Abstract：
BACKGROUND: Globally, transgender (\'trans\') women experience extreme social and economic marginalisation due to intersectional stigma, defined as the confluence of stigma that results from the intersection of social identities and positions among those who are oppressed multiple times. Among trans women, gender-based stigma intersects with social positions such as engagement in sex work and substance use, as well as race-based stigma to generate a social context of vulnerability and increased risk of HIV acquisition. In Brazil, trans women are the \'most at-risk\' group for HIV, with 55 times higher estimated odds of HIV infection than the general population; further, uptake of HIV testing and pre-exposure prophylaxis (PrEP) among trans women is significantly lower than other at-risk groups. Through extensive formative work, we developed Manas por Manas, a multilevel intervention using HIV prevention strategies with demonstrated feasibility and acceptability by trans women in Brazil, to address intersectional stigma and increase engagement in the HIV prevention continuum.
METHODS: We are conducting a two-arm randomised wait-list controlled trial of the intervention\'s efficacy in São Paulo, Brazil, to improve uptake of HIV testing and PrEP among transgender women (N=400). The primary outcomes are changes in HIV testing (self-testing and clinic based), changes in PrEP uptake and changes in PrEP persistence at baseline and follow-up assessment for 12 months at 3-month intervals.
BACKGROUND: This study was approved by University of California, San Francisco Institutional Review Board (15-17910) and Comissão Nacional de Ética em Pesquisa (Research Ethics National Commission, CAAE: 25215219.8.0000.5479) in Brazil. Participants provided informed consent before enrolment. We are committed to collaboration with National Institutes of Health officials, other researchers, and health and social services communities for rapid dissemination of data and sharing of materials. The results will be published in peer-reviewed academic journals and scientific presentations.
BACKGROUND: NCT03081559.
METHODS: We are conducting a two-arm randomised wait-list controlled trial of the intervention\'s efficacy in São Paulo, Brazil, to improve uptake of HIV testing and PrEP among transgender women (N=400). The primary outcomes are changes in HIV testing (self-testing and clinic based), changes in PrEP uptake and changes in PrEP persistence at baseline and follow-up assessment for 12 months at 3-month intervals.
BACKGROUND: This study was approved by University of California, San Francisco Institutional Review Board (15-17910) and Comissão Nacional de Ética em Pesquisa (Research Ethics National Commission, CAAE: 25215219.8.0000.5479) in Brazil. Participants provided informed consent before enrolment. We are committed to collaboration with National Institutes of Health officials, other researchers, and health and social services communities for rapid dissemination of data and sharing of materials. The results will be published in peer-reviewed academic journals and scientific presentations.
BACKGROUND: NCT03081559.
摘要：
背景：在全球范围内，跨性别（“跨性别”）妇女由于交叉的污名而经历极端的社会和经济边缘化，定义为由于多次受压迫的人之间的社会身份和地位的交集而导致的污名融合。在跨性别女性中，基于性别的污名与社会地位相交，如从事性工作和物质使用，以及基于种族的污名，以产生脆弱性和增加艾滋病毒感染风险的社会背景。在巴西,跨性别女性是艾滋病毒感染风险最高的群体，艾滋病毒感染的估计几率是普通人群的55倍；此外，跨性别女性接受HIV检测和暴露前预防(PrEP)的比例明显低于其他高危人群.通过广泛的形成工作，我们开发了ManasporManas,采用艾滋病毒预防策略的多层次干预措施，证明了巴西跨性别妇女的可行性和可接受性，解决交叉的污名，并增加对艾滋病毒预防连续体的参与。
方法：我们正在圣保罗进行一项关于干预效果的双臂随机等待名单对照试验，巴西,提高跨性别女性对HIV检测和PrEP的吸收(N=400)。主要结果是艾滋病毒检测的变化（基于自我检测和临床），基线时PrEP摄取的变化和PrEP持久性的变化，并以3个月为间隔进行12个月的随访评估。
背景：这项研究得到了加州大学的批准，旧金山机构审查委员会(15-17910)和国家委员会(国家研究伦理委员会，CAAE：25215219.8.0000.5479）在巴西。参与者在注册前提供了知情同意书。我们致力于与美国国立卫生研究院官员合作，其他研究人员,以及卫生和社会服务社区，以快速传播数据和共享材料。研究结果将发表在同行评审的学术期刊和科学报告中。
背景：NCT03081559。
方法：我们正在圣保罗进行一项关于干预效果的双臂随机等待名单对照试验，巴西,提高跨性别女性对HIV检测和PrEP的吸收(N=400)。主要结果是艾滋病毒检测的变化（基于自我检测和临床），基线时PrEP摄取的变化和PrEP持久性的变化，并以3个月为间隔进行12个月的随访评估。
背景：这项研究得到了加州大学的批准，旧金山机构审查委员会(15-17910)和国家委员会(国家研究伦理委员会，CAAE：25215219.8.0000.5479）在巴西。参与者在注册前提供了知情同意书。我们致力于与美国国立卫生研究院官员合作，其他研究人员,以及卫生和社会服务社区，以快速传播数据和共享材料。研究结果将发表在同行评审的学术期刊和科学报告中。
背景：NCT03081559。
