HIV prevention among Latina transgender women who have sex with men: Evaluation of a locally developed intervention

项目摘要 美国有大量且快速增长的拉丁裔人口。与此同时，拉美裔和 在美国，变性人携带着不成比例的艾滋病毒负担。目前，没有有效的艾滋病毒预防措施。 存在针对与男性发生性行为的变性人的干预措施。响应RFA-PS-16-003 “评价当地制定或适应(本土)的艾滋病毒预防干预措施 变性人与男性发生性关系“，我们的社区和大学合作计划进行为期4年的研究 (U01)细化、全面实施和严格评估旨在实现以下目标的小组联合干预 通过增加避孕套的使用，促进行为、生物医学和社会/结构方法预防艾滋病毒， 拉丁裔变性人中艾滋病毒检测、PrEP使用和安全过渡相关医疗服务的使用 与男人发生性关系的女人。这一干预措施被称为Chias Creando Acceso a la Salud(Chias；Girls Creating Access to Health)是由一个社区组织与 拉丁裔变性人妇女，并受到社会认知理论和赋权教育理论的启发。 尽管数据显示CHICAS前景看好，但它还没有得到评估。 这项拟议的研究是社区和大学建立了良好合作伙伴关系的结果。总共有100名拉丁裔 与男性发生性关系的变性女性将被录取。参与者将完成初始基线 评估旨在衡量当前性健康行为、医疗保健使用情况以及心理、社交、 以及文化对性行为和医疗保健使用的影响。参与者随后将被随机分配到4- 分时段小组联合HIV预防干预组与延迟干预组的比较 组(等待名单)。所有参与者还将在3个月和6个月的随访中完成相同的评估。 参与艾滋病预防干预的参与者与延迟干预中的同龄人比较 预计将展示：(A)性交期间自我报告的避孕套使用量增加； (B)增加艾滋病毒检测；(C)更多地使用PrEP；和(D)更多地使用与安全过渡有关的 医疗保健服务(包括医疗保健和精神卫生服务)。由此产生的结果和产品 将传播研究，为公共卫生实践、研究和政策提供信息。结果和产品将 包括：(1)西班牙语小群体艾滋病预防干预措施，即：文化干预 一致性，旨在降低拉丁裔变性人女性的风险，并准备传播和进一步 如果发现是有效的，则执行；以及(2)更深入地了解艾滋病毒风险，使用与过渡有关的 医疗服务，以及对拉丁裔变性人妇女的干预。

Project Summary The United States has a large and rapidly growing Latino population. At the same time, Latinos and transgender persons in the US carry disproportionate HIV burden. Currently, no efficacious HIV prevention interventions exist for transgender persons who have sex with men. In response to RFA-PS-16-003 “Evaluating Locally-Developed or Adapted (Homegrown) Combination HIV Prevention Interventions for Transgender Persons who have Sex with Men”, our community-university partnership proposes a 4-year study (U01) to refine, fully implement, and rigorously evaluate a small-group combination intervention designed to promote behavioral, biomedical, and social/structural approaches to HIV prevention by increasing condom use, HIV testing, PrEP use, and use of safe transition-related healthcare services among Latina transgender women who have sex with men. The intervention, known as Chicas Creando Acceso a la Salud (ChiCAS; Girls Creating Access to Health), was developed locally by a community-based organization, in partnership with Latina transgender women, and is informed by social cognitive theory and theory of empowerment education. Although data suggest that ChiCAS is promising, it has not yet been evaluated. The proposed study is a result of a well-established community-university partnership. A total of 100 Latina transgender women who have sex with men will be enrolled. Participants will complete an initial baseline assessment designed to measure current sexual health behaviors, healthcare use, and psychological, social, and cultural influences on sexual behaviors and healthcare use. Participants then will be randomized to the 4- session small-group combination HIV prevention intervention group or a delayed-intervention comparison group (waitlist). All participants also will complete identical assessments at 3-month and 6-month follow-up. Participants in the HIV prevention intervention, relative to their peers in the delayed-intervention comparison group, are anticipated to demonstrate (a) increased self-reported use of condoms during sexual intercourse; (b) increased HIV testing; (c) increased use of PrEP; and (d) increased use of safe transition-related healthcare services (including medical care and mental health services). The results and products from this study will be disseminated to inform public health practice, research, and policy. Results and products will include: (1) a Spanish-language combination small-group HIV prevention intervention that is: culturally congruent, designed to reduce risk among Latina transgender women, and ready for dissemination and further implementation if found to be efficacious; and (2) a deeper understanding of HIV risk, use of transition-related healthcare services, and intervention among Latina transgender women.