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

摘要：跨性别女性互联：一个移动的应用程序提供的性健康促进计划 在过去的二十年里，艾滋病毒的流行严重影响了美国的变性妇女。 疾病预防控制中心的人有任何风险群体的艾滋病毒发病率最高（56%的黑人变性妇女是 艾滋病毒感染者），自我报告的流行率与艾滋病毒检测数据之间的差异表明，许多 感染艾滋病毒的变性妇女不知道自己的艾滋病毒状况。其他公共卫生状况 跨性别妇女包括基于歧视的身体和言语虐待，精神健康状况不佳，酗酒， 药物使用，以及因医疗保健服务有限和负面医疗保健而导致的医疗保健需求未得到满足 遭遇这些同时发生的问题增加了变性妇女的性风险。尽管有这些 美国国家艾滋病毒/艾滋病战略指出， 专门针对跨性别人群的努力微乎其微，缺乏基于证据的 解决变性妇女独特需求的方案，让从业人员实施方案 专为与男性发生性关系的男性（MSM）或cisgender女性设计，即使跨性别女性的 性别虐待、性别转换、性交易和暴力的经历使他们与大多数男男性行为者不同 和顺性别女性该项目将通过完成跨性别妇女的发展， Connected：一款性健康促进移动的应用程序，旨在通过 基于力量的艾滋病毒/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因素。根据需要， 在第一阶段研究中确定的跨性别女性，该应用程序将重点关注性健康/伤害 减少，身份确认，影响健康的结构性问题，以及连通性。在第二阶段结束时， 移动的干预措施将通过以下方式扩大变性妇女的艾滋病毒预防机会： 为各组织提供一个具有成本效益且易于实施的干预方案， （2）不要求参与者参加多次面对面的会议， 位置，而是支持在任何时间或地点实施迭代干预;（3）允许变性人 女性在私人环境中匿名查看手机上的程序;以及（4）提供有效的手段， 跨性别妇女通过移动的技术相互联系和与供应商联系。一期工程 证明了创建一个应用程序的可行性，该应用程序只需三个 活动，同时吸引目标受众。第二阶段将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，所有这些活动都是在 专家和社区成员。一项随机对照研究将使用 一些措施，包括性传播感染预防、改善寻求保健的情况、感知的社会支持。

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.