Injection Practices and HIV Risk Behavior among Transgendered Persons in Pue

描述（由申请人提供）：艾滋病毒/艾滋病继续不成比例地影响拉丁裔社区，美国有超过20万例病例归因于该人群。生活在加勒比岛上的波多黎各人是拉丁美洲人中艾滋病毒感染率最高的人之一，这一模式与波多黎各大规模和日益增长的注射毒品流行病密切相关。虽然在波多黎各研究了静脉注射药物的做法，但某些弱势群体和注射做法在很大程度上被忽视了。这项建议的重点是男变女变性人（MTF-TG），他们在波多黎各的科学文献中通常是缺失的，并且是艾滋病毒感染的高风险人群。除了MTF-TG与主要由注射吸毒引起的艾滋病毒流行密不可分这一事实外，我们的初步研究表明，他们从事包括使用非法市场激素和硅胶注射在内的人体改造活动。我们的社区合作伙伴正在使用MTF-TG进行唯一的艾滋病毒预防干预，他们指出，这一群体的成员经常在“抽吸派对”期间进行自我注射，目的是改造身体，以及在吸毒期间。这些做法尚未得到科学研究，也没有针对这一人群的社会背景、意义和注射做法的集中描述性研究。因此，我们的研究旨在：(1)确定波多黎各跨性别社区中药物和激素注射的意义和做法；(2)描述和绘制该人群中药物和激素注射的社会背景；(3)记录波多黎各的药物、激素和硅胶注射实践与艾滋病毒风险之间的关系。我们将对32个理论上抽样的MTF-TG进行定性访谈；MTF- TG中药物、硅胶和激素注射社会背景的人种志制图；以及通过受访者驱动抽样（RDS）招募96名MTF-TG的调查。该研究由一组由美国国立卫生研究院（NIH）资助的艾滋病研究人员领导，他们在该文化地区研究过变性人和弱势群体。该研究将提供有关该社区被忽视的风险行为的重要信息，并将提供有关这些行为发生的社会背景的详细描述。这将有助于指导未来的试点干预措施，旨在减少这一弱势群体的艾滋病毒感染和高危吸毒和注射做法。

DESCRIPTION (provided by applicant): HIV/AIDS continues to affect the Latino community disproportionately, with more than 200,000 cases in the US attributed to this population. Puerto Ricans living on the Caribbean island have among the highest prevalence rates of HIV among Latinos, a pattern that is closely connected to the large and growing injecting drug epidemic in Puerto Rico. While intravenous drug injection practices have been studied in Puerto Rico, certain vulnerable populations and injection practices have been largely neglected. This proposal focuses on male-to-female transgendered persons (MTF-TG), who are generally absent from the scientific literature generated in Puerto Rico, and are at high risk of HIV infection. In addition to the fact that MTF-TG are embedded in an HIV epidemic that is mostly driven by injecting drug use, our preliminary studies show that they engage in body modification practices involving the use of illegal market hormone and silicone injections. Our community partners, who are conducting the only HIV prevention intervention with MTF-TG, indicate that members of this population often engage in self-injection practices during "pumping parties" for the purpose of body modification, as well as during drug use. These practices have not been scientifically studied, nor are there focused descriptive studies of the social context, meanings, and practices of injection in this population. Therefore, our study aims to: (1) identify the meanings and practices of drug and hormone injection in the transgendered community in Puerto Rico; (2) describe and map the social contexts of drug and hormone injection in this population; and (3) document the relationship between drug, hormone, and silicone injection practices and risk for HIV in Puerto Rico. We will conduct qualitative interviews with 32 theoretically sampled MTF-TG; ethnographic mapping of the social contexts of drug, silicone, and hormone injection among MTF- TG; and surveys with 96 MTF-TG recruited through respondent-driven sampling (RDS). Led by a team of NIH- funded HIV/AIDS researchers with experience with transgendered persons and vulnerable populations in this cultural region, the study will yield important information on risk practices that have been overlooked in this community and will provide detailed descriptions of the social contexts in which they occur. This will help guide future pilot interventions aimed at reducing HIV infection and high-risk drug use and injection practices in this vulnerable group.