Culturally Relevant HIV Prevention for High-Risk Women

描述(由申请人提供)：变性人妇女(出生时被指定为男性，身份为女性)是一个研究不足的群体，艾滋病毒感染率在22%-66%之间。公共卫生干预研究没有为变性人妇女提供任何理论驱动的、基于证据的干预措施。变性人妇女独特的文化背景创造了独特的风险因素，需要进行系统的调查，然后纳入与文化相关的、以社区为基础的干预方法。这份K08申请描述了一项全面、综合的培训和研究计划，旨在作为一条通往科学独立和专业知识的途径，以开发和测试一种创新的、迫切需要的干预措施，以改善受艾滋病毒疫情严重影响的高度边缘化人口的健康结果。拟议的以下培训目标如下：(1)获得在边缘人群中评价和应用行为改变理论的专门知识；(2)提高使用混合方法收集和分析数据的技能，重点是与测量发展和理论测试相关的技术；(3)获得临床试验方法方面的知识和经验，包括抽样、随机化、设计、方案制定和伦理问题；以及(4)获得关于为变性人妇女制定、实施和评估基于文化和理论的艾滋病毒预防干预措施的方法的培训和经验。接受指导的原始研究的具体研究目的是：(1)描述变性人妇女独特的文化背景对其艾滋病毒相关风险和保护因素的作用；(2)创建新的和调整现有的量化措施，以更准确地评估与变性人妇女艾滋病毒风险和保护因素有关的心理层面和行为；(3)确定与变性人妇女中与艾滋病毒相关的性行为和注射风险行为及保护因素有关的心理社会因素；以及(4)开发和测试针对变性人妇女的以理论为导向、有文化基础的艾滋病毒预防干预措施的可行性和可接受性。

DESCRIPTION (provided by applicant): Transgender women (assigned 'male' at birth with a female identity) are an understudied group with HIV prevalence rates in the range of 22 - 66%. Public health intervention research has produced no theory-driven, evidence-based interventions for transgender women. The unique cultural context of transgender women creates distinct risk factors that require systematic investigation and then integration into culturally relevant, community-based approaches to intervention. This K08 application describes a comprehensive, integrated training and research plan designed to serve as a pathway to scientific independence and the expertise to develop and test an innovative and urgently needed intervention to improve health outcomes among a highly marginalized population disproportionately affected by the HIV epidemic. The following training objectives are proposed: (1) to acquire expertise in the evaluation and application of theories of behavior change to marginalized populations; (2) to enhance skills in the use of mixed methods data collection and analysis, with an emphasis on techniques relevant to measurement development and theory testing; (3) to gain knowledge and experience with clinical trails methodology, including issues of sampling, randomization, design, protocol development, and ethics; and (4) to obtain training and experience in methods for developing, implementing, and evaluating culturally grounded, theory-driven HIV prevention interventions for transgender women. The specific research aims of the mentored original research are: (1) to describe the role of transgender women's unique cultural context on their HIV-related risk and protective factors; (2) to create new and to adapt existing quantitative measures to more accurately assess psychological dimension sand behavior relevant to transgender women's HIV risk and protective factors; (3) to identify psychosocial factors associated with HIV-related sexual and injection risk behaviors and protective factors among transgender women; and (4) to develop and test the feasibility and acceptability of a theory-driven, culturally grounded HIV prevention intervention for transgender women.