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

描述（由申请人提供）：高风险的男变女跨性别女性（以下简称“跨性别女性”）面临许多感染和传播艾滋病毒的共同因素，包括药物使用、从事性工作、失业、受教育程度低、无家可归和滥用激素。在洛杉矶县，估计跨性别女性的艾滋病毒感染率为15%，拉丁裔为17%，美洲原住民为29%，非裔美国人/黑人跨性别女性为48%。由于歧视/耻辱、偏见以及个人和结构性的跨性别恐惧症，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。跨性别女性使用社交网站（SNS）和基于技术的网络平台来发展社会支持结构，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，了解行为规范并获得跨性别特定资源（例如非法激素，性工作伙伴）。为了回应PA-12-113 “ LGBTI人群健康研究”根据美国国立卫生研究院艾滋病研究办公室提出的艾滋病毒相关研究计划和跨nih 2014年计划中概述的行为和社会科学优先事项，该拟议项目旨在开展形成性研究，以研究跨性别女性社会网络的自我中心结构和组成以及社交网络/技术使用如何影响她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），然后进行可行性试点测试。在第二阶段，将招募不同的跨性别女性样本（N=300）来完成两部分的评估。本研究的具体目的是：1)开发和评估文化的可行性和效用

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.