To Reach Unrestricted Services for Transgender Women (TRUST)

为跨性别女性提供不受限制的服务 (TRUST)

• 批准号: 10252940
• 负责人: Elena Cyrus
• 金额: $ 24.89万
• 依托单位: UNIVERSITY OF CENTRAL FLORIDA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10252940
• 关键词: AIDS prevention; AIDS/HIV problem; Academic Training; Accreditation; Address; Adult; Affect; African; Alcohols; Back; Behavior; Caribbean region; Color; Communities; Control Groups; Country; Data; Data Collection; Development; Drug abuse; Epidemiologist; Evidence based intervention; Faculty; Fellowship; Florida; Focus Groups; Funding; Generations; Geography; Goals; Grant; HIV; HIV risk; HIV/STD; Health; Health Care Costs; Illicit Drugs; Immigrant; Incidence; Individual; Institution; International; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Knowledge; Latin America; Latina; Latino; Lead; Logistic Regressions; Manuals; Measures; Mentored Clinical Scientist Development Award (K08); Methodology; Methods; Minority; National Institute of Drug Abuse; Outcome Measure; Participant; Personal Satisfaction; Peruvian; Phase; Population; Positioning Attribute; Postdoctoral Fellow; Preparation; Prevalence; Primary Prevention; Procedures; Process; Prophylactic treatment; Public Health; Publications; Qualitative Methods; Qualitative Research; Randomized; Research; Research Activity; Research Methodology; Research Personnel; Risk; Sampling; Secondary Prevention; Secure; Services; Sexual and Gender Minorities; Special Population; Stigmatization; Strategic Planning; Stress; Substance Use Disorder; Substance abuse problem; Surveys; Target Populations; Testing; Time; Training; Training Activity; Translational Research; Translations; United States; United States National Institutes of Health; Universities; Visit; Visual; Vulnerable Populations; Work; acceptability and feasibility; arm; base; brief intervention; career; career development; comorbidity; data format; design; effective intervention; effective therapy; efficacy evaluation; efficacy testing; ethnic minority population; experience; follow-up; gender minority; health disparity; high risk; high risk population; improved; innovation; marginalized population; men who have sex with men; method development; post intervention; pre-exposure prophylaxis; prevent; primary outcome; racial and ethnic; randomized trial; screening; screening, brief intervention, referral, and treatment; skills; social determinants; societal costs; stem; stress disorder; stressor; substance abuse brief intervention; substance abuse prevention; substance use; tenure track; therapy development; transgender; transgender men; transgender women; transmission process; uptake

ABSTRACT/SUMMARY Background: Transgender women are disproportionally affected by substance abuse and HIV. Evidence-based interventions that can address both issues simultaneously may efficiently improve the overall health of transgender women and reduce burdensome health and societal costs associated with substance abuse and HIV. In South Florida, the majority of transgender women identify as Black or Latina, and can be grouped together as transgender women of color (TWOC). TWOC are at highest risk for substance abuse and HIV acquisition, due to multiple external stressors arising as a consequence of being a gender minority and a racial/ethnic minority. Studies have demonstrated Screening, Brief Intervention, and Referral to Treatment (SBIRT) to be effective in mitigating development of substance use disorders (SUDs) in other at-risk, marginalized populations. An adapted culturally-tailored SBIRT focused on linkage to substance use services and HIV pre- and post-exposure prophylaxis (PrEP/nPEP) may effectively reduce the odds of individuals in this special population developing a SUD and also facilitate their voluntary election of HIV screening and use of PrEP/nPEP for HIV prevention. Objectives: K99 –In preparation for the independent phase, the career development phase will include training in qualitative research methods and intervention development. R00 – In the independent phase, the study objectives will be to (a) use a mixed-methods approach to obtain formative data among 40 transgender women that will aid in adapting and developing an adapted culturally tailored SBIRT intervention (SBIRT-A), (b) pre-test and refine SBIRT-A in 15 transgender women based on formative work and, (c) pilot test SBIRT-A in a sample of 76 transgender to assess feasibility and acceptability. Pilot Design: Randomized trial among 76 adult (18 years or older) HIV uninfected transgender women at moderate risk for developing a substance use disorder who will be randomized to either SBIRT-A or the control condition (INFO-C). The INFO-C group will be a time-matched comparison control where information will be provided on substance use and PrEP services in a non-SBIRT format via printed and audio-visual study material. There will be a follow-up visit, three months after baseline, to assess linkage, and barriers and facilitators, to substance use services and PrEP/nPEP. Analysis: Bivariate difference tests (chi square and t-tests) will be used to test differences between SBIRT-A and INFO-C participants for the primary outcome measures (linkage to substance use services, PrEP, and nPEP) at the 3-month visit. Multivariate binary logistic regressions (post- and pre-intervention) will be used to determine substance use as a predictor of (1) HIV/STI screening in the past three months and (2 & 3) PrEP and nPEP uptake in the past three months. Significance: Results derived from this study will help elucidate the relationship between substance use and HIV among transgender women, including TWOC, in South Florida, and will provide evidence for a larger study that can test the efficacy of SBIRT-A to reduce prevalence of substance abuse and HIV in this special population. The aims of this study are parallel to the NIH/NIDA strategic plan to decrease HIV/AIDS health disparities, prevent HIV transmission, and better understand the interaction of drug abuse and HIV/AIDS.

