Gender Identity and HIV Risk

描述(申请人提供)：我们的长期目标是减少艾滋病毒 通过以下方式在最危险的社区中感染和传播：(1)确定 艾滋病毒风险的心理社会背景下的性别特有因素 以及(2)将这些发现应用于创新模型的开发 进行有效的、有针对性的预防干预。 对于所有人群来说，艾滋病毒风险--特别是在性行为中表现出来的 行为--与人们的性别规范、期望和行为相交。 然而，对于变性人社区的成员来说，情况尤其如此。到期 面对性别认同的挑战，变性人有一种 提高对性别归因和期望如何影响性行为的认识 行为。这个应用程序将检查变性人在 男性和女性的性别角色，以了解性别如何构成艾滋病毒 风险。该特定应用程序目标是定性地和 定量评估特定性别背景之间的关系 变性人样本中的因素和艾滋病毒风险，从而为 制定处理与性别有关的问题的未来干预模式 不同高危人群的预防挑战。我们会继续推行 以下三个具体目标：(1)定性检查变性人的 性别如何影响艾滋病毒风险的经验；(2)评估经验 老年人的性别认同、社会性别角色与HIV风险的关系 变性人样本；以及(3)确定与性别相关的污名的影响， 羞耻，以及对艾滋病毒风险和防护身份的肯定和披露 行为。我们的横断面研究将结合使用 基于互联网的定性和定量方法，以吸引国家 半结构化、深度在线的变性人样本 访谈(N=60)和在线调查(N=600)。这项研究预计将产生 以下是结果。首先，它将增加我们对如何 性别规范、期望和行为影响艾滋病毒风险，以及 重要的是，哪些结构值得立即在临床环境中进行测试 和干预计划。第二，测试两者之间的关联 与性别有关的结构(跨性别认同和呈现、社会 性别角色一致性、变性人身份类型、与性别相关的污名、 内化性变性恐惧症和对性别认同的肯定)和艾滋病毒风险意愿 提供新的方法来识别感染艾滋病毒风险较高的个人 从侧重于以下目标的干预措施中获益的可能性很高 基于性别的潜在影响对他们危险的性行为的影响。值得注意的是， 虽然这项工作预计将直接惠及变性人和 他们的伴侣(他们在艾滋病毒预防工作中基本上被忽视)，它 还将提供经验基础(或其他假设、研究和 以性别为背景艾滋病毒危险因素的干预模式 其他种群。

DESCRIPTION (provided by applicant): Our long-range goal is to reduce HIV infection and transmission among communities most at risk by (1) identifying gender-specific factors underlying the psychosocial context in which HIV risk occurs and (2) applying these findings to the development of innovative models for effective, targeted prevention interventions. For all populations, HIV risk-especially as manifested in sexual behaviors-intersects with people's gendered norms, expectations, and behaviors. This is particularly so, however, for members of the transgender community. Due to challenges with their gender identity, transgendered individuals have a heightened awareness of how gender attributions and expectations affect sexual behavior. This application will examine transgender people's experiences in both the male and female gender role to understand how gender structures HIV risk. The objective of this particular application is to qualitatively and quantitatively assess the relationship between specific gendered contextual factors and HIV risk in a transgender sample, thereby providing the basis for the development of a future intervention model for addressing gender-related prevention challenges of different at-risk populations. We will pursue the following three specific aims: (1) Qualitatively examine transgender people's experiences of how gender influences HIV risk; (2) Assess the empirical relationship between gender identity, social sex role, and HIV risk in a transgender sample; and (3) Determine the impact of gender-related stigma, shame, and affirmation and disclosure of identity on HIV risk and protective behaviors. Our cross-sectional study will employ a combination of Internet-based qualitative and quantitative methodologies to engage a national sample of transgendered individuals in semi-structured, in-depth online interviews (N=60) and an online survey (N=600). This study is expected to yield the following outcomes. First, it will increase our understanding of how gendered norms, expectations, and behaviors influence HIV risk, and importantly, which constructs deserve immediate testing in clinical settings and intervention programs. Second, tests for associations between gender-related constructs (crossgender identification and presentation, social sex role conformity, type of transgender identity, gender-related stigma, internalized transphobia, and affirmation of gender identity) and HIV risk will provide new means of identifying individuals at higher risk for HIV and with high likelihood of benefiting from targeted interventions focused on the underlying gender-based influences on their risky sexual behaviors. Notably, while this work is expected to directly benefit transgender individuals and their partners (who have been largely neglected in HIV prevention efforts), it will also provide an empirical basis (or additional hypotheses, research, and an intervention model targeting gender as a contextual HIV risk factor among other populations.