Document text
Principal Investigator: Erik D. Storholm
Organization: SAN DIEGO STATE UNIVERSITY
Fiscal Year: 2024
Award: $630,223
Funding agency: National Institute of Mental Health
SUMMARY/ABSTRACT
Transgender and non-binary (TGNB) persons experience intimate partner violence (IPV) at alarming rates twice that
of their cisgender peers. Prior work has linked IPV to sexual risk behavior and increased risk for HIV seroconversion
among TGNB, but less is known about the impact of IPV on HIV and sexually transmitted infection (STI) testing, pre-
exposure prophylaxis (PrEP) uptake, and persistence among TGNB. While past findings suggest the potential for IPV
to have a strong deleterious effect on HIV prevention continuum engagement, IPV experiences and impacts on
HIV/STI risk and prevention behaviors have yet to studied among a diverse group of TGNB persons. Additional
research is currently needed to model pathways between IPV and HIV risk for subgroups of trans feminine (TF), trans
masculine (TM), and gender non-binary (GNB) persons. Guided by a framework that combines Syndemic and
Minority Stress Theory, the proposed innovative observational cohort study will examine how specific forms of IPV
(e.g., physical, sexual, emotional, controlling gender expression and/or transition) in the context of steady or casual
intimate relationships contribute to HIV/STI risk and protective behaviors among subgroups of TGNB persons over
a 24-month timeframe. Specifically, we aim to: 1. Using qualitative methodologies, explore the perceived associations
between IPV, relationship characteristics and dynamics, and HIV risk and prevention behaviors among gender
diverse TGNB persons. 2. Examine gender-based differences in the longitudinal associations of IPV with HIV testing,
PrEP uptake, PrEP persistence, STI diagnosis (primary outcomes), condomless sex, and HIV seroconversion
(secondary outcomes) among a racially and ethnically diverse cohort of TGNB persons (TF, TM, and GNB groups). 3.
Determine the individual-, interpersonal-, network-, community-, and structural-level risk and resilience factors that
mediate (or moderate) the associations between IPV and HIV risk and protective behaviors for each group. 4. Make
recommendations for interventions that interrupt the pathways between IPV and HIV/STI risk based on quantitative
data from the cohort and qualitative data, guided by technical experts. We will assess sexual risk behavior, conduct
HIV and STI testing, and assess PrEP uptake and persistence over the 24 months of follow-up. We hypothesize that
there will be differences in the frequency, severity, and overall impact of IPV on HIV/STI risk among subgroups of
TGNB persons. We also suspect greater frequency of IPV will be associated with history of childhood abuse, mental
health problems, substance use, sexual risk taking and lower levels of HIV testing, PrEP uptake, and PrEP persistence.
We anticipate that alcohol and substance use among participants and their partners will be highly associated with
episodes of IPV and with HIV risk behavior. We also hypothesize that experiences of gender affirmation, coping skills
and social support will mediate the effects of IPV on risk behavior, HIV testing, PrEP uptake, and PrEP persistence.
The proposed study will advance our understanding of both the risk and resiliency factors relevant to preventing and
reducing IPV, reducing IPV-associated risk behaviors, and increasing HIV protective behaviors among diverse TGNB
persons. This research will inform the development and adaptation of IPV, HIV, and substance abuse interventions
for TGNB persons.
Terms: <AIDS Virus><AIDS prevention><AIDS test><AIDS/HIV test><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Active Follow-up><Address><Alcohol Drinking><Alcohol consumption><Anti-HIV Positivity><Behavior><Causality><Characteristics><Child Abuse><Childhood Abuse><Communities><Coping Skills><Data><Development><Diagnosis><Emotional><Enrollment><EtOH drinking><EtOH use><Etiology><Exclusion><Family><Frequencies><Gender><Gender Role><Goals><HIV><HIV Positive><HIV Positivity><HIV Prevention><HIV Seroconversion><HIV Seronegativities><HIV Seronegativity><HIV Seropositivity><HIV antibody positive><HIV negative><HIV risk><HIV test><HIV-1 test><HIV-2 test><HIV/AIDS prevention><HTLV-III Seroconversion><HTLV-III Seronegativities><HTLV-III Seronegativity><HTLV-III Seropositivity><High-Risk Sex><History><Human Immunodeficiency Viruses><Human immunodeficiency virus test><Individual><Infection prevention><Interruption><Intervention><Intervention Strategies><Knowledge><LAV-HTLV-III><Life Experience><Link><Long-term cohort><Longitudinal cohort><Longterm cohort><Lymphadenopathy-Associated Virus><Measures><Mediating><Mental Health><Mental Hygiene><Methodology><Methods><Modeling><Outcome><Participant><Pathway interactions><Persons><Population><PrEP><Prevent infection><Psychological Health><Psychosocial Factor><Recommendation><Recording of previous events><Reporting><Research><Research Activity><Research Priority><Risk><Risk Assessment><Risk Behaviors><Risk Factors><Risky Behavior><Services><Severities><Sex Behavior><Sex Roles><Sexual Activity><Sexual Behavior><Sexually Transmitted Diseases><Sexually Transmitted Disorder><Sexually Transmitted Infection><Shapes><Social support><Subgroup><Substance abuse problem><Testing><Time><Unprotected Sex><Unsafe Sex><Venereal Diseases><Venereal Disorders><Venereal Infections><Victimization><Violence><Virus-HIV><Work><abuse of substances><active followup><alcohol ingestion><alcohol intake><alcohol product use><alcohol use><alcoholic beverage consumption><alcoholic drink intake><assigned female at birth><assigned female gender at birth><assigned female sex at birth><assigned male at birth><assigned male gender at birth><assigned male sex at birth><at risk behavior><causation><cis-gender><cisgender><cohort><condomless intercourse><condomless sex><coping strategy><design><designing><developmental><disease causation><enroll><ethanol consumption><ethanol drinking><ethanol ingestion><ethanol intake><ethanol product use><ethanol use><ethnic diversity><ethnically diverse><experience><follow up><follow-up><followed up><followup><gender affirmation><gender affirming><gender diverse><gender expression><gender identity affirmation><gender identity affirming><gender transition><high risk><histories><inattention><inattentiveness><infection risk><innovate><innovation><innovative><interventional strategy><intimate partner violence><male><minority stress><nonbinary><observational cohort study><pathway><peer><pre-exposure prophylaxis><prevent><prevent violence><preventing><prevention service><primary outcome><prospective><protective behavior><psychologic><psychological><psychosocial variables><racial diversity><racially diverse><recruit><resilience factor><resiliency factor><secondary outcome><sex activity><sex risk behavior><sexual activities><sexual minority men><sexual risk behavior><sexual risk taking><sexually acquired infection><social><social support network><stress among minorities><stress in minorities><stress to minorities><structural determinants><structural factors><substance abuse><substance use><substance using><syndemic><synergistic epidemic><theories><trans*><transfeminine><transgender><transmasculine><unprotected intercourse><uptake><violence prevention><violent><violent behavior>