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

项目摘要 变性人妇女(TW)目前是美国感染艾滋病毒风险最高的SGM人群 缔约国，特别是那些属于种族/族裔少数的国家。TW还报告了最高水平的歧视， 受害、创伤性生活事件和其他有压力的经历，是 药物滥用和精神健康问题。艾滋病毒研究人员表示，弹性可能在很大程度上是 行为干预中未开发的资源，可能与精神健康下降有关 被边缘化人群中的问题、药物滥用和艾滋病毒相关风险。每日预曝光 预防(PrEP)在预防艾滋病毒阴性者中感染艾滋病毒方面非常有效。而当 这对于少数族裔台湾族的艾滋病毒预防来说是一个令人兴奋的发展，艾滋病毒预防工作现在必须转移 重点研究在面临多次复发的高危人群中优化PrEP依从性 有压力的生活事件和无数的结构性障碍。在拟议的研究中，我们将利用一项正在进行的研究 (N=300)参加南加州PrEP演示的种族和民族多样化的TW 项目，为了进行混合方法的研究，首先使用结构方程建模(SEM)来 评估与TW中遵守PrEP最相关的风险和弹性因素。然后使用 扫描电子显微镜的发现为后续的深入定性访谈提供信息，其中包括从高到低依从性的子样本 少数群体TW将进一步探讨PrEP最突出的风险和弹性因素和经验 高危少数民族TW的依从性。这项研究将提供支持提交的初步数据 一笔干预发展赠款(NIDA R34)，用于制定以复原力为基础的干预措施，重点是 提高TW的PrEP遵从性。

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.