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.
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.
Study Type
OBSERVATIONAL
Enrollment
50
: During study period (single visit within \~12 months study duration)
Tangerine Clinic, Institute of HIV Research and Innovation
Pathum Wan, Bangkok, Thailand
RECRUITINGKey themes on chemsex behaviors and service needs
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.
Time frame: At interview (single time point)
Barriers and facilitators to implementation of transgender-tailored chemsex services
Barriers and facilitators to implementation identified using the Consolidated Framework for Implementation Research (CFIR) domains based on stakeholder and participant interviews.
Time frame: At interview (single time point)
Chemsex-related behavioral and demographic characteristics
Descriptive characteristics of participants, including demographic data, substance use patterns, and behavioral risk factors collected via questionnaire.
Time frame: At interview (single time point)
HIV-related stigma score
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)
Time frame: Baseline, Month 3, Month 6
Transgender-related stigma score
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)
Time frame: Baseline, Month 3, Month 6
PrEP adherence (self-reported adherence score)
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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)
Time frame: Baseline, Month 3, Month 6
Intervention acceptability score
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)
Time frame: Month 3