Gender, Relationship Dynamics, and HIV Risk

描述（由申请人提供）：本申请描述了一个为期四年的项目，以研究关系动态，有助于男性到女性的跨性别妇女和他们的主要男性合作伙伴之间的艾滋病毒传播的风险。本研究的目标是测试一个概念框架，将艾滋病毒风险的关系动态，这可以产生的结果，导致发展的理论驱动的，文化上适当的关系为重点的艾滋病毒预防干预变性妇女和他们的男性伴侣。这些社区是美国艾滋病毒感染风险最高的群体。我们的工作关系层面的艾滋病毒风险的概念模型强调的贡献，性别角色，权力动态，夫妇的沟通，协议的关系外，社会和社区的支持，以及耻辱。从这个框架中推导出，我们假设，艾滋病毒的风险，在一个关系中的合作伙伴产生的个人层面的因素和二元水平的因素，包括差异和分歧的合作伙伴之间的健康相关的态度和行为域。我们将使用定性和定量的方法来解决这些目标，包括对20对夫妇的深入个人访谈和对200对夫妇的横断面调查。我们提出了创新的统计技术来检验我们的假设效果。这项研究的结果将用于指导这种独特的关系二元体的艾滋病毒预防干预措施的发展，并将扩大对主要关系中艾滋病毒风险的理论理解。公共卫生影响：该项目有可能提高对导致变性妇女及其男性伴侣感染艾滋病毒风险的关系因素的理解，这将使卫生专业人员能够更有效地对这些群体进行干预。研究结果将有助于制定一个理论驱动的，文化上适当的关系为重点的艾滋病毒预防干预与这些群体。

DESCRIPTION (provided by applicant): This application describes a four-year project to study the relationship dynamics that contribute to risk for HIV transmission among male-to-female transgender women and their primary male partners. The goal of this research is to test a conceptual framework that contextualizes HIV risk within relationship dynamics, which can produce findings leading to the development of a theory-driven, culturally appropriate relationship-focused HIV prevention intervention for transgender women and their male partners. These communities are among the groups at highest risk for HIV infection in the United States. Our working conceptual model of relationship-level HIV risk emphasizes the contributions of gender roles, power dynamics, couples' communication, agreements about sex outside of the relationship, social and community support, and stigma. Deriving from this framework, we hypothesize that HIV risk for partners in a relationship arises out of both individual-level factors and dyadic-level factors, including discrepancies and disagreements between partners on health-related attitudinal and behavioral domains. We will address these aims using qualitative and quantitative methodologies, involving in-depth individual interviews with 20 couples and cross-sectional surveys with 200 couples. We propose innovative statistical techniques to examine our hypothesized effects. Findings from this research will be used to guide the development of an HIV prevention intervention for this unique relationship dyad, and will expand theoretical understanding of HIV risk within primary relationships. Public health impact: This project has the potential to improve understanding of relationship factors contributing to HIV risk among transgender women and their male partners, which will allow health professionals to intervene more effectively with these groups. Findings will contribute toward developing a theory-driven, culturally appropriate relationship-focused HIV prevention intervention with these groups.