HIV Prevention, Sexually Transmitted Infections (STIs), Substance Use
Conditions
Keywords
Chemsex, Harm reduction
Brief summary
The study is a pre-implementation cross-sectional study exploring chemsex behaviors among transgender persons and gathering perspectives from multiple stakeholders to inform the development of transgender-tailored harm reduction services.
Detailed description
This study is designed under the EPIS framework (Exploration and Preparation phases) to better understand chemsex use among transgender populations in Thailand. The study aims to: * Explore reasons and patterns of chemsex use * Assess positive and negative impacts (physical, sexual, mental, and socio-legal) * Identify key components, barriers, and facilitators for developing transgender-tailored chemsex services Data will be collected using a mixed-methods approach, including: * In-depth interviews (IDIs) * Self-administered questionnaires Participants include transgender chemsex users, their family/partners, and stakeholders such as healthcare providers and policymakers.
Interventions
BEHAVIORALUnderstanding of chemsex patterns, impacts, and service needs among transgender persons
: During study period (single visit within \~12 months study duration)
Sponsors
Institute of HIV Research and Innovation Foundation, Thailand
amfAR, The Foundation for AIDS Research
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Age ≥18 years * Able to communicate in Thai * Provide informed consent
Exclusion criteria
• Unable to participate in in-depth interview (IDI) (online or onsite)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Key themes on chemsex behaviors and service needs | At interview (single time point) | Qualitative themes identified from semi-structured in-depth interviews, including: * Reasons for engaging in chemsex * Patterns of substance use * Perceived positive and negative impacts * Harm reduction practices * Needs for transgender-tailored services Themes will be identified using thematic analysis. |
| Barriers and facilitators to implementation of transgender-tailored chemsex services | At interview (single time point) | Barriers and facilitators to implementation identified using the Consolidated Framework for Implementation Research (CFIR) domains based on stakeholder and participant interviews. |
| Chemsex-related behavioral and demographic characteristics | At interview (single time point) | Descriptive characteristics of participants, including demographic data, substance use patterns, and behavioral risk factors collected via questionnaire. |
| HIV-related stigma score | Baseline, Month 3, Month 6 | HIV-related stigma will be assessed using the HIV Stigma Scale (HSS). The HSS is a validated instrument measuring multiple domains of stigma, including personalized stigma, disclosure concerns, negative self-image, and concerns with public attitudes. The total score ranges from 40 to 160, with higher scores indicating greater levels of HIV-related stigma (worse outcome) Score (range: 40-160) |
| Transgender-related stigma score | Baseline, Month 3, Month 6 | Transgender-related stigma will be measured using the Transgender Identity Survey (TIS) (or instrument used in the protocol). This scale assesses experiences of stigma, discrimination, and internalized transphobia. Unit of Measure: Score (range: 20-100) |
| PrEP adherence (self-reported adherence score) | Baseline, Month 3, Month 6 | Self-reported adherence will be measured using a standardized adherence questionnaire assessing the number of doses taken over the past 30 days. Scores range from 0 to 100%, with higher percentages indicating better adherence (better outcome). In addition, adherence will be objectively assessed using tenofovir diphosphate (TFV-DP) concentrations in dried blood spots. Unit of Measure: Percentage (%) Drug concentration (fmol/punch) |
| Intervention acceptability score | Month 3 | Description: Acceptability will be assessed using the System Usability Scale (SUS). The SUS is a 10-item questionnaire with scores ranging from 0 to 100, with higher scores indicating better usability and acceptability (better outcome). Score (range: 0-100) |
Countries
Thailand
Contacts
CONTACTNittaya Phanuphak, MD,PhD.
CONTACTRena Janamnuaysook, MBA
PRINCIPAL_INVESTIGATORNittaya Phanuphak, MD,PhD.
Institute of HIV Research and Innovation (IHRI)
Outcome results
None listed