Capitalizing on the power of the Internet to survey Ugandan LGBT nationally

利用互联网的力量在全国范围内调查乌干达 LGBT

• 批准号: 9154454
• 负责人: Michele L. Ybarra
• 金额: $ 22.98万
• 依托单位: CENTER FOR INNOVATIVE PUBLIC HEALTH RESEARCH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-05 至 2018-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9154454
• 关键词: AIDS prevention; AIDS/HIV problem; Adult; Advisory Committees; Affect; Africa South of the Sahara; African; Area; Behavior; Bisexual; Capital; Cities; Communities; Country; Data; Decision Making; Discrimination; Eastern Africa; Ensure; Epidemic; Epidemiology; Exclusion; Face; Focus Groups; Future; Gays; Gender Identity; HIV; HIV Seropositivity; HIV risk; Health Services Accessibility; Heterosexuals; Incidence; Income; Individual; Internet; Intervention; Language; Laws; Lesbian Gay Bisexual; Lesbian Gay Bisexual Transgender; Life; Literature; Morbidity - disease rate; Participant; Pattern; Play; Population; Prevalence; Prevention; Prevention program; Preventive; Protocols documentation; PubMed; Public Health; Public Health Practice; Publishing; Research; Respondent; Risk; Risk Behaviors; Role; Safety; Seroprevalences; Sexual Partners; Sexual and Gender Minorities; Surveys; Technology; Testing; Text; Time; Uganda; Ursidae Family; Vagina; Vulnerable Populations; Woman; aged; base; behavior change; burden of illness; cognitive testing; cost; design; high risk; high risk behavior; interest; male; man; men; men who have sex with men; mortality; novel strategies; population based; protective behavior; public health relevance; sex; sexual minority; social stigma; transgender; transgender men; transgender women; women who have sex with women

 DESCRIPTION (provided by applicant): HIV/AIDS is a major contributor to morbidity and mortality in Uganda, with an estimated 7.3% adults HIV positive. Men who have sex with men (MSM) bear a particularly high disease burden, with 13.2% living with HIV. Despite this increased risk, there is a considerable dearth of scientific literature documenting the barriers and facilitators to behavior change in this vulnerable population. We need to better understand the HIV risk and protective behaviors of MSM and other sexual minority men in Uganda, if we are to develop effective prevention programming. The almost complete lack of research examining the HIV risk of sexual minority women and transgender people is also problematic. Despite assumptions that sexual minority women are not at risk for HIV, compelling seroprevalence and HIV risk behavior data suggest otherwise. Of the handful of studies that have been published on African transgender people, all but one included these women under the rubric of MSM. Individuals who self-identify as women should not be classified in research as men. Moreover, the lack of research including transgender men in Uganda is concerning, particularly given higher risk behaviors in this group in other countries. This dearth in the literature is not inconsequential. Given the invisibility of the sexual and gender minority (SGM) populations in Uganda fueled by stigma, discrimination, and anti-gay laws, what little is known is largely based upon data collected in Kampala. Population-based HIV prevalence across Ugandan regions, however, range between 4.9-9.8%. SGM adults living outside of the capital seem likely to differ from those living the capital, including access to services, connection to an SGM community, and access to available sexual partners. A comprehensive survey that includes respondents from across the country can provide greater understanding of the HIV risks facing the SGM population in Uganda and, just as importantly, of the opportunities for prevention programming for Ugandan SGM communities. To bridge these identified gaps in the literature, our specific aims are as follows: Specific Aim 1. Conduct focus groups to identify sexual decision-making behavior, salient language to query sexual and gender identity, and a survey protocol that ensures the safety of participants. Specific Aim 2. Execute a cognitive test of the survey for understandability with a Content Advisory Team of SGM Ugandan adults. Specific Aim 3. Implement a quantitative survey nationally online to: (1) Identify factors that contextualize HIV preventive behavior for SGM men and women. (2) Articulate opportunities to harness the power of technology (e.g., Internet, text messaging) to safely deliver HIV prevention programming tailored to the needs of SGM.

 描述（由申请人提供）：艾滋病毒/艾滋病是乌干达发病率和死亡率的主要原因，估计有 7.3% 的成年人艾滋病毒呈阳性。男男性行为者 (MSM) 承受着特别高的疾病负担，其中 13.2% 感染艾滋病毒。尽管风险增加，但记录这一弱势群体行为改变的障碍和促进因素的科学文献却相当缺乏。如果我们要制定有效的预防规划，我们需要更好地了解乌干达男男性行为者和其他性少数男性的艾滋病毒风险和保护行为。几乎完全缺乏对性少数女性和跨性别者艾滋病毒风险的研究也是一个问题。尽管假设性少数女性没有感染艾滋病毒的风险，但令人信服的血清流行率和艾滋病毒风险行为数据却表明事实并非如此。在已发表的关于非洲跨性别者的少数研究中，除了一项之外，所有研究都将这些女性纳入了男男性行为者的范畴。自我认同为女性的个体不应在研究中被归类为男性。此外，乌干达缺乏对跨性别男性的研究令人担忧，特别是考虑到其他国家该群体的风险行为较高。文献中的这种缺乏并非无关紧要。鉴于耻辱、歧视和反同性恋法律助长了乌干达性少数群体（SGM）的隐形性，我们所知甚少，这主要是基于在坎帕拉收集的数据。然而，乌干达各地区的人口艾滋病毒感染率在 4.9-9.8% 之间。居住在首都以外的 SGM 成年人似乎可能与居住在首都的成年人有所不同，包括获得服务的机会、与社会的联系 SGM 社区，以及接触可用性伴侣的机会。一项涵盖全国各地受访者的综合调查可以更好地了解乌干达 SGM 人群面临的艾滋病毒风险，同样重要的是，可以更好地了解乌干达 SGM 社区开展预防规划的机会。为了弥补文献中发现的这些差距，我们的具体目标如下： 具体目标 1. 开展焦点小组以确定性决策行为、询问性和性别认同的显着语言以及确保参与者安全的调查协议。 具体目标 2. 与 SGM 乌干达成人内容咨询团队一起对调查的可理解性进行认知测试。 具体目标 3. 在全国范围内进行在线定量调查，以： (1) 确定 SGM 男性和女性艾滋病毒预防行为的背景因素。 (2) 明确利用技术力量（例如互联网、短信）的机会，安全地提供适合 SGM 需求的艾滋病毒预防计划。