Culturally Relevant HIV Prevention for High-Risk Women

描述（由申请人提供）：跨性别女性（出生时具有女性身份而被指定为“男性”）是一个未被充分研究的群体，其艾滋病毒感染率在22 - 66%之间。公共卫生干预研究没有为跨性别妇女提供理论驱动的、基于证据的干预措施。跨性别女性独特的文化背景产生了独特的风险因素，需要系统调查，然后纳入与文化相关的、基于社区的干预方法。这个K08应用程序描述了一个全面的、综合的培训和研究计划，旨在作为科学独立和专业知识的途径，开发和测试一种创新的、迫切需要的干预措施，以改善受艾滋病毒流行严重影响的高度边缘化人群的健康状况。提出以下培训目标：(1)获得行为改变理论评价和应用于边缘人群的专门知识；(2)提高使用混合方法收集和分析数据的技能，重点是与测量开发和理论测试相关的技术；(3)获得临床试验方法学的知识和经验，包括抽样、随机化、设计、方案制定和伦理问题；(4)在制定、实施和评估基于文化的、理论驱动的跨性别女性艾滋病预防干预措施的方法方面获得培训和经验。指导原创性研究的具体研究目的是：(1)描述跨性别女性独特的文化背景对其hiv相关风险和保护因素的作用；(2)创建新的和调整现有的定量措施，以更准确地评估与跨性别妇女艾滋病毒风险和保护因素相关的心理维度和行为；(3)确定跨性别女性艾滋病相关性行为和注射风险行为的社会心理因素及保护因素；(4)开发并测试一种理论驱动的、基于文化的跨性别女性艾滋病预防干预措施的可行性和可接受性。

DESCRIPTION (provided by applicant): Transgender women (assigned 'male' at birth with a female identity) are an understudied group with HIV prevalence rates in the range of 22 - 66%. Public health intervention research has produced no theory-driven, evidence-based interventions for transgender women. The unique cultural context of transgender women creates distinct risk factors that require systematic investigation and then integration into culturally relevant, community-based approaches to intervention. This K08 application describes a comprehensive, integrated training and research plan designed to serve as a pathway to scientific independence and the expertise to develop and test an innovative and urgently needed intervention to improve health outcomes among a highly marginalized population disproportionately affected by the HIV epidemic. The following training objectives are proposed: (1) to acquire expertise in the evaluation and application of theories of behavior change to marginalized populations; (2) to enhance skills in the use of mixed methods data collection and analysis, with an emphasis on techniques relevant to measurement development and theory testing; (3) to gain knowledge and experience with clinical trails methodology, including issues of sampling, randomization, design, protocol development, and ethics; and (4) to obtain training and experience in methods for developing, implementing, and evaluating culturally grounded, theory-driven HIV prevention interventions for transgender women. The specific research aims of the mentored original research are: (1) to describe the role of transgender women's unique cultural context on their HIV-related risk and protective factors; (2) to create new and to adapt existing quantitative measures to more accurately assess psychological dimension sand behavior relevant to transgender women's HIV risk and protective factors; (3) to identify psychosocial factors associated with HIV-related sexual and injection risk behaviors and protective factors among transgender women; and (4) to develop and test the feasibility and acceptability of a theory-driven, culturally grounded HIV prevention intervention for transgender women.