Gender, Relationship Dynamics, and HIV Risk

描述(由申请人提供)：本申请描述了一个为期四年的项目，该项目旨在研究导致男女变性人妇女及其主要男性伴侣之间艾滋病毒传播风险的关系动态。这项研究的目标是测试一个概念框架，该框架将艾滋病毒风险与关系动态联系起来，可以产生结果，从而为变性人妇女及其男性伴侣制定以理论为导向、以文化为重点的以关系为重点的艾滋病毒预防干预措施。这些社区是美国艾滋病毒感染风险最高的群体之一。我们的关系层面艾滋病毒风险的工作概念模型强调性别角色、权力动态、夫妻沟通、关于关系外性行为的协议、社会和社区支持以及耻辱的贡献。根据这一框架，我们假设，伴侣在关系中感染艾滋病毒的风险既来自个人层面的因素，也来自二元层面的因素，包括伴侣之间在与健康相关的态度和行为领域的差异和分歧。我们将用定性和定量的方法来解决这些目标，包括对20对夫妇进行深入的个人访谈，对200对夫妇进行横断面调查。我们提出了创新的统计技术来检验我们的假设效应。这项研究的结果将被用来指导针对这种独特的关系二联体的艾滋病毒预防干预的发展，并将扩大对主要关系中艾滋病毒风险的理论理解。公共卫生影响：该项目有可能提高对跨性别妇女及其男性伴侣中导致艾滋病毒风险的关系因素的了解，这将使卫生专业人员能够更有效地与这些群体进行干预。这些发现将有助于开发与这些群体的理论驱动的、文化上适当的、以关系为重点的艾滋病毒预防干预措施。

DESCRIPTION (provided by applicant): This application describes a four-year project to study the relationship dynamics that contribute to risk for HIV transmission among male-to-female transgender women and their primary male partners. The goal of this research is to test a conceptual framework that contextualizes HIV risk within relationship dynamics, which can produce findings leading to the development of a theory-driven, culturally appropriate relationship-focused HIV prevention intervention for transgender women and their male partners. These communities are among the groups at highest risk for HIV infection in the United States. Our working conceptual model of relationship-level HIV risk emphasizes the contributions of gender roles, power dynamics, couples' communication, agreements about sex outside of the relationship, social and community support, and stigma. Deriving from this framework, we hypothesize that HIV risk for partners in a relationship arises out of both individual-level factors and dyadic-level factors, including discrepancies and disagreements between partners on health-related attitudinal and behavioral domains. We will address these aims using qualitative and quantitative methodologies, involving in-depth individual interviews with 20 couples and cross-sectional surveys with 200 couples. We propose innovative statistical techniques to examine our hypothesized effects. Findings from this research will be used to guide the development of an HIV prevention intervention for this unique relationship dyad, and will expand theoretical understanding of HIV risk within primary relationships. Public health impact: This project has the potential to improve understanding of relationship factors contributing to HIV risk among transgender women and their male partners, which will allow health professionals to intervene more effectively with these groups. Findings will contribute toward developing a theory-driven, culturally appropriate relationship-focused HIV prevention intervention with these groups.