艾滋病毒/艾滋病战略指出，艾滋病毒预防 专门针对变性人的努力微乎其微，留下了缺乏基于证据的 解决变性人女性独特需求的计划，让从业者实施计划 专为与男性发生性关系的男性(MSM)或顺性女性设计，即使是跨性别女性的 性别虐待、性别转变、交易性行为和暴力的经历使他们有别于大多数男男性接触者 和顺性女性。该项目将通过完成跨性别妇女的发展来解决这些差距 互联：一个性健康促进移动应用程序，旨在通过 基于优势的艾滋病毒/性健康方法，利用社交网络的力量来识别和鼓励 支持变性妇女健康和福祉的保护性因素。基于以下需求： 在第一阶段研究中发现的变性女性该应用程序将主要关注性健康/伤害 减少、认同肯定、影响健康的结构性问题以及连通性。在第二阶段结束时 移动提供的干预措施将把变性人妇女预防艾滋病毒的机会扩大(1) 为组织提供经济高效且易于实施的专门设计的干预选项 变性人女性；(2)不要求参与者参加多次面对面的体检 地点，取而代之的是支持随时随地的迭代干预实施；(3)允许变性人 女性在私人环境中匿名查看手机上的节目；以及(4)提供一种有效的手段来 跨性别女性通过移动技术与彼此和提供者建立联系。第一期工程 展示了创建一款改变用户知识和意图的应用程序的可行性，只需三个 活动，同时吸引目标受众。第二阶段将通过以下方式完成应用程序的开发 40多项活动，一个用于社会支持/联系的论坛/信息系统，所有这些活动都是通过以下小组的投入开发的 专家和社区成员。随机对照将使用一种 一些措施，包括防止性传播感染，改善寻求医疗保健，感受到社会支持。

ABSTRACT: , Trans Women Connected: a mobile app delivered sexual health promotion program During the past two decades, the HIV epidemic has severely impacted transgender women in the U.S. According to the CDC persons have the highest HIV incidence of any risk group (56% of Black transgender women are living with HIV), and discrepancies between self-reported prevalence and HIV testing data indicate that many HIV-infected transgender women are not aware of their HIV status. Other public health conditions among transgender women include discrimination-based physical and verbal abuse, poor mental health, alcohol and drug use, and unmet health care needs resulting from limited healthcare access and negative healthcare encounters. These co-occurring problems additively increase sexual risk for transgender women. Despite these health disparities and health-care access barriers, the U.S. National HIV/AIDS Strategy notes that HIV prevention efforts specifically targeting transgender populations have been minimal, leaving a dearth of evidence-based programs that address the unique needs of transgender women, leaving practitioners to implement programs designed for men who have sex with men (MSM) or cisgender women, even though transgender women's experiences of gender abuse, gender transition, transactional sex and violence distinguish them from most MSM and cisgender women. This project will address these gaps by completing the development of Trans Women Connected: A Sexual Health Promotion Mobile App designed to engage transgender women through a strengths-based approach to HIV/sexual health that uses the power of social networks to identify and encourage protective factors that support the health and well-being of transgender women. Based on the needs of transgender women identified during Phase I research the app will focus heavily on sexual health/harm reduction, identity affirmation, structural issues impacting health, and connectedness. At the end of Phase II the mobile delivered intervention will expand the HIV prevention opportunities for transgender women by (1) providing organizations a cost-effective and easily implementable intervention option that is specifically designed for transgender women; (2) not requiring participants to attend multiple face-to-face sessions in a physical location and instead support iterative intervention implementation at any time or place; (3) permit transgender women to anonymously view the program on their phone in private settings; and (4) offer an effective means for transgender women to connect with each other and providers via mobile technology. The Phase I project demonstrated feasibility in creating an app that changed knowledge and intentions of users with just three activities, while being appealing to the target audience. Phase II will complete the development of the app with 40+ activities, a forum/messaging system for social support/connection, all developed with input from panels of experts and community members. A randomized controlled will assess the effectiveness of the app using a number of measures including STI prevention, improvement in health care seeking, perceived social support.