Risk and Protective Factors for Adherence to Pre-Exposure Prophylaxis (PrEP) in Transwomen of Color

有色变性女性坚持暴露前预防 (PrEP) 的风险和保护因素

• 批准号: 9347219
• 负责人: Erik D. Storholm
• 金额: $ 23.13万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9347219
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Alcohol or Other Drugs use; Anti-Retroviral Agents; Attenuated; Behavior Therapy; Birth; California; Clinical; Clinical Research; Color; Coping Skills; Data; Development; Discrimination; Drug Combinations; Effectiveness; Emotional; Enrollment; Equation; Ethnic Origin; Event; Female; Funding; Future; Gender; Gender Identity; Grant; HIV; HIV Infections; HIV Seropositivity; HIV risk; Hormones; Individual; Intervention; Interview; Investigation; Life; Life Experience; Measures; Mental Health; Methods; Minority; Modeling; National Institute of Drug Abuse; Persons; Pilot Projects; Population; Prevention; Prevention strategy; Public Health; Race; Reporting; Research; Research Methodology; Research Personnel; Resistance development; Resources; Risk; Risk Behaviors; Role; Sampling; Social support; Stress; Substance Use Disorder; Substance abuse problem; Tenofovir; Testing; Time; Trauma; Treatment Failure; United States; Victimization; Woman; alcohol abstinence; base; cisgender; coping; emtricitabine; ethnic diversity; ethnic minority population; experience; high risk; high risk population; improved; male; men who have sex with men; pre-exposure prophylaxis; prevent; programs; racial and ethnic; racial diversity; resilience; sex risk; stress resilience; therapy development; transgender; transgender women; transmission process; transphobia; treatment adherence

Project Abstract Transgender women (TW) are currently the SGM population at highest risk for HIV infection in the United States, especially those who are racial/ethnic minorities. TW also report the highest levels of discrimination, victimization, traumatic life events, and other stressful experiences and are of the highest risk groups for substance abuse and mental health problems. HIV researchers have suggested resiliency may be a largely untapped resource in behavioral interventions and that it may be associated with reductions in mental health problems, substance abuse, and HIV related risk among marginalized populations. Daily pre-exposure prophylaxis (PrEP) is extremely effective in preventing HIV infection among those who are HIV-negative. While this is an exciting development for HIV prevention among minority TW, HIV prevention efforts must now shift focus to research on optimizing PrEP adherence among this high-risk population facing multiple recurring stressful life events and numerous structural barriers. In the proposed study, we will leverage an ongoing study of (N =300) racially and ethnically diverse TW enrolled in the Southern California based PrEP demonstration project, in order to conduct mixed-methods research, first using structural equation modeling (SEM) to assessing the risk and resiliency factors most associated with PrEP adherence among TW. Then using the SEM findings to inform follow-on, in-depth qualitative interviews with a sub-sample of high- to low-adherence minority TW to further explore those risk and resiliency factors and experiences most salient to PrEP adherence among high-risk minority TW. This study will provide the preliminary data to support the submission of an intervention development grant (NIDA R34) to develop a resilience-based intervention focused on improving PrEP adherence for TW.

项目摘要