Social Networks and Technology Use of Transgender Women with/at High Risk for HIV

描述(由申请人提供)：高危男女变性妇女(下称“变性妇女”)同时面临许多艾滋病毒感染和传播的辅助因素，包括吸毒、从事性工作、失业、低教育程度、无家可归和激素滥用。在洛杉矶县，估计艾滋病毒在变性妇女中的总流行率为15%，拉丁裔为17%，美洲原住民为29%，非裔美国人/黑人跨性别者为48%。由于歧视/污名、偏见以及跨性别恐惧症的个人和结构性形式，跨性别女性形成了主要由其他跨性别女性组成的密集社区。跨性别妇女利用社交网站(SNS)和以技术为基础的(“技术”)网络平台来建立社会支持结构，与社区成员联系，获得对其性别认同的积极和重新肯定的观点，并告知行为规范和获得变性人特有的资源(例如，非法荷尔蒙、性工作伙伴)。为响应PA-12-113，“LGBTI人群健康研究”，并与美国国立卫生研究院艾滋病研究办公室提出的艾滋病相关研究计划和2014年跨NIH计划中概述的行为和社会科学优先事项保持一致，该拟议项目试图进行形成性研究，以检查跨性别者社交网络和SNS/技术使用的自我中心结构和组成如何影响他们参与艾滋病毒风险/保护行为。在第一阶段，将进行焦点小组以指导文化能力评估的发展(iPad社交网络访谈[SNI]和ACASI)，然后将进行可行性试点测试。在第二阶段，将招募不同的跨性别妇女样本(N=300)来完成两部分评估。本研究的具体目的是：1)开发和评估文化的可行性和实用性 (2)确定跨女性社交网络的特征以及这些网络中其他人的行为(即“改变”)如何影响对艾滋病毒风险/保护行为的参与；以及(3)确定使用社交网络/技术改变对参与者参与艾滋病毒风险/保护行为的影响。统计分析将使用层次化的集群模型，将参与者嵌套在他们报告的社交网络中。拟议的研究将具体说明驱动跨性别妇女艾滋病毒风险/保护行为的社会网络动态，为开发R34应用程序提供信息，以测试专门为跨性别妇女量身定做的具有文化能力的SNS/基于技术的艾滋病毒干预措施的有效性。

DESCRIPTION (provided by applicant): High-risk male-to-female transgender women (hereafter "transwomen") face numerous concurrent cofactors for HIV acquisition and transmission including substance use, engagement in sex work, unemployment, low educational attainment, homelessness and hormone misuse. In Los Angeles County, estimates of HIV prevalence among transwomen are 15% overall, and 17% among Latinas, 29% among Native Americans, and 48% among African American/black transwomen. As a result of discrimination/stigma, prejudice, and individual and structural forms of transphobia, transwomen form dense communities comprised primarily of other transwomen. Transwomen use social network sites (SNS) and technology-based ("tech") networking platforms to develop social support structures, connect with members of their community, receive positive and re- affirming perspectives on their gender identity, and inform behavioral norms and gain access to transgender specific resources (e.g., illegal hormones, sex work partners). In response to PA-12-113, "Research on the Health of LGBTI Populations," and consistent with the priorities for behavioral and social sciences outlined in the HIV-Related Research Plan put forward by the Office of AIDS Research of the National Institutes of Health and the Trans-NIH plan for 2014, this proposed project seeks to conduct formative research to examine how the egocentric structure and composition of transwomens' social networks and SNS/tech use affect their engagement in HIV risk/protective behaviors. During Phase 1, focus groups will be conducted to guide the development of culturally competent assessments (an iPad Social Network Interview [SNI] and ACASI), which will then undergo a feasibility pilot test. During Phase 2, a diverse sample of transwomen (N=300) will be recruited to complete the two-part assessment. The specific aims of this research are: 1) Develop and assess the feasibility and utility of culturally competent assessments to study the social networks, HIV risk/protective behaviors, and SNS/tech use of transwomen; 2) Determine how characteristics of transwomen's social networks, as well as the behavior of other people (i.e., "alters") in those networks, influence engagement in HIV risk/protective behaviors; and, 3) Determine how SNS/tech use with network alters influences participants' engagement in HIV risk/protective behaviors. Statistical analyses will use hierarchically clustered models that nest participants within their reported social networks. The proposed research will specify the social network dynamics driving transwomen's HIV risk/protective behaviors to inform the development a R34 application to test the efficacy of a culturally competent SNS/tech-based HIV intervention tailored specifically for transwomen.