Transgender women are 49 times more likely to become HIV positive than all adults worldwide. Data were unavailable for trans women's sexual and mental health in the Middle East and North Africa until 2015–2016, when HIV prevalence (10%) and suicide attempt (46%) rates were established in Lebanon. Because of the lack of evidence-based interventions for this marginalized group, the purpose of this study was to pilot test an adapted intervention, “Baynetna,” to assess preliminary impact on mental and sexual health. Using the gender affirmative model and community connectedness and social cohesion constructs, we pilot tested Baynetna among sixteen trans women, who attended 6 weekly 3-h trans-facilitated group-delivered sessions in Beirut with post-test assessments at 1, 3, and 6 months. Each participant acted as her own control; we used paired t-tests to assess changes at follow-up to evaluate potential differences in outcomes. Positive directionality in intervention impact on gender affirmation satisfaction, community connectedness, and social cohesion was demonstrated. An increase in HIV testing proportion between 6 months before and after enrollment was achieved. Higher social cohesion was associated with less suicidal thoughts (p = .05). There was a significant (p = .019) relationship between more community connectedness and lower depression scores. War event exposure was associated with higher anxiety (p = .02; p = .004). Those who reported never having had a sexually transmitted infection had higher gender affirmation satisfaction scores (7.5, 95% confidence interval: 1.4–13.6) (p = .019). Increases in community connectedness, social cohesion, and gender affirmation satisfaction scores confirm Baynetna's proposed mechanisms of impact. Proportional HIV testing increases demonstrate prevention objectives' progress. The significant results contribute to confidence in Baynetna's mechanisms of action and support the hypothesis that the Gender Affirmation model is applicable to the Lebanese context. We have shown for the first time that the adapted intervention, and its constructs, are applicable in this context outside the United States.

中文翻译：

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中东跨性别妇女首次艾滋病毒/艾滋病干预试点结果：黎巴嫩贝鲁特跨性别社区内的性别肯定和社会支持。


跨性别女性感染艾滋病毒的可能性是全世界所有成年人的 49 倍。直到 2015 年至 2016 年，黎巴嫩的艾滋病毒感染率 (10%) 和自杀未遂率 (46%) 确定后，中东和北非跨性别女性的性健康和心理健康数据才得以获取。由于缺乏针对这一边缘群体的循证干预措施，本研究的目的是试点测试一种适应性干预措施“Baynetna”，以评估对心理和性健康的初步影响。利用性别肯定模型以及社区联系和社会凝聚力构建，我们在 16 名跨性别女性中进行了 Baynetna 试点测试，这些女性在贝鲁特参加了 6 次每周 3 小时的跨性别小组授课课程，并在 1、3 和 6 进行了测试后评估几个月。每个参与者都充当自己的控制者；我们使用配对t检验来评估随访中的变化，以评估结果的潜在差异。干预措施对性别肯定满意度、社区连通性和社会凝聚力的影响具有积极的方向性。入组前后 6 个月内 HIV 检测比例有所增加。较高的社会凝聚力与较少的自杀念头相关（ p = .05）。更多的社区联系和更低的抑郁评分之间存在显着的关系 ( p = .019)。战争事件暴露与较高的焦虑程度相关（ p = .02； p = .004）。那些自称从未感染过性传播感染的人的性别肯定满意度得分较高（7.5，95% 置信区间：1.4–13.6）（ p = .019）。 社区联系性、社会凝聚力和性别肯定满意度得分的提高证实了 Baynetna 提出的影响机制。艾滋病毒检测比例的增加表明了预防目标的进展。重要的结果有助于增强人们对 Baynetna 作用机制的信心，并支持性别肯定模型适用于黎巴嫩背景的假设。我们首次表明，经过调整的干预措施及其结构适用于美国以外的情况。