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

 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因素，估计有7.3%的成人艾滋病毒阳性。男男性行为者（MSM）的疾病负担特别高，13.2%的人感染了艾滋病毒。尽管这种风险增加，有一个相当缺乏的科学文献记录的障碍和促进因素，在这个脆弱的人群的行为改变。如果我们要制定有效的预防方案，我们需要更好地了解乌干达男男性接触者和其他性少数男性的艾滋病毒风险和保护行为。几乎完全没有研究性少数妇女和变性人感染艾滋病毒的风险，这也是一个问题。尽管假设性少数女性没有感染艾滋病毒的风险，但令人信服的血清阳性率和艾滋病毒风险行为数据表明并非如此。在已经发表的关于非洲变性人的少数研究中，除了一项研究之外，所有研究都将这些女性纳入了MSM的范畴。自我认同为女性的个人不应在研究中被归类为男性。此外，乌干达缺乏包括变性男子在内的研究令人担忧，特别是考虑到其他国家这一群体的高风险行为。文献中的这种缺乏并非无关紧要。鉴于乌干达的性和性别少数群体（SGM）人口因耻辱、歧视和反同性恋法律而不可见，我们所知甚少的主要是基于在坎帕拉收集的数据。然而，乌干达各地区基于人口的艾滋病毒流行率在4.9- 9.8%之间。生活在首都以外的SGM成年人似乎可能与生活在首都的人不同，包括获得服务，与 SGM社区，并获得可用的性伴侣。包括来自全国各地的受访者的全面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，乌干达SGM社区预防方案的机会。为了弥合这些文献中的差距，我们的具体目标如下：具体目标1。进行焦点小组，以确定性决策行为，突出的语言来查询性和性别身份，并调查协议，以确保参与者的安全。 具体目标2。与SGM乌干达成年人的内容咨询团队一起对调查进行认知测试。 具体目标3。在全国范围内开展在线定量调查，以：（1）确定SGM男性和女性艾滋病毒预防行为的背景因素。(2)阐明利用技术力量的机会（例如，互联网，短信），以安全地提供艾滋病毒预防规划的需要SGM。

 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.