基于IMB模型的跨性别男男性行为者艾滋病高危行为干预策略研究

性传播现已成为中国艾滋病传播的主要途径。男男性接触者之间无保护的肛门性行为使其成为了艾滋病病毒最易感的人群。2014年中国新增HIV感染者中，男男性行为者占四分之一。跨性别男男性行为者是男男性接触的特殊亚类，是指以女性角色与男性发生性行为的男性，该人群处于主流社会的边缘，大多从事商业性服务，因此其艾滋病感染风险更大，但国内该人群在艾滋病高危行为研究领域基本空白。本次研究将基于健康行为理论框架，开展该人群的跨性别现状、艾滋病病毒感染风险、艾滋病高危行为及相关社会心理因素研究。利用结构方程拟合该人群的高危行为预防的信息-动机-行为技巧模型，通过模型修正来评估预防工作的薄弱环节，从信息认知干预、心理动机干预和行为技巧干预三个层面制定有针对性的综合干预模式。同时通过随机对照的实验性研究，结合前瞻性队列随访评价综合干预模式的近、中期效果，为制定目标人群艾滋病预防工作的策略和措施提供理论依据。

Unprotected sexual intercourse has recently become the most attributable risk factor for HIV transmission in China. Individuals with unprotected anal sex (UAI), particularly among men who have sex with men (MSM), is most vulnerable to HIV infection. Nationally, MSM made up one fourth of the total number of the newly HIV infection cases in 2014. As a special subset of MSM, male-to-female transgender persons which refer to those who are men biologically but have sex with men as the opposite gender, have extremely high risk of HIV infection due to their social marginalization and active engagement in commercial services. However, researches regarding the high HIV risk behaviors of the male-to-female transgender persons are rare in China. This project aims to investigate the epidemiology of and risk factors for HIV infection among male-to-female transgender persons who have sex with men based on the framework of health behavior theories, including transgender situation, risk of HIV infection, AIDS high risk behaviors and related psychosocial factors. We intend to develop an information-motivation-behavioral skills model focusing on the prevention of HIV/AIDS risk behaviors among this group of individuals using the structure equation model, identify the loopholes in previous intervention through model modification, and ultimately design an integrated and well-targeting intervention model from the perspectives of cognitive information, psychological motivation and behavioral skills. Furthermore, a randomized control trial will be conducted to evaluate the short and mid-term effects of the integrated intervention proposed and developed from the prospective cohort follow-up. The results of this project could provide evidence and theoretical basis for a tailored AIDS prevention and intervention strategies for the target population in China.