摘要/总结 背景：跨性别妇女受到药物滥用和艾滋病毒的严重影响。循证 同时解决这两个问题的干预措施可以有效地改善跨性别者的整体健康状况。 这将有助于提高妇女的健康水平，减少与药物滥用和艾滋病毒有关的沉重的健康和社会成本。在南佛罗里达， 大多数跨性别女性认同为黑人或拉丁裔，并可以归类为有色人种的跨性别女性 （TWOC）。由于多种外部压力源，TWOC在药物滥用和艾滋病毒感染方面的风险最高， 作为性别少数和种族/族裔少数的后果。研究表明，筛选，简短 干预和转诊治疗（SBIRT），以有效减轻物质使用障碍的发展 （SUD）在其他处于风险中的边缘化人群中。一个经过调整的文化定制的SBIRT侧重于与实质内容的联系 使用服务和艾滋病毒暴露前和暴露后预防（PrEP/nPEP）可以有效地降低个人感染艾滋病毒的几率。 这一特殊人群发展为SUD，并促进他们自愿选择艾滋病毒筛查和使用 PrEP/nPEP用于预防艾滋病毒。目标：K99 -为独立阶段，职业发展阶段做准备 将包括定性研究方法和干预发展方面的培训。R 00-在独立阶段， 研究目标将是：（a）使用混合方法获得40名变性妇女的形成性数据， 将有助于调整和开发适应文化的SBIRT干预（SBIRT-A），（B）预测试和完善 SBIRT-A在15名变性妇女的基础上形成的工作，（c）试点测试SBIRT-A在76名变性， 评估可行性和可接受性。初步设计：在76名未感染HIV的成人（18岁或以上）中进行的随机试验 有中度物质使用障碍风险的跨性别女性，将随机接受SBIRT-A 或控制条件（INFO-C）。INFO-C组将是一个时间匹配的比较对照组，其中信息将 通过印刷和视听学习材料以非SBIRT格式提供物质使用和PrEP服务。那里 将在基线后三个月进行一次后续访问，以评估与物质使用的联系、障碍和促进因素 服务和PrEP/nPEP。分析：将使用双变量差异检验（卡方和t检验）来检验差异 SBIRT-A和INFO-C参与者之间的主要成果指标（与物质使用服务的联系，PrEP， 和nPEP）。将使用多变量二元logistic回归（干预后和干预前）， 确定物质使用作为（1）过去三个月艾滋病毒/性传播感染筛查和（2和3）PrEP和nPEP的预测因素 在过去的三个月里。意义：本研究的结果将有助于阐明 在南佛罗里达，包括TWOC在内的跨性别妇女中使用药物和艾滋病毒，并将提供证据， 更大的研究，可以测试SBIRT-A的疗效，以减少药物滥用和艾滋病毒的流行，在这个特殊的 人口这项研究的目的与NIH/NIDA减少艾滋病毒/艾滋病健康差距的战略计划平行， 预防艾滋病毒传播，更好地了解药物滥用与艾滋病毒/艾滋病的相互作用。